caa a22 4500 397564414 CHVBK 20180308164824.0 cr unu---uuuuu 161202e19961204xx s 000 0 eng 10.1093/jnci/88.23.1717 doi (NATIONALLICENCE)oxford-10.1093/jnci/88.23.1717 Tobacco, Colorectal Cancer, and Adenomas: a Review of the Evidence [Elektronische Daten] [Edward Giovannucci, Maria Elena Martinez] Although tobacco has been clearly implicated as a cause of a number of cancers, earlier studies had not generally found cigarette smokers to be at higher risk for cancers of the large bowel. Unlike the earlier studies, more recent studies have tended to find cigarette smokers to be at higher risk of colorectal cancer. In addition, cigarette smoking has been consistently associated with a higher risk of colorectal adenomas, precursors of cancers. We hypothesize that smoking is an initiator of colorectal carcinogenesis. The consistent finding of a positive association between smoking and risk of adenomas may reflect the presumably shorter induction period for these lesions. Recent studies indicate that an increased risk for large-bowel cancer emerges only after about four decades after one begins smoking, perhaps accounting for the null studies that were conducted earlier during the smoking epidemic. Most studies had not taken into account an induction period between timing of smoking and risk for cancer. The increasing male-to-female mortality ratio from colorectal cancer over the latter half of this century in the United States may have been a result of tobacco use by men earlier in the century. If the associations observed with colorectal adenomas and cancers in recent studies are causal, approximately 20% of the large-bowel cancers in men would be attributable to smoking. On the basis of the strength of the available evidence, intensified effort to prevent smoking among young people is warranted. [J Natl Cancer Inst 1996;88:1717-30] © Oxford University Press REVIEW nationallicence Giovannucci Edward Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston, MA aut Martinez Maria Elena Department of Nutrition, Harvard School of Public Health Boston aut JNCI: Journal of the National Cancer Institute Oxford University Press 88/23(1996-12-04), 1717-1730 0027-8874 88:23<1717 1996 88 jnci https://doi.org/10.1093/jnci/88.23.1717 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jnci/88.23.1717 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Giovannucci Edward Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston, MA aut NATIONALLICENCE 700 1- Martinez Maria Elena Department of Nutrition, Harvard School of Public Health Boston aut NATIONALLICENCE 773 0- JNCI: Journal of the National Cancer Institute Oxford University Press 88/23(1996-12-04), 1717-1730 0027-8874 88:23<1717 1996 88 jnci Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford