Japanese Journal of Clinical Oncology Advance Access originally published online on January 19, 2006
Japanese Journal of Clinical Oncology 2006 36(1):25-39; doi:10.1093/jjco/hyi207
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© 2006 Foundation for Promotion of Cancer Research
Tobacco Smoking and Colorectal Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population
1 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 2 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, 3 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, 4 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, 5 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya and 6 Department of Epidemiology and Preventive Medicine, Gifu University School of Medicine, Gifu, Japan
For reprints and all correspondence: Tetsuya Mizoue, Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan. E-mail: mizoue{at}phealth.med.kyushu-u.ac.jp
Received August 28, 2005; accepted October 12, 2005
Background: It is unclear whether tobacco smoking is related to colorectal cancer risk in Japan. We evaluated the association among the Japanese population based on a systematic review of epidemiologic evidence.
Methods: Original data were obtained from searches of MEDLINE using PubMed, complemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.
Results: A total of six cohort studies and 15 case–control studies were thus identified. A substantial degree of heterogeneity was observed in the association between smoking and colon cancer; most case–control studies published before 1994 reported an inverse association, whereas studies conducted over the last decade did not find any significant association. Recent cohort studies have shown a non-significant 20–40% increase in colon cancer risk associated with current smoking. Several recent case–control studies and some cohort studies have identified a weak to strong positive association between smoking and rectal cancer.
Conclusion: We conclude that tobacco smoking possibly increases the risk of colorectal cancer among the Japanese population. More specifically, tobacco smoking may possibly increase the risk of rectal cancer; however, epidemiologic evidence is still insufficient to demonstrate any clear association with colon cancer.
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