Cigarette smoking, alcohol, and the risk of colorectal adenomas

Gastroenterology. 1993 May;104(5):1445-51. doi: 10.1016/0016-5085(93)90354-f.


Background: The present study was designed to further assess the reported association between cigarette smoking, alcohol, and colorectal adenomas.

Methods: A number of environmental and life-style risk factors were examined in 236 patients with histologically proven adenomas and 409 controls with no adenomas.

Results: Age, sex, race, and indication for procedure were similar in cases and controls. Those who had ever smoked were not at increased risk for adenomas compared with those who had never smoked. Years of smoking, cigarettes per day, and total pack-years showed no dose-response effect. Results for men and women were similar. Alcohol was a significant risk factor for men but not for women. Men in the highest quartile of daily caloric intake from alcohol were more than four times more likely than nondrinkers to develop adenomas, with a statistically significant trend in risk from the lowest to the highest quartile. These findings persisted after controlling for other potential risk factors for adenomas. The risk for colon and rectal polyps were similar. Men in the highest tertile of beer consumption were nearly six times more likely to develop adenomas than nondrinkers.

Conclusions: Beer drinking is a risk factor for colorectal adenomas in this population.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenoma / etiology*
  • Aged
  • Alcohol Drinking / adverse effects*
  • Beer / adverse effects
  • Case-Control Studies
  • Colonic Diseases / etiology
  • Colorectal Neoplasms / etiology*
  • Diet / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polyps / etiology
  • Rectal Diseases / etiology
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects*