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Smoking, snus use and risk of right‐ and left‐sided colon, rectal and anal cancer: A 37‐year follow‐up study

Nordenvall, Caroline, Nilsson, Per J., Ye, Weimin, Nyrén, Olof·2011·International Journal of Cancer
DOI 10.1002/ijc.25305
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Abstract

Although some authorities consider smoking to be an established risk factor for colorectal cancer, the international literature is not entirely consistent. Further, only 1 study has addressed the association with smokeless tobacco and none with Scandinavian moist snuff (snus). This retrospective cohort study included 336,381 male Swedish construction workers with detailed information on tobacco use at cohort entry in 1971–1992. Complete follow‐up through 2007 was accomplished by means of linkage to population and health registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from Cox proportional hazards regression models estimated relative risks, adjusted for age and body mass index. Subjects who were never‐users of any tobacco served as reference. After up to 37 years of follow‐up, pure smoking was associated with a marginally increased risk of colon cancer (HR 1.08, 95% CI 0.99–1.19), a modestly elevated risk of rectal cancer (HR 1.16, 95% CI 1.04–1.30) and a substantial excess risk of anal cancer (HR 2.41, 95% CI 1.06–5.48). Snus use was not significantly associated with an increased risk of colorectal or anal cancer, although the point estimate for colon cancer was similar to that observed among smokers. Swedish data provide meager support for the association between tobacco use and colorectal cancer. A general tendency among Swedish men to quit smoking in recent decades might have attenuated true associations. A link between smoking and anal cancer was confirmed.

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Cited by

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Authors
Nordenvall, C., Nilsson, P. J., Ye, W., & Nyrén, O.
Venue
International Journal of Cancer
Publisher
Wiley
Published
2010-10-27
Volume
128
Issue
1
Pages
157-165
ISSN
  • 0020-7136
  • 1097-0215
DOI
10.1002/ijc.25305
Cited by
39
References
2
Language
en
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)

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