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Carcinogenesis. 2003 Mar;24(3):565-71.

Cigarette smoking and genetic alterations in sporadic colon carcinomas.

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  • 1Division of Human Nutrition and Epidemiology, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.


Cigarette smoking has been inconsistently associated with colon cancer risk. To evaluate the hypothesis that smoking is primarily linked to a specific colon tumor subgroup(s), we assessed associations between smoking and the occurrence of mutations in the APC, K-ras and p53 genes, p53 overexpression, and microsatellite instability (MSI) in a Dutch population-based case-control study on sporadic colon carcinomas. The study population consisted of 176 cases and 249 controls. Smoking status (never, ever), number of cigarettes smoked per day (never, <15, > or =15), total years of smoking (never, < or =30, >30), and years since first started smoking (never, < or =35, >35) were all evaluated. Cigarette smoking status was significantly differently related to p53 overexpression-positive (p53(pos)) tumors compared with p53 overexpression-negative (p53(neg)) tumors (p53(pos) versus p53(neg), OR 0.4, 95% CI 0.2-0.9), as well as to tumors with transversion mutations in APC, K-ras or p53 (transv(+)) compared with tumors without transversion mutations in one of these genes (transv(-)) (transv(+) versus transv(-), OR 2.5, 95% CI 1.0-5.9). Positive associations were observed with p53(neg) tumors and transv(+) tumors when compared with the population-based controls (ever versus transv(-), OR 1.5, 95% CI 0.9-2.8 and OR 2.2, 95% CI 0.9-5.6, respectively), inverse associations with p53(pos) tumors and transv(-) tumors (ever versus never, OR 0.5, 95% CI 0.3-1.0 and OR 0.8, 95% CI 0.5-1.3, respectively). Similar patterns of association were observed for the other smoking variables evaluated. In addition, although statistically non-significant, smoking was more notably positively associated with tumors that exhibit K-ras mutations, especially K-ras transversion mutations, than with tumors without K-ras mutations. An inverse relationship between smoking and the occurrence of APC mutations was suggested, whereas no clear associations were observed with MSI. Our data suggest that smoking-related colon cancers develop through a p53(neg) pathway and that smoking particularly results in colon carcinomas with transversion mutations.

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