Smoking-associated risks of conventional adenomas and serrated polyps in the colorectum

Jane C. Figueiredo, Seth D. Crockett, Dale C. Snover, Carolyn B. Morris, Gail McKeown-Eyssen, Robert S. Sandler, Dennis J. Ahnen, Douglas J. Robertson, Carol A. Burke, Robert S. Bresalier, James M. Church, Timothy R Church, John A. Baron

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Purpose: Prior studies suggest cigarette smoking is associated with 1.5- to twofold increased risk of colorectal adenomas and possibly a higher risk of serrated polyps. Further clarification of risk differences between adenomas and serrated polyps is needed with regard to co-occurrence and polyp location.

Methods: We conducted a combined analysis of conventional adenoma and serrated polyp occurrence using individual-level data from 2,915 patients participating in three colonoscopy-based clinical trials. All participants had ≥1 adenomas removed at baseline and were followed for up to 4 years. Smoking habits and other lifestyle factors were collected at baseline using questionnaires. We used generalized linear regression to estimate risk ratios and 95 % confidence intervals.

Conclusions: Cigarette smoking has only a weak association with adenomas, but is associated with a significantly increased risk of serrated polyps, particularly in the left colorectum. Since a minority of left-sided serrated polyps is thought to have malignant potential, the role of smoking in initiation phases of carcinogenesis is uncertain.

Results: Smokers were at slightly increased risk of adenomas compared to never smokers [current: RR 1.29 (95 % CI 1.11–1.49) and former: RR 1.18 (1.05–1.32)]. Smoking was associated with greater risk of serrated polyps [current: RR 2.01 (1.66–2.44); former: RR 1.42 (1.20–1.68)], particularly in the left colorectum. Associations between current smoking and occurrence of serrated polyps only [RR 2.33 (1.76–3.07)] and both adenomas and serrated polyps [RR 2.27 (1.68–3.06)] were more pronounced than for adenomas only [RR 1.31 (1.08–1.58)]. Results were similar for other smoking variables and did not differ by gender or for advanced adenomas.

Original languageEnglish (US)
Pages (from-to)377-386
Number of pages10
JournalCancer Causes and Control
Issue number3
StatePublished - Mar 2015

Bibliographical note

Funding Information:
This project has been funded in part with federal funds (N01-CO-12400, R01-CA-059005, U54-CA-100971) from the National Cancer Institute, National Institutes of Health. We thank all the individuals who participated in this clinical trial.

Publisher Copyright:
© 2014, The Author(s).


  • Adenomas
  • Colorectal
  • Serrated polyps
  • Smoking
  • Tobacco


Dive into the research topics of 'Smoking-associated risks of conventional adenomas and serrated polyps in the colorectum'. Together they form a unique fingerprint.

Cite this