Tobacco smoking and colorectal cancer: a population-based case-control study in Newfoundland and Labrador
- PMID: 21033532
- PMCID: PMC6973587
- DOI: 10.1007/BF03405287
Tobacco smoking and colorectal cancer: a population-based case-control study in Newfoundland and Labrador
Abstract
Objective: Newfoundland and Labrador (NL) has the highest incidence rate of both colorectal cancer (CRC) and smoking prevalence in Canada. The objective of this study was to examine if CRC is associated with smoking in this population.
Methods: Newly diagnosed cases identified between 1999 and 2003 were frequency-matched by 5-year age group and sex with controls selected from the residents of NL through random digit dialing. A total of 702 cases and 717 controls consented to participate in the study and completed a set of self-administered questionnaires. Measures of tobacco use included type of tobacco, age of initiation of smoking, years of smoking, years since started smoking, number of cigarettes smoked daily, pack years, and years since abstention from smoking. Odds ratios were estimated using multivariate logistic regression.
Results: In comparison with non-smokers, former and current smokers were at a significantly elevated risk of CRC with corresponding odds ratios of 1.36 and 1.96. The risk significantly increased with cigarette smoking years, the amount of cigarettes smoked daily, and cigarette pack years. The risk significantly decreased with years of abstention from smoking cigarettes. This association was stronger among drinkers and in men. In addition, this effect was observed to be slightly stronger for rectum than colon cancer.
Discussion: In summary, cigarette smoking increased the risk of CRC in the NL population. The risk of CRC associated with cigarette smoking varies by sex, drinking status, and site of CRC.
Objectif: C’est à Terre-Neuve-et-Labrador (T.-N.-L.) que l’on observe les plus hauts taux d’incidence du cancer colorectal (CCR) et de prévalence du tabagisme au Canada. Nous avons cherché à déterminer si le CCR était associé au tabagisme dans cette population.
Méthode: Les cas nouvellement diagnostiqués déclarés entre 1999 et 2003 ont été assortis par fréquence selon le groupe d’âge (intervalles de cinq ans) et le sexe; les témoins ont été sélectionnés par composition aléatoire parmi les résidents de T.-N.-L. En tout, 702 cas et 717 témoins ont consenti à participer à l’étude et ont répondu à un ensemble de questionnaires à remplir soi-même. Les indicateurs de tabagisme étaient le genre de tabac, l’âge d’initiation au tabac, les années de tabagisme, les années écoulées depuis l’initiation au tabac, le nombre de cigarettes fumées par jour, le nombre de paquets par année et le nombre d’années d’abstention du tabagisme. Nous avons estimé les rapports de cotes par régression logistique multivariée.
Résultats: Par comparaison avec les non-fumeurs, les anciens fumeurs et les fumeurs actuels présentaient un risque significativement élevé de CCR avec des rapports de cotes de 1,36 et de 1,96, respectivement. Le risque augmentait de façon significative avec les années de tabagisme, le nombre de cigarettes fumées par jour et le nombre de paquets de cigarette par année. Le risque diminuait de façon significative avec les années d’abstention du tabagisme. Cette association était plus prononcée chez les consommateurs d’alcool et les hommes. De plus, cet effet était légèrement plus prononcé pour le cancer du rectum que pour le cancer du côlon.
Discussion: Pour résumer, l’usage de la cigarette accroît le risque de CC. dans la population de T.-N.-L. Le risque de CC. associé à l’usage de la cigarette varie selon le sexe, la consommation d’alcool et le site de CCR.
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