Alcohol Drinking, Cigarette Smoking, and Risk of Colorectal Adenomatous and Hyperplastic Polyps

Abstract

The authors evaluated alcohol drinking and cigarette smoking in relation to risk of colorectal polyps in a Nashville, Tennessee, colonoscopy-based case-control study. In 2003-2005, cases with adenomatous polyps only (n = 639), hyperplastic polyps only (n = 294), and both types of polyps (n = 235) were compared with 1,773 polyp-free controls. Unordered polytomous logistic regression was used to calculate adjusted odds ratios and 95% confidence intervals. Consumption of at least five alcoholic drinks per week was not strongly associated with development of polyps. Odds ratios for all polyp types were increased for dose, duration, and pack-years of cigarette smoking and were stronger for hyperplastic polyps than for adenoma. Compared with never smoking, dose-response relations were particularly strong for current smoking and duration; for > or =35 years of smoking, odds ratios were 1.9 (95% confidence interval (CI): 1.4, 2.5) for adenomatous polyps only, 5.0 (95% CI: 3.3, 7.3) for hyperplastic polyps only, and 6.9 (95% CI: 4.4, 11.1) for both types of polyps. Compared with current smoking, time since cessation was associated with substantially reduced odds; for > or =20 years since quitting, odds ratios were 0.4 (95% CI: 0.3, 0.6) for adenoma only, 0.2 (95% CI: 0.1, 0.3) for hyperplastic polyps only, and 0.2 (95% CI: 0.2, 0.4) for both polyp types. These findings support the adverse role of cigarette smoking in colorectal tumorigenesis and suggest that quitting smoking may substantially reduce the risk of colorectal polyps.

Changing trends in colorectal cancer: possible cause and clinical implications

“…Risk factors for these include high intake of red meat and animal fat, low consumption of vegetables and fiber, sedentary life style, obesity and lower socioeconomic status. Alcohol consumption and smoking [30][31][32], use of aspirin and nonsteroidal anti-inflammatory drugs (NSAID) [33][34][35] and especially postmenopausal HRT use [15,19,20,[36][37][38][39][40] have also an important influence on CRC risk. Although we cannot fully evaluate the possible effects of all the mentioned risk factors for CRC, it seems unlikely that considerable changes in dietary and lifestyle habits oc- [22].…”

Colorectal cancer in the world: incidence, mortality and risk factors

“…A Cohort study on 18,707 Korean adults after 11 years of follow-up showed that alcohol consumption was associated with an increased risk of CRC development among men. Also, the increase in duration and amount of alcohol consumption is directly related to the increase in CRC incidence (Shrubsole et al, 2008). The Health Professionals Follow-Up Study (HPFS) findings suggest that there is a positive relationship between alcohol consumption in men and CRC risk (Thygesen et al, 2008).…”

Modifiable Risk Factors for Colorectal Neoplasms and Hyperplastic Polyps

“…(1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). However, only a few studies using full colonoscopy to detect polyps have investigated the association between HP and smoking and between colorectal polyps and obesity or alcohol consumption (1,9,13,15,16). It is important to investigate the association between modifiable risk factors, such as obesity, smoking and alcohol and adenoma because most colorectal cancers arise from adenomas (17).…”

“…Chan et al (32) We found ten studies (1,5,7,10,12,13,16,29,33,34) regarding the association between ethanol consumption and colon polyps where all polyps were diagnosed by full colonoscopy. Three (1,13,16) of the ten studies also investigated the association between ethanol and HP. None of the three suggested a significant association.…”