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Smokers, drinkers and men appear to develop colorectal cancer at earlier ages

Alcohol use, tobacco use and male gender are associated with an earlier onset of colorectal cancer and also with location of tumors, findings that could have important implications for screening, according to a study in the March 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Colorectal cancer is the second leading cause of cancer deaths, according to background information in the article. Screening asymptomatic patients is an important strategy for reducing these deaths, because by the time patients experience symptoms, the cancer may have progressed beyond the point where it can be cured. Generally, physicians recommend that patients begin screening at age 50 years, the authors write. However, physicians might recommend that individuals with certain risk factors, including family history, begin screening at earlier ages. Screening methods include flexible sigmoidoscopy, which involves inserting a flexible optical instrument through the rectum into the lower portion of the large intestine, and colonoscopy, which involves inserting a longer flexible optical instrument through the rectum and into the entire colon, is more expensive, has higher complication rates and usually is performed by a gastroenterologist or surgeon rather than a primary care physician.

Anna L. Zisman, M.D., and colleagues at EvanstonNorthwestern Healthcare, Feinberg School of Medicine, Northwestern University, Evanston, Ill., examined the records of 161,172 patients with colorectal cancer to assess whether certain risk factors, alcohol and tobacco use, should also be considered in screening decisions. They analyzed the relationship between use of these substances and age of onset of colon cancer as well as location of onset--distal or proximal colon. Distal tumors, including those in the lower left part of the colon and the rectum, can generally be detected by flexible sigmoidoscopy, while proximal tumors in the right side of the colon can be
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Contact: Amy Ferguson
847-570-3146
JAMA and Archives Journals
27-Mar-2006


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