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Cigarette Smoking Strongly Tied to Death From Colorectal Cancer

NEW YORK (Reuters Health) Dec 01 - Cigarette smoking increases the risk of dying from colorectal cancer, according to results of a large prospective cohort study with long-term follow-up. "These findings support the proposition that colorectal cancer be added to the list of tobacco-associated malignancies," Dr. Susan Gapstur and colleagues conclude.

The team from Northwestern University in Chicago examined the association between cigarette smoking and colorectal cancer mortality in the Chicago Heart Association Detection Project in Industry study, which screened 39,299 smoking and nonsmoking men and women between 1967 and 1973 and followed them through 1997, an average of 26 years.

By 1997, 208 men and 141 women had died of colorectal carcinoma, the investigators report in the January 15, 2004 issue of the journal Cancer published online Monday. For men and women combined, those who smoked more than 20 cigarettes per day and were younger than age 50 at entry had nearly twice the risk of dying from colorectal cancer as nonsmokers (relative risk = 1.87).

In analyses restricted to women younger than age 50 at baseline, those who smoked 1 to 20 and >20 cigarettes per day had a multivariate-adjusted relative risk of colorectal cancer mortality of 2.4 and 2.49, respectively, compared to their age-matched counterparts who did not smoke.

"It is interesting," the authors write, and "contrary to expectation" that there was no association between smoking and colorectal cancer mortality in men or in women who were older than age 50 at entry.

In an editorial, Drs. Graham A. Colditz and Kathleen P. Yaus of Harvard cite data suggesting that an estimated 12% of colon carcinoma deaths reported in men and women are due to cigarette smoking.

"Implementing strategies to reduce smoking should be our highest prevention priority," they write.

Cancer 2004.

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