Associations between Smoking, Passive Smoking, GSTM-1, NAT2, and Rectal Cancer

Martha L. Slattery; Sandra Edwards; Karen Curtin; Donna Schaffer; Susan Neuhausen

DOI: Published September 2003

Article Figures & Data

Tables

Table 1

Description of study population

	Men			Women
		Cases n %	Controls n %	Cases n %	Controls n %
Age (yr)
<45	36 (6.4)	43 (6.4)	37 (9.4)	42 (7.9)
45–54	112 (20.0)	134 (19.9)	85 (21.6)	106 (19.9)
55–64	176 (31.5)	193 (28.7)	114 (29.0)	156 (29.3)
65–74	162 (29.0)	206 (30.6)	103 (26.2)	139 (26.1)
75–79	73 (13.1)	97 (14.4)	54 (13.7)	89 (16.7)
Education level
<High school	57 (10.2)	76 (11.3)	47 (12.0)	51 (9.6)
High school	125 (22.4)	126 (18.8)	101 (25.7)	144 (27.1)
Some college	278 (49.7)	323 (48.1)	195 (49.6)	255 (47.9)
College graduate +	99 (17.7)	147 (21.9)	50 (12.7)	82 (15.4)
Cigarette smoker
Never	209 (37.6)	297 (44.2)	232 (59.2)	328 (61.7)
Stopped ≥5 yr	229 (41.2)	272 (40.5)	93 (23.7)	118 (22.2)
Current (<5 yr)	118 (21.2)	103 (15.3)	67 (17.1)	86 (16.2)
Cigar smoker
Never	505 (90.3)	609 (90.6)	392 (99.8)	530 (99.6)
Ever	54 (9.7)	64 (9.4)	1 (0.2)	2 (0.4)
Pipe smoker
Never	499 (89.3)	598 (88.9)	393 (100)	531 (99.8)
Ever	60 (10.7)	75 (11.1)	0	1 (0.2)

Table 2

Associations between cigarette smoking and rectal cancer risk in men and women

	Men					Women
		Cases (n)	Controls (n)	OR (95% CI)^a	Cases (n)	Controls (n)	OR (95% CI)
Cigarette smoking
Never	209	297	1.0	232	328	1.0
Former	229	272	1.2 (0.9–1.6)	93	118	1.0 (0.7–1.5)
Current (<5 yr)	118	103	1.5 (1.1–2.1)	67	86	1.0 (0.7–1.5)
Age started smoking
Never	209	297	1.0	232	328	1.0
≤16 yr	153	166	1.2 (0.9–1.7)	50	56	1.1 (0.7–1.7)
17–20 yr	137	133	1.5 (1.1–2.0)	65	83	1.1 (0.7–1.6)
>20 yr	60	77	1.1 (0.8–1.7)	46	65	1.0 (0.6–1.5)
Years, Since stopping
Never smoked	209	297	1.0	232	328	1.0
≥15 yrs	170	200	1.2 (0.9–1.6)	66	80	1.1 (0.7–1.6)
5–14 yrs	59	72	1.1 (0.8–1.7)	27	38	1.0 (0.6–1.7)
Current (<5 yr)	118	103	1.5 (1.1–2.1)	67	86	1.0 (0.7–1.5)
Pack-years^b
Never	211	298	1.0	233	329	1.0
≤20	132	194	1.0 (0.7–1.3)	73	108	0.9 (0.6–1.3)
>20	215	179	1.7 (1.3–2.3)	83	92	1.2 (0.8–1.7)
Usual number cigarettes/day
Never smoked	209	298	1.0	232	328	1.0
<20	258	276	1.3 (1.01–1.7)	130	172	1.0 (0.7–1.4)
≥20	92	100	1.3 (0.9–1.8)	30	30	1.2 (0.7–2.2)

^a Adjusted for age, physical activity level, alcohol intake, and body size.
^b People who smoked <0.5 pack-years were classified as never having smoked, thus numbers across categories differ slightly.

