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Apr 13 06 1:45 AM
Smokers and Drinkers Get Head Start on Colorectal Cancer By Neil Osterweil, MedPage Today Staff Writer Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of California, San Francisco March 28, 2006 Source News Article: CBS News, Forbes, MSNBC MedPage Today Action Points
Explain to applicable patients that this study suggests that men and women who drink alcohol or smoke cigarettes, or do both, seem to be at a higher risk than non-smokers/drinkers for early onset colorectal cancer.
Suggest to these patients a need for vigilance about screening for colorectal cancer.
Review EVANSTON, Ill., March 28 - Men and women who smoke or drink, or either, have a likelihood of developing colorectal cancer five to eight years earlier than abstemious persons, reported researchers here.
Moreover, their review of records on more than 161,000 patients with colorectal cancer revealed that men as a gender tended to develop colorectal cancer about two years earlier than women, according to Hemant K. Roy, M.D., and colleagues at Northwestern.
The study, published in the March 27 Archives of Internal Medicine, indicated that patients who both smoked cigarettes and drink alcohol were likely to develop the disease about eight years earlier than non-smoking teetotalers. Smoking but not drinking had a greater effect on women than men.
"Our report provides compelling evidence that modifiable risk factors such as alcohol and tobacco use are associated with a younger age at diagnosis and a predilection for distal colorectal cancer," the authors wrote.
"These data underscore the need for cessation of alcohol and tobacco use as an integral part of a colorectal cancer prevention program," they continued. "If replicated in other data sets, our findings would argue that screening should be initiated at a younger age in alcohol and tobacco users."
To determine how risk factors such as lifestyle choice and gender could affect the incidence of colorectal cancer, the authors used data from a commercial cancer database (IMPAC Medical Registry Services Cancer Information Resource File).
They gathered data on people diagnosed with colorectal cancer diagnosed from June 1, 1993, to December 31, 2003, and classified them into current, past, or never-users of alcohol and tobacco.
They used logistic regression modeling for location of tumors (proximal or distal), and linear regression modeling for age at diagnosis and the variables that included gender, race insurance status.
Looking at data on a total of 161,172 patients with colorectal cancer, the authors found that current drinking and current smoking were each associated with 5.2 years younger age at onset, and the two combined were associated with a 7.8-year head start for disease onset (P<0.001 for all). Men also tended to develop cancer 1.9 years earlier than women (P<0.001).
Drinkers were about 20% more likely than non-drinkers to have distal cancers (odds ratio, 1.192, 95% confidence interval, 1.15-1.23), and smokers were about 16% more likely than non-smokers to have distal tumors (odds ratio, 1.164; 95% CI, 1.12-1.21). Men were also significantly more likely than women to have tumors in a distal location (odds ratio, 1.42, P<0.001).
The effects of smoking but not drinking on age of onset were greater among women than among men (adjusted age difference, 2.6 years; P<0.001).
"This is the first report, to our knowledge, to demonstrate that alcohol and tobacco use is associated with a younger age at colorectal cancer presentation," the investigators wrote. "The magnitude of effect suggests clinical applicability for the timing of screening initiation. Furthermore, alcohol and tobacco use along with male gender increased the probability of distal cancers, possibly having relevance to the choice of screening modality."
Primary source: Archives of Internal Medicine Source reference: Zisman AL et al.
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Copied from the post Crutches to Quit Smoking
The casual suggestion of celebrating successfully not smoking for a given time period with an alcoholic beverage of any kind really does not belong at a site dealing with treating a drug addiction. Are there people who may celebrate this way here at Freedom? Sure there are--I suspect that a lot of our members drink occasionally. But there are some members and readers here who don't drink to celebrate either by personal choice or, because they can no longer drink to celebrate without having to drink all of the time whether there is anything to celebrate or not. These are people who are recovering alcoholics and who hopefully know their own limitations. I suspect that some of these people may be put off by the suggestion of using alcohol to celebrate quitting smoking. Also, there are likely members and readers here who while they may not be alcoholic themselves, they may have family members and friends who are and who may think that buying wine to share with these people is not an appropriate method of celebrating breaking free from the nicotine addiction.
As it says above:
Freedom is a quit smoking education and support site. We try to get the message out that life goes on without smoking--things you could do before can still be done after quitting. Things that could not be done before, such as safe or controlled drinking for a recovering alcoholic cannot be done now either. So as a general rule of thumb now, we are asking members to minimize the amount of time they are posting about drinking at this site. We have ample strings to cover alcohol issues. We will continue to bring them up as holidays come up, and around weekends where drinking situations are often encountered more frequently. But we ask that people who are regular users of alcohol not to raise the issue over and over again.
All posting members need to stay cognizant of this concept. It is not saying that issues involving drinking cannot be discussed. Again, if a person finds him or herself in a social drinking situation and it creates smoking thoughts, or if a person is nervous about how to get through a party or gathering where he or she will be drinking, it is totally legitimate to raise these concerns and for others to explain how they deal with such circumstances. Suggesting or encouraging the use of alcohol though to others who you do not know their full histories on is a risky proposition.
As we discuss in the thread The Freedom Classroom
Every person posting at Freedom has an awesome responsibility because every word you are writing is capable of influencing hundreds or even thousands of people. Considering what we are trying to influence them to do, which is to quit smoking and to save their lives, it is easy to see how why we feel that this is indeed an awesome responsibility.
So everyone be aware and stay cognizant to the fact any advice written on this board is being read by hundreds to thousands of people. Make sure that any specific suggestions that you are sharing is sound advice for all people. Offering celebratory drinks to all people is an unwarranted suggestion in the event the people who you may be making the offer to are people in recovery from alcohol.
It is similar to our members getting offered a cigar to celebrate the birth of a baby or other special occasions. While the act may seem acceptable to some people in some social circles, I think most of our members and readers would feel that this act would be uncomfortable to say the least, and in poor taste if the offer was being made by a person who knew you had quit smoking, and that you had made it clear to that person that you realize that you are a nicotine addict and cannot smoke without relapsing.
Be prepared that such offers may occur from others. Offers for drinks will likely happen at times even if you are a person who is in recovery from alcohol. Understand that if you are a person in recovery that the reason that you have maintained your sobriety up to this point is that you have worked out some sort of response to deal with such offers and the bottom line is that it is your responsibility to stick to your commitment not to drink.
The same concept holds true for all of our members regarding smoking. I hope most of our members and readers never find themselves feeling that there is a right time to pass along a cigar or any tobacco product to another person to celebrate any event. All members and readers must be aware though that offers of tobacco products to you can occur over time. Once again, it is the personal responsibility of each member and reader to sustain his or her own quit even at such times by remembering that in spite of the nature of these offers that the only way to sustain your own quit and truly have something to celebrate is to stick to your own personal commitment to never take another puff.
Joel
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