Colorectal cancer: tobacco and alcohol forward about ten years the onset

The alcohol and tobacco lead of almost ten years the age of onset of colorectal cancer and promotes the appearance of distal forms of the disease in men, according to results of a study published in the "Archives of Internal Medicine. "

Colorectal cancer remains the second leading cause of cancer deaths in France. Screening at fifty is reserved for people with a medium level of risk, mainly determined by the presence of hereditary factors. However, the number of neoplastic lesions found during a colonoscopy performed in people aged forty to fifty years, and asymptomatic with no hereditary factor proves far from negligible, say Anna Zisman and colleagues at the University Northwestern.

According to them, the general recommendations can be optimized, and only a more individualized approach, taking into account all the risk factors, both hereditary and environmental, could lead to a breakthrough in testing.

They therefore conducted a large retrospective study to assess the value of taking account of smoking and alcohol consumption to identify the age and conditions of screening for colorectal cancer.

Among the 166,172 patients included in the study (50% male), the vast majority (89%) had an adenocarcinoma, the other being diagnosed with mucinous adenocarcinoma.

After adjustment to take into account the influence of different variables, the authors found that the use of alcohol and / or tobacco consumers were younger at diagnosis. The average age of diagnosis of the disease in people who have never drunk alcohol or never smoked cigarettes rose to 71.3 years, against 62.6 years among consumers of these two substances.

The researchers also examined the effect of alcohol and tobacco on the location of colorectal cancer. It is clear from their analysis that consumers of alcohol and tobacco tend to have a distal form of the disease, closer rectum, but this effect is dissipating with smoking cessation.

Finally, the impact of tobacco appears to be greater in women than in men, which is not the case of alcohol, the authors report, however, admit that they do not know if this difference is due to social factors (inhalation rate, type of cigarettes smoked) or biological (hormonal, genetic).

Now remains to confirm these findings in other studies. If necessary, it would reinforce the idea of advancing age of colorectal cancer screening among consumers of alcohol and tobacco and adjust the technique chosen (colonoscopy or sigmoidoscopy) in terms of risk factors, the researchers conclude.