Cigarette smoking and colorectal cancer incidence and mortality: Systematic review and meta-analysis

Peter S. Liang, Ting Yi Chen, Edward Giovannucci

Research output: Contribution to journalArticle

267 Citations (Scopus)

Abstract

The association between cigarette smoking and colorectal cancer (CRC) has been controversial. To synthesize the available data, we conducted a comprehensive meta-analysis of all prospective studies. A total of 36 studies were included in our meta-analysis. We examined the association between smoking and CRC, colon cancer and rectal cancer in terms of incidence and mortality. Separate analyses were conducted for smoking status, daily cigarette consumption, duration, pack-years and age of initiation. Relative to nonsmokers, current and former smokers had a significantly increased risk of CRC incidence and mortality, respectively. When CRC data were combined with colon/rectal cancer data, current smokers had a significantly increased risk of CRC incidence. All 4 dose-response variables examined-daily cigarette consumption (RR = 1.38 for an increase of 40 cigarettes/day), duration (RR = 1.20 for an increase of 40 years of duration), pack-years (RR = 1.51 for an increase of 60 pack-years) and age of initiation (RR = 0.96 for a delay of 10 years in smoking initiation) - were significantly associated with CRC incidence (all p-values < 0.0001). The relationship between duration of smoking and rectal cancer incidence was also significant. Among the subset of studies that distinguished cancer by site, a higher risk was seen for rectal cancer than for colon cancer for all analyses. Among prospective studies, a consistent association exists between smoking and CRC. The association is stronger for rectal cancer than for colon cancer in the subset of studies that differentiated cancer by site.

Original languageEnglish (US)
Pages (from-to)2406-2415
Number of pages10
JournalInternational Journal of Cancer
Volume124
Issue number10
DOIs
StatePublished - May 15 2009

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Colonic Neoplasms
Meta-Analysis
Colorectal Neoplasms
Smoking
Rectal Neoplasms
Mortality
Incidence
Tobacco Products
Prospective Studies
Neoplasms

Keywords

  • Colorectal cancer
  • Meta-analysis
  • Smoking

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Cigarette smoking and colorectal cancer incidence and mortality : Systematic review and meta-analysis. / Liang, Peter S.; Chen, Ting Yi; Giovannucci, Edward.

In: International Journal of Cancer, Vol. 124, No. 10, 15.05.2009, p. 2406-2415.

Research output: Contribution to journalArticle

Liang, Peter S. ; Chen, Ting Yi ; Giovannucci, Edward. / Cigarette smoking and colorectal cancer incidence and mortality : Systematic review and meta-analysis. In: International Journal of Cancer. 2009 ; Vol. 124, No. 10. pp. 2406-2415.
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