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

missed by methods other than colonoscopy.

Patients who were classified as alcohol or tobacco users, defined as those who had smoked or drank alcohol in the previous year, developed cancer at a younger age than non-drinkers and non-smokers. Current alcohol and tobacco users developed cancer an average of 7.8 years earlier (age 63.2 years in women and 62.1 years in men) than those who had never drank or smoked. Those who had never smoked but drank or who had never drank but smoked were each an average of 5.2 years younger at cancer diagnosis than those who neither smoked nor drank. Individuals who stopped drinking one year or more prior to the study and had never smoked developed cancer an average of 2.1 years earlier than those who had never drank or smoked. The effect of smoking appeared to be particularly large for women; women who smoke but never drank developed cancer 6.3 years younger than those who never drank or smoked, compared with 3.7 years in men. In additional, current alcohol and tobacco consumption was associated with an increased likelihood of distal colorectal cancer, although women in all categories were less likely to have distal cancer than men.

These findings suggest that individuals who smoke and drink should undergo screening for colorectal cancer beginning at a younger age, the authors write. In addition, women who do not smoke or drink may be more prone to proximal cancers and might therefore want to consider undergoing colonoscopy instead of flexible sigmoidoscopy. "In the future, we envision the development of risk scores with exogenous (e.g., alcohol and tobacco use, age, body mass index, diet and calcium consumption) and hereditary factors to tailor an individual's colorectal cancer screening program," they conclude.


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Contact: Amy Ferguson
847-570-3146
JAMA and Archives Journals
27-Mar-2006


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