Background: Colorectal cancer can be treated by surgical resection combined with radiotherapy and chemotherapy to achieve satisfactory short-term efficacy, but it is easy to relapse. Smoking is closely related to the risk of a variety of malignant tumors, but the relationship between smoking and colorectal cancer recurrence is not clear. The purpose of this study is to further explore the relationship between smoking cessation and colorectal recurrence based on the data from the National Health and Nutrition Examination Survey (NHANES).
Methods: Based on ten surveys conducted by the NHANES project from 1999 to 2018 (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, 2017-2018), the patients with established colorectal cancer were included as the case group. Non-cancer individuals were included in a 1:1 matching according to age and sex as the control group.. Factors related to colorectal cancer were analyzed. The colorectal cancer patients were further divided into the recurrence group and the non-recurrence group, and multivariate logistic regression analysis was used to analyze the factors related to recurrence.
Results: In the matched study of colorectal cancer patients and non-cancer individuals, the results of multivariate Logistic regression analysis showed that alcohol consumption, smoking history, and aspirin use were all significantly associated with colorectal cancer. Among colorectal cancer patients, the average age, the rate of alcohol consumption, and the rate of having a smoking history in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05), while the rate of aspirin use was lower than that in the non-recurrence group (P < 0.05). Among patients with different smoking statuses, the recurrence rate was the highest in current smokers with colorectal cancer and the lowest in those without a smoking history (P < 0.05).The results of multivariate Logistic regression analysis showed that age, aspirin use, alcohol consumption history, and smoking history were all closely related to the recurrence of colorectal cancer (P < 0.05).
Conclusion: Smoking is closely related to the recurrence of colorectal cancer. Smoking cessation may be beneficial to reduce the recurrence rate of colorectal cancer after surgery.