Smoking and colorectal cancer in a non-western population: A prospective cohort study in Japan

Kenji Wakai, Norihiko Hayakawa, Masayo Kojima, Koji Tamakoshi, Yoshiyuki Watanabe, Koji Suzuki, Shuji Hashimoto, Shinkan Tokudome, Hideaki Toyoshima, Yoshinori Ito, Akiko Tamakoshi

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Abstract

BACKGROUND: The risk of colorectal cancer in relation to smoking habits has been examined mostly in Caucasians, and evidence for other ethnic groups is still scarce. METHODS: Our data came from the Japan Collaborative Cohort (JACC) Study. From 1988 through 1990, 25,260 men and 34,619 women aged 40-79 years completed a questionnaire on cigarette smoking and other lifestyle factors. Hazard ratios (HR) were estimated by fitting proportional hazards models. RESULTS: During the mean follow-up of 7.6 years through December 1997, we documented 408 incident colon cancers and 204 rectal cancers. We found a non-significant increase in colon cancer risk in male current smokers compared with never smokers. The multivariate-adjusted hazard ratios were 1.07 (95% confidence interval [Cl]: 0.72-1.59) for ex-smokers and 1.23 (95% Cl: 0.85-1.78) for current smokers. We however failed to observe a clear dose-response relationship between smoking intensity or duration and colon cancer risk. The adjusted hazard ratio was 1.07 (95% Cl: 0.71-1.61) even for 40+ years of smoking. Almost no increase in colon cancer risk was detected for female smokers, and male smokers were not at an enhanced risk of rectal cancer. CONCLUSIONS: Cigarette smoking was not a strong risk factor for colorectal cancer even after a long-term exposure, although a weak association remains open to discussion.

Original languageEnglish
Pages (from-to)323-331
Number of pages9
JournalJournal of Epidemiology
Volume13
Issue number6
Publication statusPublished - 01-11-2003

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Colorectal Neoplasms
Japan
Cohort Studies
Smoking
Colonic Neoplasms
Prospective Studies
Population
Rectal Neoplasms
Proportional Hazards Models
Ethnic Groups
Habits
Life Style
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Wakai, K., Hayakawa, N., Kojima, M., Tamakoshi, K., Watanabe, Y., Suzuki, K., ... Tamakoshi, A. (2003). Smoking and colorectal cancer in a non-western population: A prospective cohort study in Japan. Journal of Epidemiology, 13(6), 323-331.
Wakai, Kenji ; Hayakawa, Norihiko ; Kojima, Masayo ; Tamakoshi, Koji ; Watanabe, Yoshiyuki ; Suzuki, Koji ; Hashimoto, Shuji ; Tokudome, Shinkan ; Toyoshima, Hideaki ; Ito, Yoshinori ; Tamakoshi, Akiko. / Smoking and colorectal cancer in a non-western population : A prospective cohort study in Japan. In: Journal of Epidemiology. 2003 ; Vol. 13, No. 6. pp. 323-331.
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Wakai, K, Hayakawa, N, Kojima, M, Tamakoshi, K, Watanabe, Y, Suzuki, K, Hashimoto, S, Tokudome, S, Toyoshima, H, Ito, Y & Tamakoshi, A 2003, 'Smoking and colorectal cancer in a non-western population: A prospective cohort study in Japan', Journal of Epidemiology, vol. 13, no. 6, pp. 323-331.

Smoking and colorectal cancer in a non-western population : A prospective cohort study in Japan. / Wakai, Kenji; Hayakawa, Norihiko; Kojima, Masayo; Tamakoshi, Koji; Watanabe, Yoshiyuki; Suzuki, Koji; Hashimoto, Shuji; Tokudome, Shinkan; Toyoshima, Hideaki; Ito, Yoshinori; Tamakoshi, Akiko.

In: Journal of Epidemiology, Vol. 13, No. 6, 01.11.2003, p. 323-331.

Research output: Contribution to journalArticle

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T1 - Smoking and colorectal cancer in a non-western population

T2 - A prospective cohort study in Japan

AU - Wakai, Kenji

AU - Hayakawa, Norihiko

AU - Kojima, Masayo

AU - Tamakoshi, Koji

AU - Watanabe, Yoshiyuki

AU - Suzuki, Koji

AU - Hashimoto, Shuji

AU - Tokudome, Shinkan

AU - Toyoshima, Hideaki

AU - Ito, Yoshinori

AU - Tamakoshi, Akiko

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Y1 - 2003/11/1

N2 - BACKGROUND: The risk of colorectal cancer in relation to smoking habits has been examined mostly in Caucasians, and evidence for other ethnic groups is still scarce. METHODS: Our data came from the Japan Collaborative Cohort (JACC) Study. From 1988 through 1990, 25,260 men and 34,619 women aged 40-79 years completed a questionnaire on cigarette smoking and other lifestyle factors. Hazard ratios (HR) were estimated by fitting proportional hazards models. RESULTS: During the mean follow-up of 7.6 years through December 1997, we documented 408 incident colon cancers and 204 rectal cancers. We found a non-significant increase in colon cancer risk in male current smokers compared with never smokers. The multivariate-adjusted hazard ratios were 1.07 (95% confidence interval [Cl]: 0.72-1.59) for ex-smokers and 1.23 (95% Cl: 0.85-1.78) for current smokers. We however failed to observe a clear dose-response relationship between smoking intensity or duration and colon cancer risk. The adjusted hazard ratio was 1.07 (95% Cl: 0.71-1.61) even for 40+ years of smoking. Almost no increase in colon cancer risk was detected for female smokers, and male smokers were not at an enhanced risk of rectal cancer. CONCLUSIONS: Cigarette smoking was not a strong risk factor for colorectal cancer even after a long-term exposure, although a weak association remains open to discussion.

AB - BACKGROUND: The risk of colorectal cancer in relation to smoking habits has been examined mostly in Caucasians, and evidence for other ethnic groups is still scarce. METHODS: Our data came from the Japan Collaborative Cohort (JACC) Study. From 1988 through 1990, 25,260 men and 34,619 women aged 40-79 years completed a questionnaire on cigarette smoking and other lifestyle factors. Hazard ratios (HR) were estimated by fitting proportional hazards models. RESULTS: During the mean follow-up of 7.6 years through December 1997, we documented 408 incident colon cancers and 204 rectal cancers. We found a non-significant increase in colon cancer risk in male current smokers compared with never smokers. The multivariate-adjusted hazard ratios were 1.07 (95% confidence interval [Cl]: 0.72-1.59) for ex-smokers and 1.23 (95% Cl: 0.85-1.78) for current smokers. We however failed to observe a clear dose-response relationship between smoking intensity or duration and colon cancer risk. The adjusted hazard ratio was 1.07 (95% Cl: 0.71-1.61) even for 40+ years of smoking. Almost no increase in colon cancer risk was detected for female smokers, and male smokers were not at an enhanced risk of rectal cancer. CONCLUSIONS: Cigarette smoking was not a strong risk factor for colorectal cancer even after a long-term exposure, although a weak association remains open to discussion.

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Wakai K, Hayakawa N, Kojima M, Tamakoshi K, Watanabe Y, Suzuki K et al. Smoking and colorectal cancer in a non-western population: A prospective cohort study in Japan. Journal of Epidemiology. 2003 Nov 1;13(6):323-331.