This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Giovannucci, E. Search for Related Content PubMed PubMed Citation Articles by Giovannucci, E.

An Updated Review of the Epidemiological Evidence that Cigarette Smoking Increases Risk of Colorectal Cancer

Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School and Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115

Carcinogens from tobacco reach the colorectal mucosa through either the alimentary tract or the circulatory system and could possibly damage or alter expression of important cancer-related genes. Twenty-one of 22 studies found that long-term, heavy cigarette smokers have a 2–3-fold elevated risk of colorectal adenoma. Risk of large adenomas, immediate cancer precursors, was elevated in smokers in 12 of 12 studies. The studies of smoking and colorectal cancer risk conducted earlier in the twentieth century consistently did not show any association. However, 27 studies in various countries, including the vast majority of those that have been analyzed in the past several years, now show an association between tobacco use and colorectal cancer. In the United States, 15 of 16 studies conducted after 1970 in middle-age men and elderly men and, in the 1990s, in women demonstrate an association. This temporal pattern is consistent with an induction period of three to four decades between genotoxic exposure and the diagnosis of colorectal cancer and with men as a group having begun smoking several decades earlier than women. Overall, accumulating evidence, much within the past decade, strongly supports the addition of colorectal cancer to the list of tobacco-associated malignancies and the possibility that up to one in five colorectal cancers in the United States may be potentially attributable to tobacco use.

This article has been cited by other articles:

				S. A. Kenfield, M. J. Stampfer, B. A. Rosner, and G. A. Colditz Smoking and Smoking Cessation in Relation to Mortality in Women JAMA, May 7, 2008; 299(17): 2037 - 2047. [Abstract] [Full Text] [PDF]

				G. D. Batty, M. Kivimaki, L. Gray, G. Davey Smith, M. G. Marmot, and M. J. Shipley Cigarette smoking and site-specific cancer mortality: testing uncertain associations using extended follow-up of the original Whitehall study Ann. Onc., May 1, 2008; 19(5): 996 - 1002. [Abstract] [Full Text] [PDF]

				M. J. Shrubsole, H. Wu, R. M. Ness, Y. Shyr, W. E. Smalley, and W. Zheng Alcohol Drinking, Cigarette Smoking, and Risk of Colorectal Adenomatous and Hyperplastic Polyps Am. J. Epidemiol., May 1, 2008; 167(9): 1050 - 1058. [Abstract] [Full Text] [PDF]

				Y. Feng, J. R. Neale, M. A. Doll, and D. W. Hein Chemoprevention of Arylamine-Induced Colorectal Aberrant Crypts Experimental Biology and Medicine, January 1, 2008; 233(1): 71 - 75. [Abstract] [Full Text] [PDF]

				E. D. Paskett, K. W. Reeves, T. E. Rohan, M. A. Allison, C. D. Williams, C. R. Messina, E. Whitlock, A. Sato, and J. R. Hunt Association Between Cigarette Smoking and Colorectal Cancer in the Women's Health Initiative J Natl Cancer Inst, November 21, 2007; 99(22): 1729 - 1735. [Abstract] [Full Text] [PDF]

				A. O. O. Chan, M. H. Jim, K. F. Lam, J. S. Morris, D. C. W. Siu, T. Tong, F. H. Ng, S. Y. Wong, W. M. Hui, C. K. Chan, et al. Prevalence of Colorectal Neoplasm Among Patients With Newly Diagnosed Coronary Artery Disease JAMA, September 26, 2007; 298(12): 1412 - 1419. [Abstract] [Full Text] [PDF]

				R. J. Turesky, J.-M. Yuan, R. Wang, S. Peterson, and M. C. Yu Tobacco Smoking and Urinary Levels of 2-Amino-9H-Pyrido[2,3-b]Indole in Men of Shanghai, China Cancer Epidemiol. Biomarkers Prev., August 1, 2007; 16(8): 1554 - 1560. [Abstract] [Full Text] [PDF]

				M. Luchtenborg, K. K.L. White, L. Wilkens, L. N. Kolonel, and L. Le Marchand Smoking and Colorectal Cancer: Different Effects by Type of Cigarettes? Cancer Epidemiol. Biomarkers Prev., July 1, 2007; 16(7): 1341 - 1347. [Abstract] [Full Text] [PDF]

				J. M. van der Bol, R. H.J. Mathijssen, W. J. Loos, L. E. Friberg, R. H.N. van Schaik, M. J.A. de Jonge, A. S.Th. Planting, J. Verweij, A. Sparreboom, and F. A. de Jong Cigarette Smoking and Irinotecan Treatment: Pharmacokinetic Interaction and Effects on Neutropenia J. Clin. Oncol., July 1, 2007; 25(19): 2719 - 2726. [Abstract] [Full Text] [PDF]

