Cigarette smoking's impact lingers after quitting: Current, former smokers may face impaired pancreatic duct cell function, elevated colorectal cancer risk

In a separate smoking-related study also released at the ACG meeting, "Smoking Cessation and the Risk for Advanced Neoplasia: Risk for Women Persists Longer than for Men," researchers from the University of Connecticut found that the risk of advanced pre-cancerous tissue changes (neoplasia) was significantly elevated for women -- even if they stopped smoking -- but not for men--suggesting that the impact of smoking in women has a longer effect than in men.

In the study, "Cigarette Smoking Impairs Pancreatic Duct Cell Function," researchers from Center for Pancreatic Disease at Brigham and Women's Hospital in Boston assessed pancreatic duct cell function in smokers and non-smokers (current and past). A total of 131 subjects (74 smoked and 57 never smoked) underwent secretin-stimulated endoscopic pancreatic function testing (ePFT), for pancreatic fluid bicarbonate analysis. Cigarette smoking exposure was found to be associated with an abnormal ePFT result, and there was no statistical difference in peak bicarbonate concentration between current and former smokers, according to the results.

The risk of pancreatic duct cell dysfunction was 56.78 percent in former or current smokers and 26.32 percent in nonsmokers, according to Vivek Kadiyala, MD, who presented the findings. "Our data suggests the risk of duct cell dysfunction was doubled in patients who smoked compared to nonsmokers," said Dr. Kadiyala.

"These findings indicate that anyone with a history of smoking, either current or past is at greater risk of impaired pancreatic duct cell function," said Dr. Kadiyala. "Additionally, the findings underscore the value that early smoking cessation may have for patients with chronic pancreatitis and as a result healthcare providers should advise patients to quit smoking as part of their overall treatment plan."

Elevated Colorectal Cancer Risk for Women, Even After Smoking Cessation

Even after women quit smoking they are still at an increased risk for colorectal cancer, according to researchers at the University of Connecticut who examined the risk of advanced neoplasia in 2428 male and female patients over age 45 who have quit smoking.

The recent ACG colorectal cancer screening guidelines include smoking as a risk factor that should be considered when screening for colorectal cancer. Although the risk for neoplasia increases after 10 pack years of exposure, there is little data regarding the risk for advanced neoplasia after quitting.

"The risk of advanced neoplasia was significantly elevated for women and men whether they were current smokers and/ or former smokers who quit within five years of screening colonoscopy," said Joseph C. Anderson, MD, FACG, also of the White River Junction VA Medical Center in Vermont, who presented the findings. "The risk was elevated for female smokers who quit six to ten years prior to screening but not for male smokers."

Dr. Anderson said the data suggests that the impact of smoking has a longer effect in women than in men, and that the data could have an impact on colorectal cancer screening in male versus female smokers. "If smoking is used as a factor for determining when to begin screening, for example, we might have different parameters for men and women."