Table 3

Associations between passive smoking and rectal cancer in men and women

	Men					Women
		Cases (n)	Controls (n)	OR (95% CI)^a	Cases (n)	Controls (n)	OR (95% CI)
Passive smoking in the home (h/wk)
Recent
None	493	614	1.0	337	462	1.0
1–10	17	20	1.0 (0.5–2.0)	17	29	0.7 (0.4–1.4)
>10	47	36	1.5 (1.0–2.4)	37	38	1.1 (0.7–1.9)
10 years ago
None	463	583	1.0	300	418	1.0
1–10	31	35	1.1 (0.6–1.7)	28	42	0.8 (0.5–1.4)
>10	61	52	1.3 (0.9–2.0)	60	64	1.2 (0.8–1.8)
20 years ago
None	407	525	1.0	258	369	1.0
1–10	42	45	1.2 (0.8–1.9)	40	61	0.9 (0.6–1.4)
>10	101	93	1.3 (0.9–1.8)	86	97	1.2 (0.8–1.7)
Long-term average
None	389	501	1.0	235	342	1.0
1–10	85	102	1.0 (0.7–1.4)	78	95	1.1 (0.8–1.6)
>10	75	58	1.5 (1.0–2.2)	68	83	1.0 (0.7–1.6)
Passive smoking outside the home (h/w)
Recent
None	316	417	1.0	258	369	1.0
1–10	152	179	1.1 (0.9–1.5)	103	151	0.8 (0.6–1.1)
>10	77	60	1.5 (1.0–2.2)	27	30	1.0 (0.6–1.8)
10 years ago
None	214	289	1.0	181	243	1.0
1–10	185	239	1.1 (0.8–1.4)	147	202	0.9 (0.7–1.2)
>10	143	128	1.4 (1.0–1.9)	51	69	0.9 (0.6–1.3)
20 years ago
None	135	185	1.0	138	199	1.0
1–10	181	252	1.0 (0.7–1.3)	154	204	1.0 (0.8–1.4)
>10	225	215	1.4 (1.0–1.8)	89	114	1.0 (0.7–1.5)
Long-term average
None	113	154	1.0	113	144	1.0
1–10	148	221	0.9 (0.6–1.2)	126	180	0.9 (0.6–1.2)
>10	273	270	1.3 (1.0–1.8)	138	180	0.9 (0.6–1.2)
Total passive smoke (h/wk)
Recent
None	303	398	1.0	242	316	1.0
1–10	142	167	1.2 (0.9–1.5)	95	137	0.8 (0.6–1.1)
>10	99	90	1.3 (0.9–1.8)	50	61	0.9 (0.6–1.4)
10 years ago
None	194	237	1.0	160	221	1.0
1–10	175	228	1.1 (0.8–1.5)	130	179	0.9 (0.6–1.2)
>10	170	155	1.5 (1.1–2.0)	87	110	0.9 (0.6–1.3)
20 years ago
None	115	165	1.0	119	171	1.0
1–10	165	239	1.0 (0.7–1.4)	124	170	1.0 (0.7–1.4)
>10	256	244	1.5 (1.1–2.0)	135	175	1.0 (0.7–1.4)
Long-term average
None	93	135	1.0	92	122	1.0
1–10	315	393	1.2 (0.8–1.6)	197	284	0.8 (0.6–1.2)
>10	122	113	1.4 (1.0–2.1)	83	94	1.0 (0.6–1.5)
Long-term average (10 and 20 yr ago)
None	95	140	1.0	99	133	1.0
1–10	232	311	1.1 (0.8–1.5)	160	231	0.8 (0.6–1.2)
>10	205	195	1.5 (1.04–2.1)	114	142	0.9 (0.6–1.4)

^a Adjusted for age, physical activity level, alcohol in take, usual cigarettes smoked/day (passive smoking only), and body size.

