Associations between amount of smoking and alcohol intake and risk of colorectal neoplasm

Hazards of Recurrence, Second Primary, or Other Tumor at Ten Years After Surgery for Non-Small-Cell Lung Cancer

INTRODUCTION

Better treatment options entail the risk of multiple tumors in a patient's lifetime. We studied the incidence, risk factors, and prognostic impact of second primaries and other malignancies in patients with operated non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

We retrospectively analyzed 342 consecutive patients with curatively resected NSCLC between 2003 and 2007.

RESULTS

Among the 342 patients analyzed, 172 (50.3%) developed locoregional and/or distant recurrence; 25 (7.3%) had a second primary lung cancer, 97 (28.3%) had 1 or more malignancies other than NSCLC either in their history (n = 61; 17.8%) or following resection (n = 64; 18.7%). One hundred fifteen patients (33.6%) had a malignancy other than primary NSCLC. Eight patients developed both a second primary lung cancer and another malignancy. Older age and lower N-stage were significantly correlated with the occurrence of an additional tumor, as shown by a logistic regression nomogram. Whereas the risk of recurrence decreases over time, the risk of developing a second tumor, particularly a second primary lung cancer, remains high during up to 10 years of follow-up. One hundred seventy patients (49.7%) died of the primary (n = 158; 46.2%) or second primary (n = 12; 3.5%) NSCLC, 23 (6.7%) died of another malignancy, and 66 (19.3%) died due to unrelated causes (overall 10-year survival, 33.3%).

CONCLUSIONS

Second primary lung cancer or other malignancy occurs in 33% of patients with NSCLC; 26% of patients are affected within 10 years after resection of lung cancer. With curative treatment of secondary tumors, there is no negative influence on long-term prognosis of NSCLC; therefore, follow-up beyond 5 years is strongly advisable.

Alcohol consumption is associated with the risk of developing colorectal neoplasia: Propensity score matching analysis

Although alcohol intake is known to be associated with the development of colorectal cancer, the effect of alcohol consumption on the development of colorectal neoplasm (CRN) is unclear. We performed a retrospective cohort analysis with 1 to 1 propensity score matching in a single center of Korea. Among 1,448 patients who underwent index and surveillance colonoscopy, 210 matched pairs were analyzed. The 5-year cumulative occurrence of overall CRN after index colonoscopy was higher in the significant alcohol consumption group (defined as alcohol consumption more than 30 g/day in men and 20 g/day in women) (vs. without significant alcohol consumption group) (40% vs. 27.6%, p = 0.004). Significant alcohol consumption increased the development of overall CRN (adjusted hazard ratio [aHR]: 1.86, 95% confidence interval [CI]: 1.28–2.70, p = 0.001) at surveillance colonoscopy. However, this effect was not valid on the development of advanced CRN. In subgroup analysis considering the risk classification of index colonoscopy, significant alcohol consumption increased the overall CRN development at surveillance colonoscopy in the normal group (patients with no detected adenoma in the index colonoscopy) (aHR: 1.90, 95% CI: 1.16–3.13, p = 0.01). Alcohol consumption habits should be considered in optimizing time intervals of surveillance colonoscopy.

The impact of passive smoking on the risk of colorectal neoplasia in never, former, and current smokers

BACKGROUND AND AIM

Active smoking is well known to be a risk factor for colorectal neoplasia (CRN). However, it remains unclear whether passive smoking is also related to the risk of CRN. This study investigated the effect of passive smoking on the risk of CRN in never, former, and current smokers.

METHODS

A cross-sectional study was performed on asymptomatic examinees who underwent colonoscopy as part of a health check-up.

RESULTS

Of 136 707 participants, 33 052 (24.2%) were never passive smokers, and 103 655 (75.8%) were ever passive smokers. The mean age of the study population was 41.0 years. The proportion of never, former, and current smokers was 56.9%, 21.4%, and 24.8%, respectively, and the proportion of overall CRN and advanced CRN (ACRN) was 15.4% and 1.7%, respectively. Ever passive smoke exposure was associated with an increased risk of overall CRN in never smokers (adjusted odds ratio [AOR] 1.08; 95% confidence interval [CI] 1.02-1.13) and former smokers (AOR 1.08; 95% CI 1.00-1.17) but not in current smokers (AOR 1.02; 95% CI 0.94-1.11). Additionally, it significantly increased the risk of ACRN among never smokers (AOR 1.17; 95% CI 1.01-1.35) and tended to increase the risk of ACRN among former smokers (AOR 1.26; 95% CI 0.99-1.61). Moreover, the risk of CRN increased with increasing frequency and duration of passive smoking in never and former smokers.

CONCLUSIONS

Passive smoking was an independent risk factor for CRN in never and former smokers. Never and former smokers who are highly exposed to passive smoke as well as current smokers should be given priority for colonoscopy.

Cigarette smoke extracts induced the colon cancer migration via regulating epithelial mesenchymal transition and metastatic genes in human colon cancer cells

There was considerable evidence that exposure to cigarette smoke is associated with an increased risk for colon cancer. Nevertheless, the mechanism underlying the relationship between cigarette smoking and colon cancer remains unclear. Moreover, there were only a few studies on effects of complexing substance contained in cigarette smoke on colon cancer. Thus, we further investigated whether cigarette smoke extract (CSE) affects the cell cycle, apoptosis and migration of human metastatic colon cancer cells, SW-620. MTT assay revealed that SW-620 cell proliferation was significantly inhibited following treatments with all CSEs, 3R4F, and two-domestic cigarettes, for 9 days in a concentration-dependent manner. Moreover, CSE treatments decreased cyclin D1 and E1, and increased p21 and p27 proteins by Western blot analysis in SW-620 cells. Additionally, the treatment of the cells with CSE contributed to these effects expressing by apoptosis-related proteins. An increased migration or invasion ability of SW-620 cells following CSE treatment was also confirmed by a scratch or fibronectin invasion assay in vitro. In addition, the protein levels of E-cadherin as an epithelial maker were down-regulated, while the mesenchymal markers, N-cadherin, snail, and slug, were up-regulated in a time-dependent manner. A metastatic marker, cathepsin D, was also down-regulated by CSE treatment. Taken together, these results indicate that CSE exposure in colon cancer cells may deregulate the cell growth by altering the expression of cell cycle-related proteins and pro-apoptotic protein, and stimulate cell metastatic ability by altering epithelial-mesenchymal transition (EMT) markers and cathepsin D expression. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 690-704, 2017.