Smoking increases the risk for colorectal adenomas in patients with lynch syndrome

Renate Winkels, Akke Botma, Frnzel J.B. Van Duijnhoven, Fokko M. Nagengast, Jan H. Kleibeuker, Hans F.A. Vasen, Ellen Kampman

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background & Aims: Individuals with Lynch syndrome have a high risk of developing colorectal carcinomas and adenomas at a young age, due to inherited mutations in mismatch repair genes. We investigated whether modifiable lifestyle factors, such as smoking and alcohol intake, increase this risk. Methods: Using data from the GeoLynch cohort study, a prospective analysis of 386 subjects with Lynch syndrome, we calculated hazard ratios for the association between smoking and alcohol intake and development of colorectal adenoma. We used robust variance estimates in the calculation of 95% confidence intervals to account for dependency within families and adjusted for confounding by age, sex, smoking (in the analyses of alcohol intake), number of colonoscopies during the follow-up, colonic resection, and body mass index. Results: During a median follow-up of 10 months, 58 subjects developed a histologically confirmed colorectal adenoma. The hazard ratio for current smokers was 6.13 (95% confidence interval, 2.84-13.22) and for former smokers was 3.03 (95% confidence interval, 1.49-6.16) compared with never smokers. Among ever smokers, a higher number of pack-years was associated with an increased risk for colorectal adenoma (P for trend =.03). There was a trend of alcohol intake increasing the risk of colorectal adenomas, although this was not statistically significant; the hazard ratio for the highest tertile of intake (median, 22 g/day) vs the lowest tertile (median, 0.4 g/day) was 1.56 (95% confidence interval, 0.71-3.43). Conclusions: Among people with Lynch syndrome, current smokers have an increased risk of colorectal adenomas. Former smokers have a lower risk than current smokers, but greater risk than never smokers. Individuals with Lynch syndrome should be encouraged to avoid smoking.

Original languageEnglish (US)
Pages (from-to)241-247
Number of pages7
JournalGastroenterology
Volume142
Issue number2
DOIs
StatePublished - Jan 1 2012

Fingerprint

Hereditary Nonpolyposis Colorectal Neoplasms
Adenoma
Smoking
Alcohols
Confidence Intervals
DNA Mismatch Repair
Colonoscopy
Life Style
Colorectal Neoplasms
Body Mass Index
Cohort Studies
Mutation

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Winkels, R., Botma, A., Van Duijnhoven, F. J. B., Nagengast, F. M., Kleibeuker, J. H., Vasen, H. F. A., & Kampman, E. (2012). Smoking increases the risk for colorectal adenomas in patients with lynch syndrome. Gastroenterology, 142(2), 241-247. https://doi.org/10.1053/j.gastro.2011.10.033
Winkels, Renate ; Botma, Akke ; Van Duijnhoven, Frnzel J.B. ; Nagengast, Fokko M. ; Kleibeuker, Jan H. ; Vasen, Hans F.A. ; Kampman, Ellen. / Smoking increases the risk for colorectal adenomas in patients with lynch syndrome. In: Gastroenterology. 2012 ; Vol. 142, No. 2. pp. 241-247.
@article{c411e05a0beb4f20a887155d5fe9bbbb,
title = "Smoking increases the risk for colorectal adenomas in patients with lynch syndrome",
abstract = "Background & Aims: Individuals with Lynch syndrome have a high risk of developing colorectal carcinomas and adenomas at a young age, due to inherited mutations in mismatch repair genes. We investigated whether modifiable lifestyle factors, such as smoking and alcohol intake, increase this risk. Methods: Using data from the GeoLynch cohort study, a prospective analysis of 386 subjects with Lynch syndrome, we calculated hazard ratios for the association between smoking and alcohol intake and development of colorectal adenoma. We used robust variance estimates in the calculation of 95{\%} confidence intervals to account for dependency within families and adjusted for confounding by age, sex, smoking (in the analyses of alcohol intake), number of colonoscopies during the follow-up, colonic resection, and body mass index. Results: During a median follow-up of 10 months, 58 subjects developed a histologically confirmed colorectal adenoma. The hazard ratio for current smokers was 6.13 (95{\%} confidence interval, 2.84-13.22) and for former smokers was 3.03 (95{\%} confidence interval, 1.49-6.16) compared with never smokers. Among ever smokers, a higher number of pack-years was associated with an increased risk for colorectal adenoma (P for trend =.03). There was a trend of alcohol intake increasing the risk of colorectal adenomas, although this was not statistically significant; the hazard ratio for the highest tertile of intake (median, 22 g/day) vs the lowest tertile (median, 0.4 g/day) was 1.56 (95{\%} confidence interval, 0.71-3.43). Conclusions: Among people with Lynch syndrome, current smokers have an increased risk of colorectal adenomas. Former smokers have a lower risk than current smokers, but greater risk than never smokers. Individuals with Lynch syndrome should be encouraged to avoid smoking.",
author = "Renate Winkels and Akke Botma and {Van Duijnhoven}, {Frnzel J.B.} and Nagengast, {Fokko M.} and Kleibeuker, {Jan H.} and Vasen, {Hans F.A.} and Ellen Kampman",
year = "2012",
month = "1",
day = "1",
doi = "10.1053/j.gastro.2011.10.033",
language = "English (US)",
volume = "142",
pages = "241--247",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "2",

