Smoking multiplies colorectal cancer risks in women

• Smoking and alcohol use are well-established risk factors for colorectal cancer.
• Dr. Zisman and her colleagues looked at women's susceptibility compared to men.
• Using the IMPAC Medical Registry Services Cancer Information Resource File, a large database from over 350 teaching and community hospitals, the investigators conducted a regression analysis of gender, tobacco and alcohol use.
• They found that while age of onset of colorectal cancer was slightly younger in males than females in the non-smoking/non-drinking group, current smokers had a markedly decreased age of presentation for both men and women.
• An assessment of the differential sensitivity to smoking and alcohol use in men and women revealed that women are sensitive to smoking as a risk factor for colorectal cancer but not alcohol.
• Most guidelines recommend that screening for colorectal cancer should begin at age 50 for individuals at average risk.
• "However there is no consensus regarding the age at which we should stop screening," commented Aaron Walfish, M.D. of Beth Israel Medical Center in New York.
• According to Dr. Walfish, "Older patients often have other health problems that increase the risk of undergoing endoscopy, so we need more evidence regarding the usefulness of screening in this older population.
• In both age groups, the researchers found that a similar percentage of patients had polyps or masses (43 percent in the 75 and older group vs. 42 percent in the 65 to 69 group), and that a similar percentage had larger polyps or masses (49 percent in the 75 and older group vs. 58 percent in the 65 to 69 group had polyps greater than or equal to 1 cm.) There were no complications from the screening procedure reported in either age group.