Cigarette smoking and colorectal carcinoma mortality in a cohort with long‐term follow‐up

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Abstract
BACKGROUND: Evidence suggests that colorectal carcinoma (CRC) may be a tobacco‐associated malignancy.METHODS: In the current study, the authors examined the association between cigarette smoking and CRC mortality in the Chicago Heart Association Detection Project in Industry study, a cohort of 39,299 men and women with an average of 26 years of follow‐up. To assess whether the association was stronger in participants with a potentially long history of smoking, the authors also stratified the analysis using a baseline age ≥ 50 years versus < 50 years.RESULTS: Using multivariate Cox regression analysis, there was a marginally significant trend (P = 0.06) for men and women combined between smoking and CRC mortality. In the age‐stratified analysis in the older participant group, there was no apparent association for men, women, or men and women combined. In the younger participant group, there appeared to be dose‐response relations for women and for men and women combined (P value for trend = 0.008 and 0.03, respectively) between smoking and CRC mortality. The relative risk for women who smoked >20 cigarettes/day compared with never smokers was 2.49 (95% confidence interval [95% CI], 0.87–7.12), and was 1.87 for men and women combined (95% CI, 1.08–3.22).CONCLUSIONS: The results of the current study support an association between cigarette smoking and CRC mortality, particularly in women age < 50 years. Cancer 2004;100:288–93. © 2003 American Cancer Society.