Cigarette smoking is a key risk factor for the development of colorectal polyps, a new study suggests.

Pramod Joseph, MD, gastroenterologist, Our Lady of Mercy Medical Center-New York Medical College, New York, United States, presented these findings here on October 15th at the 68th Annual Scientific Meeting of the American College of Gastroenterology. The researchers decided to study the association between cigarette smoking and the risk of colorectal neoplasia in an ongoing prospective study, said Dr. Joseph, in light of epidemiological studies suggesting limited evidence for a link. The study enrolled 347 women and 214 men, with a mean age of 56 years, and a mean body mass index of 28.7. About half the patients were Hispanic, 36% were African American, 11% were Caucasian, and the rest were other races. Eighty-six of the patients were current smokers who consumed an average of 7.4 packs of cigarettes per week. Overall, polyps were found in 29.6% of patients. Colonoscopic examination revealed polyps in 24 of the 86 smokers, with pathology revealing tubular adenoma in 10 patients and carcinoma in situ in 2 patients. On average, colon polyps developed 4 years earlier in smokers compared with nonsmokers (P=0.0289), the researchers reported. Among the patients who had polyps, the mean age of smokers was 53 years, compared with 57 years for the nonsmokers. Current smokers were 2.33 times more likely to have polyps than nonsmokers (P=0.031), with the risk of polyps increasing by 9.1% for every pack of cigarettes smoked per week (P=0.022). Logistic regression analysis using age, sex, race, alcohol use, Aspirin use and smoking behaviour as explanatory variables also showed that the risk of polyps increased 3.9% for every year of age (P< 0.0005). Also, men were 88% more likely to develop polyps than women (P=0.013), the study showed. Douglas K. Rex, MD, FACG, Professor of Medicine, Indiana University School of Medicine, Indianapolis, United States and President of the American College of Gastroenterology, says the new study is one of several trials showing that smoking can increase the risk of colon polyps and malignancies. "Cigarette smoking is often overlooked in this regard," said Dr. Joseph. About 20% of cases of colon cancer can be attributed to it -- something that even most doctors fail to recognize."

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