Table 4

Associations between GSTM-1 and NAT2-imputed phenotype and rectal cancer in men and women

	Men					Women
		Cases (n)	Controls (n)	OR (95% CI)^a	Cases (n)	Controls (n)	OR (95% CI)
GSTM-1
Present	230	279	1.0	167	188	1.0
Null	243	295	1.0 (0.8–1.3)	161	251	0.7 (0.6–1.0)
NAT2 (acetylator status)
Slow	247	306	1.0	162	214	1.0
Rapid	204	255	1.0 (0.8–1.3)	153	215	0.9 (0.7–1.3)
GSTM-1/NAT2 combined
Present/slow	130	148	1.0	83	87	1.0
Present/rapid	89	125	0.8 (0.6–12)	77	97	0.8 (0.5–1.2)
Null/slow	117	156	0.9 (0.6–1.2)	77	123	0.6 (0.4–1.0)
Null/rapid	115	127	1.0 (0.7–1.4)	76	117	0.7 (0.5–1.1)

^a Adjusted for age, physical activity level, alcohol intake, usual number of cigarettes smoked/day, and body size.

Table 5

GSTM-1, NAT2-imputed phenotype, and cigarette smoking exposure and rectal cancer in men

	GST present n (cases/controls)	GST null n (cases/controls)	GST present OR (95% CI)^a	GST null OR (95% CI)
Cigarette smoking status
Never	84/123	88/124	1.0	1.1 (0.7–1.6)
Former	106/112	90/128	1.5 (1.0–2.2)	1.1 (0.7–1.6)
Current (<5 yr)	39/44	63/43	1.3 (0.8–2.2)	2.0 (1.2–3.3)
Pack-years smoked
None	86/123	88/125	1.0	1.1 (0.7–1.6)
≤20	56/78	53/88	1.1 (0.7–1.7)	0.9 (0.6–1.4)
>20	88/77	101/81	1.8 (1.2–2.8)	1.9 (1.2–2.9)
Total long-term passive smoking (h/wk)
None	42/59	39/54	1.0	1.0 (0.6–1.8)
1–10	95/126	104/139	1.0 (0.6–1.7)	1.0 (0.6–1.6)
>10	82/82	89/91	1.3 (0.8–2.1)	1.3 (0.8–2.1)
	Slow acetylator	Rapid acetylator	Slow acetylator	Rapid acetylator
Cigarette smoking status
Never	90/143	74/105	1.0	1.2 (0.8–1.8)
Former	112/128	75/105	1.5 (1.0–2.1)	1.2 (0.8–1.8)
Current (<5 yr)	44/35	53/45	2.0 (1.2–3.4)	1.7 (1.0–2.8)
Pack-years smoked
None	91/144	75/105	1.0	1.2 (0.8–1.8)
≤20	57/79	45/77	1.2 (0.7–1.8)	0.9 (0.6–1.5)
>20	98/82	84/72	2.1 (1.4–3.2)	1.9 (1.2–3.0)
Total long-term passive smoking (h/wk)
None	40/65	38/48	1.0	1.3 (0.7–2.4)
1–10	100/142	90/119	1.1 (0.7–1.8)	1.2 (0.7–1.9)
>10	98/89	65/77	1.7 (1.0–2.8)	1.3 (0.7–2.1)

^a Adjusted for age, physical activity level, alcohol intake, usual number of cigarettes smoked/day (for passive smoking), and body size.

Table 6

Combined effect of GSTM-1 genotype and NAT2-imputed phenotype and cigarette smoking on rectal cancer risk in men

	GST present NAT2 slow n (case/control)	GST present NAT2 rapid n (case/control)	GST null NAT2 slow n (case/control)	GST null NAT2 rapid n (case/control)
Cigarette smoking status
Never	46/72	33/49	44/70	41/54
Former	62/57	40/53	50/71	35/51
Current (<5 yr)	22/19	15/23	22/15	38/22
	OR (95% CI)^a	OR (95% CI)	OR (95% CI)	OR (95% CI)
Never	1.0	1.2 (0.6–2.1)	1.1 (0.6–1.8)	1.3 (0.7–2.3)
Former	1.9 (1.1–3.2)	1.3 (0.7–2.3)	1.2 (0.7–3.0)	1.1 (0.6–2.1)
Current (<5 yr)	1.9 (0.9–3.9)	1.0 (0.5–2.2)	2.3 (1.1–5.0)	2.5 (1.3–4.8)