				C. S Guerreiro, M. L Cravo, M. Brito, P. M Vidal, P. O Fidalgo, and C. N Leitao The D1822V APC polymorphism interacts with fat, calcium, and fiber intakes in modulating the risk of colorectal cancer in Portuguese persons Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1592 - 1597. [Abstract] [Full Text] [PDF]

				H. P. S. Wong, L. Yu, E. K. Y. Lam, E. K. K. Tai, W. K. K. Wu, and C.-H. Cho Nicotine Promotes Colon Tumor Growth and Angiogenesis through {beta}-Adrenergic Activation Toxicol. Sci., June 1, 2007; 97(2): 279 - 287. [Abstract] [Full Text] [PDF]

				E. J. Coups, S. L. Manne, N. J. Meropol, and D. S. Weinberg Multiple Behavioral Risk Factors for Colorectal Cancer and Colorectal Cancer Screening Status Cancer Epidemiol. Biomarkers Prev., March 1, 2007; 16(3): 510 - 516. [Abstract] [Full Text] [PDF]

				E. L. Goode, J. D. Potter, W. R. Bamlet, D. N. Rider, and J. Bigler Inherited variation in carcinogen-metabolizing enzymes and risk of colorectal polyps Carcinogenesis, February 1, 2007; 28(2): 328 - 341. [Abstract] [Full Text] [PDF]

				W. S. Samowitz, H. Albertsen, C. Sweeney, J. Herrick, B. J. Caan, K. E. Anderson, R. K. Wolff, and M. L. Slattery Association of Smoking, CpG Island Methylator Phenotype, and V600E BRAF Mutations in Colon Cancer J Natl Cancer Inst, December 6, 2006; 98(23): 1731 - 1738. [Abstract] [Full Text] [PDF]

				M. C. Stern, K. D. Siegmund, D. V. Conti, R. Corral, and R. W. Haile XRCC1, XRCC3, and XPD Polymorphisms as Modifiers of the Effect of Smoking and Alcohol on Colorectal Adenoma Risk Cancer Epidemiol. Biomarkers Prev., December 1, 2006; 15(12): 2384 - 2390. [Abstract] [Full Text] [PDF]

				A. Begleiter, D. Hewitt, A. W. Maksymiuk, D. A. Ross, and R. P. Bird A NAD(P)H:Quinone Oxidoreductase 1 Polymorphism Is a Risk Factor for Human Colon Cancer Cancer Epidemiol. Biomarkers Prev., December 1, 2006; 15(12): 2422 - 2426. [Abstract] [Full Text] [PDF]

				S. I. Berndt, E. A. Platz, M. D. Fallin, L. W. Thuita, S. C. Hoffman, and K. J. Helzlsouer Genetic Variation in the Nucleotide Excision Repair Pathway and Colorectal Cancer Risk. Cancer Epidemiol. Biomarkers Prev., November 1, 2006; 15(11): 2263 - 2269. [Abstract] [Full Text] [PDF]

				M. W. Foster, J. J. Mulvihill, and R. R. Sharp Investments in Cancer Genomics: Who Benefits and Who Decides Am J Public Health, November 1, 2006; 96(11): 1960 - 1964. [Abstract] [Full Text] [PDF]

				J. J. Kelly, A. P. Lanier, S. Alberts, and C. L. Wiggins Differences in Cancer Incidence among Indians in Alaska and New Mexico and U.S. Whites, 1993-2002. Cancer Epidemiol. Biomarkers Prev., August 1, 2006; 15(8): 1515 - 1519. [Abstract] [Full Text] [PDF]

				V. M. Chia, P. A. Newcomb, J. Bigler, L. M. Morimoto, S. N. Thibodeau, and J. D. Potter Risk of Microsatellite-Unstable Colorectal Cancer Is Associated Jointly with Smoking and Nonsteroidal Anti-inflammatory Drug Use. Cancer Res., July 1, 2006; 66(13): 6877 - 6883. [Abstract] [Full Text] [PDF]

				B.-T. Ji, J. L. Weissfeld, W.-H. Chow, W.-Y. Huang, R. E. Schoen, R. B. Hayes, and for the Prostate, Lung, Colorectal, and Ovarian Tr Tobacco smoking and colorectal hyperplastic and adenomatous polyps. Cancer Epidemiol. Biomarkers Prev., May 1, 2006; 15(5): 897 - 901. [Abstract] [Full Text] [PDF]

				F. Vigna-Taglianti, P. Vineis, A. Liberati, and F. Faggiano Quality of systematic reviews used in guidelines for oncology practice Ann. Onc., April 1, 2006; 17(4): 691 - 701. [Abstract] [Full Text] [PDF]

