DOI QR코드

DOI QR Code

Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study

대사증후군 성인의 흡연 및 음주 상태가 대장암 발생 위험에 미치는 영향: 전향적 코호트 연구

  • Received : 2019.03.15
  • Accepted : 2019.11.20
  • Published : 2019.12.31

Abstract

Purpose: The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24. Results: During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42). Conclusion: Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

Keywords

References

  1. World Health Organization. The global cancer observatory in Republic of Korea [Internet]. Lyon: International Agency for Research on Cancer; c2018 [cited 2018 Nov 3]. Available from: http://gco.iarc.fr/today/data/factsheets/populations/410-korea-republic-of-fact-sheets.pdf.
  2. World Health Organization. The global cancer observatory: Colorectal cancer [Internet]. Lyon: International Agency for Research on Cancer; c2018 [cited 2018 Nov 3]. Available from: http://gco.iarc.fr/today/data/factsheets/cancers/10_8_9-Colorectum-fact-sheet.pdf.
  3. Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: A systematic review and meta-analysis. Diabetes Care. 2012;35(11):2402-2411. https://doi.org/10.2337/dc12-0336
  4. Peng F, Hu D, Lin X, Chen G, Liang B, Zhang H, et al. Preoperative metabolic syndrome and prognosis after radical resection for colorectal cancer: The Fujian prospective investigation of cancer (FIESTA) study. International Journal of Cancer. 2016;139(12):2705-2713. https://doi.org/10.1002/ijc.30404
  5. National Health Insurance Service (NHIS). 2016 Health examination statistical yearbook [internet]. Wonju: NHIS; c2017 [cited 2018 Mar 30]. Available from: http://www.nhis.or.kr/bbs7/boards/B0039/24877.
  6. Ko S, Yoon SJ, Kim D, Kim AR, Kim EJ, Seo HY. Metabolic risk profile and cancer in Korean men and women. Journal of Preventive Medicine and Public Health. 2016;49(3):143-152. https://doi.org/10.3961/jpmph.16.021
  7. Hughes LAE, Simons CCJM, van den Brandt PA, van Engeland M, Weijenberg MP. Lifestyle, diet, and colorectal cancer risk according to (epi)genetic instability: Current evidence and future directions of molecular pathological epidemiology. Current Colorectal Cancer Reports. 2017;13(6):455-469. https://doi.org/10.1007/s11888-017-0395-0
  8. Benowitz NL. Nicotine addiction. The New England Journal of Medicine. 2010;362(24):2295-2303. https://doi.org/10.1056/nejmra0809890
  9. Kim JY, Jung EJ, Won YS, Lee JH, Shin DY, Seo KI. Cultivated orostachys japonicus induces apoptosis in human colon cancer cells. Korean Journal of Food Science and Technology. 2012;44(3):317-323. https://doi.org/10.9721/kjfst.2012.44.3.317
  10. Croft B, Reed M, Patrick C, Kovacevich N, Voutsadakis IA. Diabetes, obesity, and the metabolic syndrome as prognostic factors in stages I to III colorectal cancer patients. Journal of Gastrointestinal Cancer. 2019;50(2):221-229. https://doi.org/10.1007/s12029-018-0056-9
  11. Hursting SD, DiGiovanni J, Dannenberg AJ, Azrad M, LeRoith D, Demark-Wahnefried W, et al. Obesity, energy balance, and cancer: New opportunities for prevention. Cancer Prevention Research. 2012;5(11):1260-1272. https://doi.org/10.1158/1940-6207.capr-12-0140
  12. Boffetta P, Hashibe M, La Vecchia C, Zatonski W, Rehm J. The burden of cancer attributable to alcohol drinking. International Journal of Cancer. 2006;119(4):884-887. https://doi.org/10.1002/ijc.21903
  13. Kwon SK, Kim JW, Kim NK. 5,10-Methylenetetrahydrofolate reductase 677C>T polymorphism and microsatellite instability in sporadic colorectal cancer. Korean Journal of Clinical Oncology. 2013;9(2):80-86. https://doi.org/10.14216/kjco.13015
