title: The influence of smoking, gender, and family history on colorectal adenomas.
abstract: Evidence independently links smoking, family history, and gender with increased risk of adenomatous polyps. Using data from the New Hampshire Colonoscopy Registry (2004-2006), we examined the relation of combined risk factors with adenoma occurrence in 5,395 individuals undergoing screening colonoscopy. Self-reported data on smoking, family history and other factors were linked to pathology reports identifying adenomatous polyps and modeled with multiple logistic regression. In adjusted models a >15 pack-year smoking history increased the likelihood of an adenoma (OR = 1.54, 95% CI 1.28-1.86), although </=15 pack-years did not (OR = 1.07, 95% CI 0.87-1.32). Gender-stratified models showed a significantly increased risk of adenoma at lower smoking exposure even for men (OR = 1.32; 95% CI:1.00-1.76), but not for women (OR = 0.85; 95% CI:0.61-1.14). An ordered logistic regression model of adenoma occurrence showed a smoking history of >/=15 pack-years associated with 61% higher odds of adenoma at successively larger size categories (95% CI 1.34-1.93). For individuals with a family history of colorectal cancer, smoking does not further increase the risk of adenomas. Smoking duration is linked to occurrence and size of adenoma, especially for men.
authors.affiliation: Department of Community and Family Medicine, Dartmouth Medical School, Hanover, Lebanon, NH 03756, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.forename: Martha
authors.initials: M
authors.lastname: Goodrich
authors.forename: Allen
authors.initials: A
authors.lastname: Dietrich
authors.forename: Lynn
authors.initials: L
authors.lastname: Butterly