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Open Access 01-03-2015 | Original Paper

Smoking-associated risks of conventional adenomas and serrated polyps in the colorectum

Authors: Jane C. Figueiredo, Seth D. Crockett, Dale C. Snover, Carolyn B. Morris, Gail McKeown-Eyssen, Robert S. Sandler, Dennis J. Ahnen, Douglas J. Robertson, Carol A. Burke, Robert S. Bresalier, James M. Church, Timothy R. Church, John A. Baron

Published in: Cancer Causes & Control | Issue 3/2015

Abstract

Purpose

Prior studies suggest cigarette smoking is associated with 1.5- to twofold increased risk of colorectal adenomas and possibly a higher risk of serrated polyps. Further clarification of risk differences between adenomas and serrated polyps is needed with regard to co-occurrence and polyp location.

Methods

We conducted a combined analysis of conventional adenoma and serrated polyp occurrence using individual-level data from 2,915 patients participating in three colonoscopy-based clinical trials. All participants had ≥1 adenomas removed at baseline and were followed for up to 4 years. Smoking habits and other lifestyle factors were collected at baseline using questionnaires. We used generalized linear regression to estimate risk ratios and 95 % confidence intervals.

Results

Smokers were at slightly increased risk of adenomas compared to never smokers [current: RR 1.29 (95 % CI 1.11–1.49) and former: RR 1.18 (1.05–1.32)]. Smoking was associated with greater risk of serrated polyps [current: RR 2.01 (1.66–2.44); former: RR 1.42 (1.20–1.68)], particularly in the left colorectum. Associations between current smoking and occurrence of serrated polyps only [RR 2.33 (1.76–3.07)] and both adenomas and serrated polyps [RR 2.27 (1.68–3.06)] were more pronounced than for adenomas only [RR 1.31 (1.08–1.58)]. Results were similar for other smoking variables and did not differ by gender or for advanced adenomas.

Conclusions

Cigarette smoking has only a weak association with adenomas, but is associated with a significantly increased risk of serrated polyps, particularly in the left colorectum. Since a minority of left-sided serrated polyps is thought to have malignant potential, the role of smoking in initiation phases of carcinogenesis is uncertain.

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Title: Smoking-associated risks of conventional adenomas and serrated polyps in the colorectum
Authors: Jane C. Figueiredo
Seth D. Crockett
Dale C. Snover
Carolyn B. Morris
Gail McKeown-Eyssen
Robert S. Sandler
Dennis J. Ahnen
Douglas J. Robertson
Carol A. Burke
Robert S. Bresalier
James M. Church
Timothy R. Church
John A. Baron
Publication date: 01-03-2015
Publisher: Springer International Publishing
Published in: Cancer Causes & Control / Issue 3/2015
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-014-0513-0

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