  14. Ministry of Health and Welfare. Statistics of current smoking and alcohol drinking [Internet]. Daejeon: Statistics Korea; c2017 [cited 2019 Feb 28]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_11702_N001&conn_path=I2.
  15. Hamada T, Nowak JA, Masugi Y, Drew DA, Song M, Cao Y, et al. Smoking and risk of colorectal cancer sub-classified by tumor-infiltrating T cells. Journal of the National Cancer Institute. 2019;111(1):42-51. https://doi.org/10.1093/jnci/djy137
  16. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome. Circulation. 2009;120(16):1640-1645. https://doi.org/10.1161/circulationaha.109.192644
  17. Statistics Korea. Middle income bracket [Internet]. Daejeon: Statistics Korea; c2010 [cited 2018 Nov 2]. Available from: http://kostat.go.kr/incomeNcpi/income/income_dg/4/4/index.static.
  18. Park JH. Measuring BMI cutoff points of Korean adults using morbidity of BMI-related diseases. The Korean Journal of Obesity. 2011;20(1):36-43. https://doi.org/10.7570/kjo.2011.20.1.36.
  19. Oh JE. Association between smoking status and metabolic syndrome in men. The Korean Journal of Obesity. 2014;23(2):99-105. https://doi.org/10.7570/kjo.2014.23.2.99
  20. National Cancer Institute (NIH). NCI dictionary of cancer terms [Internet]. Bethesda (MD): NIH; c2014 [cited 2018 Nov 2]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year.
  21. World Health Organization (WHO). Global status report on alcohol and health 2018. Geneva: WHO; 2018. p. 38-58.
  22. Bae JM, Park GH. An illustrated guide to medical statistics using SPSS. Seoul: Hannarae; 2012. p. 190-204.
  23. Kang DY. Statistics analysis of KoGES cohort data. Paper presented at: The First Training Workshop Utilizing the KoGES Data; 2018 Sep 10; Seoul, Korea.
  24. Byeon JS. Special review: Endoscopic therapy of early colon cancer. The Korean Journal of Medicine. 2010;79(2):119-124.
  25. Zhao J, Halfyard B, Roebothan B, West R, Buehler S, Sun Z, et al. Tobacco smoking and colorectal cancer: A population-based case-control study in Newfoundland and Labrador. Canadian Journal of Public Health. 2010;101(4):281-289. https://doi.org/10.1007/bf03405287
  26. Pande M, Lynch PM, Hopper JL, Jenkins MA, Gallinger S, Haile RW, et al. Smoking and colorectal cancer in Lynch syndrome: Results from the colon cancer family registry and The University of Texas M.D. Anderson Cancer Center. Clinical Cancer Research. 2010;16(4):1331-1339. https://doi.org/10.1158/1078-0432.CCR-09-1877
  27. Park SW, Lee DW, Park JW, Ryoo SB, Shin R, Jeong SY, et al. Impact of body mass index on overall survival after surgery for colorectal cancer. Korean Journal of Clinical Oncology. 2016;12(2):91-96. https://doi.org/10.14216/kjco.16015
  28. Schuit AJ, van Loon AJM, Tijhuis M, Ocke MC. Clustering of lifestyle risk factors in a general adult population. Preventive Medicine. 2002;35(3):219-224. https://doi.org/10.1006/pmed.2002.1064
  29. Park MK, Kim JH. Effects of a comprehensive lifestyle improvement program for middle-aged women with cardio-cerebrovascular disease-related risk factors. Journal of Korean Academy of Community Health Nursing. 2013;24(2):111-122. https://doi.org/10.12799/jkachn.2013.24.2.111
  30. Cho SH. Effects of a smoking cessation education on smoking cessation, endothelial function, and serum carboxyhemoglobin in male patients with variant angina. Journal of Korean Academy of Nursing. 2012;42(2):190-198. https://doi.org/10.4040/jkan.2012.42.2.190
  31. Dekker FW, de Mutsert R, van Dijk PC, Zoccali C, Jager KJ. Survival analysis: Time-dependent effects and time-varying risk factors. Kidney International. 2008;74(8):994-997. https://doi.org/10.1038/ki.2008.328

Cited by

  1. Motivational Factors for Smoking Behaviors in Individuals with Metabolic Syndrome vol.15, 2021, https://doi.org/10.2147/ppa.s343874