Original articles—alimentary tractCigarette Smoking and the Risk of Colorectal Cancer: A Meta-analysis of Prospective Cohort Studies
Section snippets
Literature Search
All synonymous key words according to MeSH in study design, exposure, and outcome were used to identify the prospective cohort studies in MEDLINE from 1950 to April 2008 and EMBASE from 1980 to April 2008. Search terms included “prospective study,” “cohort study,” “colon/rectal/colorectal,” “cancer/neoplasm/carcinoma,” and “cigarette/tobacco/smoke.” Manual searches on the bibliographies of original articles or systematic reviews were also conducted. Only full publications from English-language
Results
We identified 2356 articles through searching in the database. All abstracts were scanned, and 132 full publications reporting cigarette smoking and CRC incidence were retrieved. Twenty-nine independent prospective cohort studies fulfilling inclusion criteria with report of CRC incidences were identified. We excluded 2 studies that reported only the risk of CRC among passive smokers46 or atomic bomb survivors from World War II.47 One study reported 2 separate groups of independent subjects
Discussion
Our meta-analysis of 28 prospective cohorts showed that smoking is associated with a modest but significantly increased risk of CRC, although no statistical significance was found among current female smokers, among men and women who smoked less than 20 cigarettes per day and smoked for less than 20 years, and also among those women who had less or even more than 20 pack-years. Compared with never smokers, current smokers who smoked at least 1 cigarette per day have an increase in the risk of
Acknowledgments
The authors thank Mr Andy Mak for his assistance in preparing this manuscript.
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Conflicts of interest The authors disclose no conflicts.