Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Smoking and Colorectal Cancer Risk in the Korean Elderly

노인 인구에서 흡연과 대장암 발생 위험간의 관련성

  • Kim, Hwa-Jung (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Lee, Seung-Mi (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Choi, Nam-Kyong (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kim, Seon-Ha (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Song, Hong-Ji (Department of Family Medicine, Hallym Medical Center) ;
  • Cho, Young-Kyun (Department of Internal Medicine, Gachon Medical School) ;
  • Park, Byung-Joo (Department of Preventive Medicine, Seoul National University College of Medicine)
  • 김화정 (서울대학교 의과대학 예방의학교실) ;
  • 이승미 (서울대학교 의과대학 예방의학교실) ;
  • 최남경 (서울대학교 의과대학 예방의학교실) ;
  • 김선하 (서울대학교 의과대학 예방의학교실) ;
  • 송홍지 (한림대학교 성심병원 가정의학과) ;
  • 조용균 (가천의과대학 내과학교실) ;
  • 박병주 (서울대학교 의과대학 예방의학교실)
  • Published : 2006.03.01
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Abstract

Objectives : The incidence of colorectal cancer increased greatly among the elderly in Korea, but the relationship between smoking and colon cancer remains controversial. Few studies have targeted Asian elderly people. We analyzed the smoking status, the amount smoked, and the smoking duration as risk factors of colorectal cancer to determine their association and causality. Methods: The cohort members (n=14, 103) consisted of 4,694 males and 9,409 females, and they were derived from the Korea Elderly Phamacepidemilogic Cohort (KEPEC), which was a population-based dynamic cohort. They were aged 65 years or more and they lived in Busan Metropolitan City between from 1993-1998; they were beneficiaries of the Korean Medical Insurance Corporation (KMIC). The baseline information was surveyed by a self-administered mailed questionnaire; after 8.7 person-years of mean follow up period, 100 cases of colorectal cancer occurred. The adjusted relative ratio (aRR) of smoking status, the smoking amount and the smoking duration were calculated from the Cox's proportional hazard model with the never-smokers as a reference group and the Cox model controlled for age, gender, precancerous lesions of CRC, medication history of NSAIDs & antibiotics, the alcohol drinking status and BMI. Results : Compared with the never smokers, the aRRs were 2.03 (95% CI=1.02-4.03) and 1.36 (95% CI=0.80-2.32) for the ex-smokers and current smokers, respectively. Statistical significant trends were not observed for the dose-relationship among the elderly, either for the mean daily amount smoked (p for trend=0.28) or for the total amount (p for trend=0.15). Still, the aRRs were 1.51 (95% CI=0.97-2.34) for the elderly who smoked less than 40 years and 2.35 (95% CI=1.16-4.74) for the elderly who had 40 years or more of smoking (p for trend=0.06). Smokers who started smoking before the age 20 had an increased aRR of 2.15 (95% CI=1.17-3.93) compared to the never smokers. Conclusions : After controlling for age, gender, precancerous lesion of CRC, medication history of NSAIDs & antibiotics, the alcohol drinking status and BMI, smoking increases the risk of colorectal cancer among elderly people. The age when starting smoking is also important.

Keywords

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