				W.-Y. Huang, S. I. Berndt, D. Kang, N. Chatterjee, S. J. Chanock, M. Yeager, R. Welch, R. S. Bresalier, J. L. Weissfeld, and R. B. Hayes Nucleotide Excision Repair Gene Polymorphisms and Risk of Advanced Colorectal Adenoma: XPC Polymorphisms Modify Smoking-Related Risk. Cancer Epidemiol. Biomarkers Prev., February 1, 2006; 15(2): 306 - 311. [Abstract] [Full Text] [PDF]

				C. Lilla, E. Verla-Tebit, A. Risch, B. Jager, M. Hoffmeister, H. Brenner, and J. Chang-Claude Effect of NAT1 and NAT2 Genetic Polymorphisms on Colorectal Cancer Risk Associated with Exposure to Tobacco Smoke and Meat Consumption Cancer Epidemiol. Biomarkers Prev., January 1, 2006; 15(1): 99 - 107. [Abstract] [Full Text] [PDF]

				T. Mizoue, M. Inoue, K. Tanaka, I. Tsuji, K. Wakai, C. Nagata, S. Tsugane, and Research Group for the Development, Evaluation of Tobacco Smoking and Colorectal Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population Jpn. J. Clin. Oncol., January 1, 2006; 36(1): 25 - 39. [Abstract] [Full Text] [PDF]

				P. Senesse, M. Touvier, E. Kesse, J. Faivre, and M.-C. Boutron-Ruault Tobacco Use and Associations of {beta}-Carotene and Vitamin Intakes with Colorectal Adenoma Risk J. Nutr., October 1, 2005; 135(10): 2468 - 2472. [Abstract] [Full Text] [PDF]

				K. M. Emmons, C. M. McBride, E. Puleo, K. I. Pollak, E. Clipp, K. Kuntz, B. H. Marcus, M. Napolitano, J. Onken, F. Farraye, et al. Project PREVENT: A Randomized Trial to Reduce Multiple Behavioral Risk Factors for Colon Cancer Cancer Epidemiol. Biomarkers Prev., June 1, 2005; 14(6): 1453 - 1459. [Abstract] [Full Text] [PDF]

				L. Hou, N. Chatterjee, W.-Y. Huang, A. Baccarelli, S. Yadavalli, M. Yeager, R. S. Bresalier, S. J. Chanock, N. E. Caporaso, B.-T. Ji, et al. CYP1A1 Val462 and NQO1 Ser187 polymorphisms, cigarette use, and risk for colorectal adenoma Carcinogenesis, June 1, 2005; 26(6): 1122 - 1128. [Abstract] [Full Text] [PDF]

				M. Luchtenborg, M. P. Weijenberg, E. Kampman, G. N. van Muijen, G. M. J. M. Roemen, M. P. A. Zeegers, R. A. Goldbohm, P. van 't Veer, A. F. P. M. de Goeij, and P. A. van den Brandt Cigarette Smoking and Colorectal Cancer: APC Mutations, hMLH1 Expression, and GSTM1 and GSTT1 Polymorphisms Am. J. Epidemiol., May 1, 2005; 161(9): 806 - 815. [Abstract] [Full Text] [PDF]

				W.-Y. Huang, N. Chatterjee, S. Chanock, M. Dean, M. Yeager, R. E. Schoen, L.-F. Hou, S. I. Berndt, S. Yadavalli, C. C. Johnson, et al. Microsomal Epoxide Hydrolase Polymorphisms and Risk for Advanced Colorectal Adenoma Cancer Epidemiol. Biomarkers Prev., January 1, 2005; 14(1): 152 - 157. [Abstract] [Full Text] [PDF]

				S. S. Maruti, D. Feskanich, G. A. Colditz, A. L. Frazier, L. A. Sampson, K. B. Michels, D. J. Hunter, D. Spiegelman, and W. C. Willett Adult Recall of Adolescent Diet: Reproducibility and Comparison with Maternal Reporting Am. J. Epidemiol., January 1, 2005; 161(1): 89 - 97. [Abstract] [Full Text] [PDF]

				E.M.J. van der Logt, S.M. Bergevoet, H.M.J. Roelofs, Z. van Hooijdonk, R.H.M. te Morsche, T. Wobbes, J.B. de Kok, F.M. Nagengast, and W.H.M. Peters Genetic polymorphisms in UDP-glucuronosyltransferases and glutathione S-transferases and colorectal cancer risk Carcinogenesis, December 1, 2004; 25(12): 2407 - 2415. [Abstract] [Full Text] [PDF]

