Original ResearchClincal—Alimentary TractSmoking Increases the Risk for Colorectal Adenomas in Patients With Lynch Syndrome
Section snippets
Population
Details of the prospective cohort of individuals with Lynch syndrome (the GeoLynch study) were described earlier.19 In short, we identified subjects known to have a pathogenic mutation in one of the mismatch repair genes—as confirmed by a clinical genetics center—through the Netherlands Foundation for the Detection of Hereditary Tumors in Leiden, the Radboud University Nijmegen Medical Centre, and the University Medical Centre in Groningen, The Netherlands. Participants had to be
Results
During a median follow-up of 10 months, 58 of 386 subjects in our cohort developed a histologically confirmed colorectal adenoma. Table 1 shows that these subjects were slightly older, slightly less educated, and more often men compared to the total cohort. In addition, these subjects were more likely to have had colorectal adenomas in the past and to have had at least one colonoscopy during follow-up compared with the total cohort. There were more smokers and former smokers, and alcohol intake
Discussion
In people with Lynch syndrome, current smoking was associated with a more than 6-fold increased risk, whereas former smoking was associated with a 2-fold increased risk compared with never smoking. Although there was a trend for alcohol increasing the risk of colorectal adenomas in our cohort of persons with Lynch syndrome, this was not statistically significant after adjusting for smoking.
Two retrospective cohort studies found that smoking was associated with increased risk of colorectal
Acknowledgments
We are indebted to all study participants for their cooperation. The authors thank Mary Velthuizen and Alice Donselaar (Netherlands Foundation for Detection of Hereditary Tumors), Maria van Vugt (Radboud University Nijmegen Medical Center), and Leontien Witjes (Wageningen University) for assistance with participant recruitment and data collection. The medical specialists of the participants are gratefully acknowledged for their collaboration.
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Loss of mismatch repair promotes a direct selective advantage in human stem cells
2022, Stem Cell ReportsCitation Excerpt :The exciting aspect of this prediction is that, if we can understand the environmental exposures that result in the selective pressures driving expansion of MMR-deficient cells, then we could intervene to prevent this and, thus, reduce tumorigenesis. One exposure that is a known risk factor for cancer in patients with LS is smoking (Brand et al., 2006; Diergaarde et al., 2007; Pande et al., 2010; Watson et al., 2004; Winkels et al., 2012), which results in exposure of colonic cells to a number of genotoxic compounds such as polycyclic aromatic hydrocarbons, N-nitrosamines, and various free radicals and oxidants that cause increased oxidative stress (Godschalk et al., 2002). Persistent oxidative stress can also arise from chronic inflammation (Todoric et al., 2016), another potential risk factor for cancer in patients with LS.
Identification and management of patients with Lynch syndrome
2019, Presse MedicaleHereditary Colorectal Cancer Syndromes
2019, Seminars in Oncology NursingCitation Excerpt :This is a growing area of study. A higher risk for developing colorectal adenomas has been described among individuals with LS who smoke,16 are overweight,17 or have dietary patterns high in meat or snacking.18 In addition, extended aspirin use has been shown to significantly decrease the risk for colorectal cancer among individuals with LS.
Cancer prevention in hereditary colorectal cancer syndromes: Chemoprevention and lifestyle changes
2018, Seminars in Colon and Rectal SurgeryCitation Excerpt :As part of the GEOLynch study, the effect of smoking was analyzed over a 10-month follow-up period. Compared to a reference of never-smokers, the HR for adenoma formation in current-smokers was 6.13 (95% CI 2.84-13.22) and former smokers 3.03 (95% CI 1.49-6.16) with an upward trend in risk that correlated to pack-year history.41 In a multicenter cohort study including the Colon Cancer Family Registry and MD Anderson Cancer Center Registry, this “dose dependent” relationship was demonstrated, with light smoking (<10 cigarettes a day) and a shorter duration of smoking (<10 years) associated with decreased risk for CRC (HR 0.51, 95CI 0.29-0.91).
Conflicts of interest The authors disclose no conflicts.
Funding This work was financially supported by the Dutch Cancer Society (grant UW-2005-3275); Wereld Kanker Onderzoek Fonds (WCRF NL) and World Cancer Research Fund International (WCRF International). Sponsors were not involved in the study design or in the collection, analysis, and interpretation of data.