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Posted: October 21, 2008

Women Need Less Tobacco Exposure to Increase Colon Cancer Risk

While smoking poses a health threat to both men and women, women require less tobacco exposure than men to have a significant increased risk for colorectal cancer, according to new scientific research. In a separate analysis, researchers found smoking may increase the risk of pancreatic cancer precursor lesions, particularly in patients with a strong family history of the disease.

While previous research has demonstrated that smoking is associated with a doubled risk for colorectal neoplasia, less is known about the exposure quantity needed. Neoplasia is abnormal and uncontrolled cell growth that can develop into cancer.


Dr. Joseph C. Anderson, of the University of Connecticut in Farmington, and Dr. Zvi A. Alpern, of Stony Brook University in New York, compared the quantity of tobacco exposure to increased colorectal cancer risk both in men and women. The levels of tobacco exposure were measured by multiplying the packs of cigarettes smoked per day by the number of years smoked, so-called pack years.


In a large cross-sectional study, Anderson and Alpern analyzed data of 2,707 patients, with an average age 57, who underwent colonoscopy between 1999 and 2006. Data collected included age, height, weight, family history of colon cancer, medication use, surgery, exercise, diet and smoking history.


Patients were divided into three smoking groups: heavy exposure, low exposure, and no exposure. The heavy exposure group was placed into two different groups: those who smoked 30 pack years or less and those who smoked more than 30 pack years.


After adjusting for potentially conflicting factors such as age, body mass index, and family history, researchers found women who smoked less than 30 pack years were almost twice as likely to develop significant colorectal neoplasia compared to women who were not exposed to cigarette smoke.


“While men and women shared a similar two-fold risk for developing significant colorectal neoplasia, women required less tobacco exposure in pack years than men to have an increase in colorectal cancer risk,” said Anderson, whose findings were presented at the 73rd Annual American College of Gastroenterology Scientific Meeting in Orlando, Florida.


In a separate study conducted at Memorial Sloan-Kettering Cancer Center in New York, Dr. Emmy Ludwig and her colleagues examined tobacco exposure and the risk of pancreatic cancer precursor lesions in patients enrolled in a family pancreatic cancer registry and screening program.


In this analysis, at-risk relatives of related pancreatic cancer patients were screened using MRCP (magnetic resonance cholangiopancreatography) or CT scan with an endoscopic ultrasound performed if imaging showed any pancreatic abnormality. Patients underwent surgery if suspicious lesions were found.


Of the 113 relatives who completed at least one screening, 8.9% had a significant pancreatic lesion, six of whom underwent surgery. In a key finding, researchers found 70% of relatives with pancreatic abnormalities had a history of smoking compared to 40% of participants who did not smoke.


“Because more of the relatives with positive findings smoked than did relatives without positive findings, our study suggests that smoking may have been responsible for the development of the precursor lesions, especially in light of the fact that smoking is a known risk factor for pancreatic carcinoma,” Said Ludwig, the study’s lead investigator.

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