				M. L. Slattery, W. Samowtiz, K. Ma, M. Murtaugh, C. Sweeney, T. R. Levin, and S. Neuhausen CYP1A1, Cigarette Smoking, and Colon and Rectal Cancer Am. J. Epidemiol., November 1, 2004; 160(9): 842 - 852. [Abstract] [Full Text] [PDF]

				L. Sharp and J. Little Polymorphisms in Genes Involved in Folate Metabolism and Colorectal Neoplasia: A HuGE Review Am. J. Epidemiol., March 1, 2004; 159(5): 423 - 443. [Abstract] [Full Text] [PDF]

				T. Otani, M. Iwasaki, S. Yamamoto, T. Sobue, T. Hanaoka, M. Inoue, and S. Tsugane Alcohol Consumption, Smoking, and Subsequent Risk of Colorectal Cancer in Middle-Aged and Elderly Japanese Men and Women: Japan Public Health Center-based Prospective Study Cancer Epidemiol. Biomarkers Prev., December 1, 2003; 12(12): 1492 - 1500. [Abstract] [Full Text] [PDF]

				M. L. Slattery, S. Edwards, K. Curtin, D. Schaffer, and S. Neuhausen Associations between Smoking, Passive Smoking, GSTM-1, NAT2, and Rectal Cancer Cancer Epidemiol. Biomarkers Prev., September 1, 2003; 12(9): 882 - 889. [Abstract] [Full Text] [PDF]

				E. S.L. Liu, Y.-N. Ye, V. Y. Shin, S.-T. Yuen, S.-Y. Leung, B. C.Y. Wong, and C.-H. Cho Cigarette smoke exposure increases ulcerative colitis-associated colonic adenoma formation in mice Carcinogenesis, August 1, 2003; 24(8): 1407 - 1413. [Abstract] [Full Text] [PDF]

				O. L. van der Hel, H. B. Bueno de Mesquita, M. Roest, B. Slothouber, C. van Gils, P. A. H. van Noord, D. E. Grobbee, and P. H. M. Peeters No Modifying Effect of NAT1, GSTM1, and GSTT1 on the Relation between Smoking and Colorectal Cancer Risk Cancer Epidemiol. Biomarkers Prev., July 1, 2003; 12(7): 681 - 682. [Full Text] [PDF]

				B. Diergaarde, A. Vrieling, A. A. van Kraats, G. N.P. van Muijen, F. J. Kok, and E. Kampman Cigarette smoking and genetic alterations in sporadic colon carcinomas Carcinogenesis, March 1, 2003; 24(3): 565 - 571. [Abstract] [Full Text] [PDF]

				J.H. Barrett, G. Smith, R. Waxman, N. Gooderham, T. Lightfoot, R.C. Garner, K. Augustsson, C.R. Wolf, D.T. Bishop, D. Forman, et al. Investigation of interaction between N-acetyltransferase 2 and heterocyclic amines as potential risk factors for colorectal cancer Carcinogenesis, February 1, 2003; 24(2): 275 - 282. [Abstract] [Full Text] [PDF]

				P. Boyle and M. E. Leon Epidemiology of colorectal cancer Br. Med. Bull., December 1, 2002; 64(1): 1 - 25. [Abstract] [Full Text] [PDF]

				R. J. Mitchell, S. M. Farrington, M. G. Dunlop, and H. Campbell Mismatch Repair Genes hMLH1 and hMSH2 and Colorectal Cancer: A HuGE Review Am. J. Epidemiol., November 15, 2002; 156(10): 885 - 902. [Abstract] [Full Text] [PDF]

				M. M. de Jong, I. M. Nolte, G. J. te Meerman, W. T. A. van der Graaf, E. G. E. de Vries, R. H. Sijmons, R. M. W. Hofstra, and J. H. Kleibeuker Low-penetrance Genes and Their Involvement in Colorectal Cancer Susceptibility Cancer Epidemiol. Biomarkers Prev., November 1, 2002; 11(11): 1332 - 1352. [Abstract] [Full Text] [PDF]

				P. D. Terry and T. E. Rohan Cigarette Smoking and the Risk of Breast Cancer in Women: A Review of the Literature Cancer Epidemiol. Biomarkers Prev., October 1, 2002; 11(10): 953 - 971. [Abstract] [Full Text] [PDF]

				L. M. Morimoto, P. A. Newcomb, C. M. Ulrich, R. M. Bostick, C. J. Lais, and J. D. Potter Risk Factors for Hyperplastic and Adenomatous Polyps: Evidence for Malignant Potential? Cancer Epidemiol. Biomarkers Prev., October 1, 2002; 11(10): 1012 - 1018. [Abstract] [Full Text] [PDF]