Associations Between the Age at Diagnosis and Location of Colorectal Cancer and the Use of Alcohol and Tobacco

Abstract

Background: Individualizing recommendations for colorectal cancer (CRC) screening intervals and modalities requires accurate risk assessment. Although hereditary predisposition is commonly used, the effect of exogenous risk factors has remained largely unexplored. To address this, we analyzed the age at presentation and location of CRC in relation to alcohol and tobacco use. Methods: We queried the IMPAC Medical Registry Services Cancer Information Resource File for CRCs diagnosed between June 1, 1993, and December 31, 2003. Subjects were classified as current, past, or never users of alcohol and tobacco. A logistic regression model for location of CRC and a linear regression model for age at diagnosis were constructed using these explanatory variables along with gender, race, and insurance status. Results: Our data set consisted of 161 172 patients with CRC. Current drinking, smoking, and smoking plus

Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening

“…The results from this study are consistent with three other published papers that have reported an earlier age of diagnosis for colorectal cancer in those who were current cigarette smokers (Buc et al 2006;Michalek and Cummings 1987;Zisman et al 2006). The biological mechanism underlying these observations is unclear.…”

“…Zisman et al raised the possibility of spurious results due to competing causes of mortality (Zisman et al 2006). There is little doubt that smokers have a shorter life expectancy than never smokers due to a higher death rate from various causes (Bronnum-Hansen and Juel 2001).…”

“…Despite recent evidence of an association between smoking and colorectal cancer, as well as knowledge about other etiologic factors, only age and family history factor are taken into consideration for recommendations on screening for CRC (Smith et al 2003;Winawer et al 2003 Only a few studies have examined the issue of smoking, colorectal cancer, and age at diagnosis (Buc et al 2006;Michalek and Cummings 1987;Zisman et al 2006). All three of the studies reported a significantly younger age at colorectal cancer diagnosis for those exposed to tobacco smoke compared to those not exposed.…”

“…For smokers, our group was the first to report an earlier age at diagnosis of cancer at a variety of cancer sites, including colorectal cancer (Michalek and Cummings 1987). These studies have hypothesized that cigarette smoking reduces the body's resistance to malignancies, which could hasten tumor growth and result in a younger age at diagnosis (Michalek and Cummings 1987;Zisman et al 2006). …”

Oncological treatment and outcome of colorectal cancer in Greenland

“…familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC)) have yet been observed in Greenland [3], however, lifestyle and nutritional risk factors may also be implicated in the observed age difference. Smoking and regular alcohol consumption are known to be associated with younger ages at the onset of CRC [40,41]. Alcohol consumption in Greenland is lower than in Denmark [42], but smoking is markedly higher with 66% of the adult population smoking in 2004 [43].…”