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Smoking habits strongly linked to colorectal polyps

22 Sep 2018

There is a strong association between smoking duration and colorectal polyps, independent of smoking intensity, cessation and other potential confounders, reports a recent study. Such association is more robust with distal rather than proximal polyps, and with serrated polyps rather than adenomas.

Current smoking more strongly correlated with greater odds for distal (odds ratio [OR], 4.00; 95 percent CI, 2.40–6.68) vs proximal polyps (OR, 2.52; 1.46–4.36), and with serrated polyps (OR, 6.36; 2.77–14.57) vs adenomas (OR, 3.01; 1.90–4.74). Colorectal polyps correlated with all levels of smoking intensity (daily cigarettes).

Moreover, there was a dose-response association between smoking duration and colorectal polyps. Smoking duration of ≥20 years showed a robust association with distal polyps (OR, 4.01; 1.62–9.84), independently of potential confounders, smoking intensity and years since smoking cessation. All associations were stronger for distal serrated polyps.

An earlier study found several lifestyle factors, particularly smoking and alcohol, to be associated with colorectal serrated polyps risk, suggesting that the risk of serrated pathway colorectal neoplasms could be reduced with lifestyle changes. [Gastroenterology 2017;152:92-104]

A case-control study was conducted in 828 consecutive patients aged 40–70 years undergoing screening or diagnostic colonoscopy to examine the association between lifetime smoking habits and colorectal polyps of different classifications. Those with medically treated diabetes, colectomy and belonging to colorectal cancer high-risk group were not included.

The authors stratified polyps according to histology (serrated or adenomatous polyp) and location. All participants had anthropometric measurements, as well as a structure medical and lifestyle interview.

“Smoking is an established risk factor for several cancers, including colorectal cancer,” the authors said.

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