J Korean Acad Nurs.  2019 Dec;49(6):713-723. 10.4040/jkan.2019.49.6.713.

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

• Jo A
• Oh H

• KMID: 2505800
• DOI: http://doi.org/10.4040/jkan.2019.49.6.713

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 longterm 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.

Keyword

Colonic Neoplasms; Metabolic Syndrome; Cigarette Smoking; Alcohol Drinking; Cohort Studies

Figure

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  Figure 1 Selection process of subject.

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  Figure 2 Follow-up period.

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  Figure 3 Cumulative incidence rate of colon cancer according to cigarette smoking and alcohol consumption in adults with metabolic syndrome.

Reference

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. DOI: 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. DOI: 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. DOI: 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. DOI: 10.1007/s11888-017-0395-0.

8. Benowitz NL. Nicotine addiction. The New England Journal of Medicine. 2010; 362(24):2295–2303. DOI: 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. DOI: 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. DOI: 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. DOI: 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. DOI: 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. DOI: 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. DOI: 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. DOI: 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. DOI: 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.

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. DOI: 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. DOI: 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. DOI: 10.14216/kjco.16015.

28. Schuit AJ, van Loon AJM, Tijhuis M, Ocké MC. Clustering of lifestyle risk factors in a general adult population. Preventive Medicine. 2002; 35(3):219–224. DOI: 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. DOI: 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. DOI: 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. DOI: 10.1038/ki.2008.328.