Public Release: 

Smoking found to be an important risk factor for colorectal polyps

Researchers recommend screening smokers at an earlier age

American College of Gastroenterology

SEATTLE (October 21, 2002)--Stony Brook University researchers have identified smoking as a key risk factor for colorectal polyps. Rajeev Attam, M.D., and colleagues analyzed the medical records of 1,566 consecutive patients who had a screening colonoscopy, and they found that the incidence of polyps was higher among current smokers than ex-smokers or non-smokers. Ex-smokers were defined as people who had quit more than 10 years ago but had smoked for more than 10 years. The results of the study will be presented at the 67th Annual Scientific Meeting of the American College of Gastroenterology.

"It is well established that family history of colon cancer is predictive of colorectal polyps, but our statistical analysis indicates that being a current smoker is equally predictive," said Dr. Attam, the lead author of the study. "Polyps were found in about 19 percent of ex-smokers and about 17 percent of non-smokers, whereas 25 percent of smokers had polyps."

The Stony Brook scientists collected data for 354 smokers, 364 ex-smokers, and 848 non-smokers who had a screening colonoscopy between December 1999 and April 2002. In addition to noting the colonoscopy results, the researchers examined data for age, sex, family, and personal history of colon cancer, smoking habits, alcohol and wine consumption habits, fruit and vegetable intake, body mass index, weekly exercise habits, and history of inflammatory bowel disease.

"Perhaps an even more important finding is that a much larger proportion of the smokers had more than two polyps, had a polyp larger than 1 centimeter, or had a polyp with a greater potential for malignancy. These differences had high statistical significance," said Dr. Attam.

"Although current guidelines recommend that people with average risk start screening colonoscopy at age 50, our results suggest that physicians should consider performing screening colonoscopy in current smokers before age 50."


The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal (GI) tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. Consumers can get more information on GI diseases through the following ACG-sponsored programs:

  • 1-800-978-7666 (free brochures on common GI disorders, including ulcer, colon cancer, gallstones, and liver disease)
  • 1-800-HRT-BURN (free brochure and video on heartburn and GERD)
  • (ACG's Web site)

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