}

Winkels, R, Botma, A, Van Duijnhoven, FJB, Nagengast, FM, Kleibeuker, JH, Vasen, HFA & Kampman, E 2012, 'Smoking increases the risk for colorectal adenomas in patients with lynch syndrome', Gastroenterology, vol. 142, no. 2, pp. 241-247. https://doi.org/10.1053/j.gastro.2011.10.033

Smoking increases the risk for colorectal adenomas in patients with lynch syndrome. / Winkels, Renate; Botma, Akke; Van Duijnhoven, Frnzel J.B.; Nagengast, Fokko M.; Kleibeuker, Jan H.; Vasen, Hans F.A.; Kampman, Ellen.

In: Gastroenterology, Vol. 142, No. 2, 01.01.2012, p. 241-247.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Smoking increases the risk for colorectal adenomas in patients with lynch syndrome

AU - Winkels, Renate

AU - Botma, Akke

AU - Van Duijnhoven, Frnzel J.B.

AU - Nagengast, Fokko M.

AU - Kleibeuker, Jan H.

AU - Vasen, Hans F.A.

AU - Kampman, Ellen

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Background & Aims: Individuals with Lynch syndrome have a high risk of developing colorectal carcinomas and adenomas at a young age, due to inherited mutations in mismatch repair genes. We investigated whether modifiable lifestyle factors, such as smoking and alcohol intake, increase this risk. Methods: Using data from the GeoLynch cohort study, a prospective analysis of 386 subjects with Lynch syndrome, we calculated hazard ratios for the association between smoking and alcohol intake and development of colorectal adenoma. We used robust variance estimates in the calculation of 95% confidence intervals to account for dependency within families and adjusted for confounding by age, sex, smoking (in the analyses of alcohol intake), number of colonoscopies during the follow-up, colonic resection, and body mass index. Results: During a median follow-up of 10 months, 58 subjects developed a histologically confirmed colorectal adenoma. The hazard ratio for current smokers was 6.13 (95% confidence interval, 2.84-13.22) and for former smokers was 3.03 (95% confidence interval, 1.49-6.16) compared with never smokers. Among ever smokers, a higher number of pack-years was associated with an increased risk for colorectal adenoma (P for trend =.03). There was a trend of alcohol intake increasing the risk of colorectal adenomas, although this was not statistically significant; the hazard ratio for the highest tertile of intake (median, 22 g/day) vs the lowest tertile (median, 0.4 g/day) was 1.56 (95% confidence interval, 0.71-3.43). Conclusions: Among people with Lynch syndrome, current smokers have an increased risk of colorectal adenomas. Former smokers have a lower risk than current smokers, but greater risk than never smokers. Individuals with Lynch syndrome should be encouraged to avoid smoking.

AB - Background & Aims: Individuals with Lynch syndrome have a high risk of developing colorectal carcinomas and adenomas at a young age, due to inherited mutations in mismatch repair genes. We investigated whether modifiable lifestyle factors, such as smoking and alcohol intake, increase this risk. Methods: Using data from the GeoLynch cohort study, a prospective analysis of 386 subjects with Lynch syndrome, we calculated hazard ratios for the association between smoking and alcohol intake and development of colorectal adenoma. We used robust variance estimates in the calculation of 95% confidence intervals to account for dependency within families and adjusted for confounding by age, sex, smoking (in the analyses of alcohol intake), number of colonoscopies during the follow-up, colonic resection, and body mass index. Results: During a median follow-up of 10 months, 58 subjects developed a histologically confirmed colorectal adenoma. The hazard ratio for current smokers was 6.13 (95% confidence interval, 2.84-13.22) and for former smokers was 3.03 (95% confidence interval, 1.49-6.16) compared with never smokers. Among ever smokers, a higher number of pack-years was associated with an increased risk for colorectal adenoma (P for trend =.03). There was a trend of alcohol intake increasing the risk of colorectal adenomas, although this was not statistically significant; the hazard ratio for the highest tertile of intake (median, 22 g/day) vs the lowest tertile (median, 0.4 g/day) was 1.56 (95% confidence interval, 0.71-3.43). Conclusions: Among people with Lynch syndrome, current smokers have an increased risk of colorectal adenomas. Former smokers have a lower risk than current smokers, but greater risk than never smokers. Individuals with Lynch syndrome should be encouraged to avoid smoking.

UR - http://www.scopus.com/inward/record.url?scp=84856153402&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856153402&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2011.10.033

DO - 10.1053/j.gastro.2011.10.033

M3 - Article

C2 - 22062356

AN - SCOPUS:84856153402

VL - 142

SP - 241

EP - 247

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 2

ER -

Winkels R, Botma A, Van Duijnhoven FJB, Nagengast FM, Kleibeuker JH, Vasen HFA et al. Smoking increases the risk for colorectal adenomas in patients with lynch syndrome. Gastroenterology. 2012 Jan 1;142(2):241-247. https://doi.org/10.1053/j.gastro.2011.10.033