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Smoking: A Huge Modifiable Risk Factor for Colorectal Cancer

How patients who quit smoking can decrease their risk of colorectal cancer

March is National Colorectal Cancer Awareness Month and a great time for tobacco treament specialists and other healthcare providers to remind patients about the benefits of smoking cessation to lower their risk of this deadly cancer. Colorectal cancer is the third leading cause of cancer-death for both men and women in the U.S. and is expected to cause 52,550 deaths this year.

The latest report from the U.S. Surgeon General (2014) on smoking found that there is enough evidence to conclude that smoking is a cause of colorectal cancer. A large prospective cohort study looking at more than 180,000 people in the US found that current and former smokers had a 27% higher risk of developing colorectal cancer, even when controlling for screening and other risk factors. This risk dropped the longer a person had been quit and with earlier age of cessation. Another recent study found that women who smoke may have a higher risk of rectal cancer than their male counterparts, with risk increasing with the number of pack-years smoked.

While overall colorectal cancer diagnosis has been declining over the last few decades due to increased screening and lifestyle modifications, such as quitting smoking, the incidence in people younger than 50 has been increasing by 1-2% each year since the 1990s. This is why the US Preventative Services Taskforce recommends that regular screening for colorectal cancer begin at age 45 and continue through age 75. This can be done with either stool tests, flexible colonoscopy, CT colonography, or sigmoidoscopy.

If you are looking for good evidence-based resources, the CDC has fact sheets on risks, screening options, and other resources for patients.

For more content on smoking-related health risks, check out one of our upcoming Duke-UNC Tobacco Treatment Specialist trainings. Learn more about our tobacco comprehensive treatment specialist training or our 1-day intensive CE trainings at

About The Author

Rachael Joyner is a family nurse practitioner with the Duke Smoking Cessation Program. She holds a National Certificate in Tobacco Treatment Practice and received her Doctorate in Nursing Practice from the University of Florida. She loves working collaboratively with patients to help them become tobacco free.


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