Tobacco use and colorectal cancer survival: P129

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Aim:Nicotine has been implicated as a modifier of cancerprogression and thus possibly of cancerprognosis. We investigated the effect of tobacco use, including smoking and use of Scandinavian moist snuff (‘snus’), on colorectal cancer survival in a large cohort of Swedish male construction workers.Method:The cohort comprised of 336 381 workers with detailed information on tobacco use at health check-ups during 1971-1992. Complete follow-up was accomplished via linkage to population and health registers, and 4393 colorectal cancer cases were identified through 2007. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for cancer-specific death were derived from Coxproportional hazards regression models adjusted for age, body mass index and period of diagnosis. Cases that were never-users of any tobacco served as reference.Results:Tobacco use was not associated with an increased risk of colorectal cancer-specific death (HR 1.04, 95%CI 0.93-1.15). Tobacco use was not significantly linked to colon cancer survival, whereas smokers had a slightly increased risk of rectal cancer-specific death (HR 1.19, 95%CI 1.00- 1.43).Conclusion:There was no strong association between tobacco use and colorectal cancer survival. A borderline significantly increased risk of rectal cancer death among smokers was, however, noted. Reasons for this possible difference between cancer sites are unknown.

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