Cigarettes and alcohol in relation to colorectal cancer: the Singapore Chinese Health Study

• Published in: British journal of cancer Vol. 96; no. 5; pp. 821 - 827
• Main Authors: TSONG, W. H, KOH, W.-P, YUAN, J.-M, WANG, R, SUN, C.-L, YU, M. C
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 12.03.2007
• Subjects: Aged; Alcohol; Alcohol Drinking - adverse effects; Beer; Biological and medical sciences; Cancer research; Cigarettes; Colorectal cancer; Colorectal Neoplasms - etiology; Epidemiology; Ethanol; Exercise; Female; Health care; Humans; Male; Medical research; Medical sciences; Middle Aged; Population; Preventive medicine; Questionnaires; Risk Assessment; Risk Factors; Singapore - epidemiology; Skin cancer; Smoking; Smoking - adverse effects; Tobacco, tobacco smoking; Toxicology; Tumors; Women; Asia; China; Singapore; Minneapolis Minnesota; United States > US; Rectal disease; Ethanol; Health; Colorectal cancer; Tobacco smoking; Malignant tumor; alcohol drinking; Colonic disease; Cigarette; cigarette smoking; Alcoholic beverage; Singapore Chinese; Cancerology; Digestive diseases; Intestinal disease; Chinese
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6603623

The relations were examined between colorectal cancer and cigarette smoking and alcohol consumption within the Singapore Chinese Health Study, a population-based, prospective cohort of 63 257 middle-aged and older Chinese men and women enrolled between 1993 and 1998, from whom baseline data on cigarette smoking and alcohol consumption were collected through in-person interviews. By 31 December 2004, 845 cohort participants had developed colorectal cancer (516 colon cancer, 329 rectal cancer). Compared with nondrinkers, subjects who drank seven or more alcoholic drinks per week had a statistically significant, 72% increase in risk of colorectal cancer hazard ratio (HR)=1.72; 95% confidence interval (CI)=1.33-2.22). Cigarette smoking was associated with an increased risk of rectal cancer only. Compared with nonsmokers, HRs (95% CIs) for rectal cancer were 1.43 (1.10-1.87) for light smokers and 2.64 (1.77-3.96) for heavy smokers. Our data indicate that cigarette smoking and alcohol use interact in the Chinese population in an additive manner in affecting risk of rectal cancer, thus suggesting that these two exposures may share a common etiologic pathway in rectal carcinogenesis.