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The Effect of Smoking on the Number and Type of Rectal Aberrant Crypt Foci (ACF)—First Identifiable Precursors of Colorectal Cancer (CRC)

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Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury, 10-082 Olsztyn, Poland
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Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, 10-082 Olsztyn, Poland
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Department of Anatomy, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland
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Department of Emergency Medicine and Disaster Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland
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2nd Department of General, Gastroenterologic and Gastrointestinal Oncologic Surgery, Medical University of Lublin, University Hospital No.1, 20-059 Lublin, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(1), 55; https://doi.org/10.3390/jcm10010055
Received: 14 November 2020 / Revised: 8 December 2020 / Accepted: 23 December 2020 / Published: 26 December 2020
(This article belongs to the Section Oncology)
Background: The problem of smoking and its influence on the occurrence of precursors and advanced colorectal cancer is often discussed in the medical literature. Tobacco smoke can provide a non-nutritional source of polycyclic hydrocarbons and other substances which, when combined with an incorrect diet, may play a role in promoting carcinogenesis at the level of the genetic control mechanism. The aim of our study was to assess the effect of smoking on the frequency and type of aberrant crypt foci (ACF) in the rectum and polyps in the large intestine in people who smoke more than 20 cigarettes a day for more than 20 years. Methods and Findings: A colonoscopy combined with rectal mucosa staining with 0.25% methylene blue was performed in 131 patients. Each of the study participants gave informed consent to participate in the study. Three bioptates were collected from the foci defined macroscopically as ACF; in cases where there were fewer foci, the number of collected foci was respectively lower. On the colonoscopy day, patients completed the questionnaire regarding epidemiological data used for analysis of factors affecting the occurrence of ACF in the study group. The number of ACF in the colon was divided into three groups: −ACF < 5, 5 < ACF < 10, ACF > 10. In the statistical analysis, numerical data were presented and real numbers, range of arrhythmic means, mean standard deviation, and results of probability distribution. The Student’s test, U test, and chi2 were applied in order to determine the significance of differences of means and frequency of events in both groups. The level of significance was set at α = 0.05. Statistica 7.1 and Excel 2010 were used. Most smokers are in the age groups between 51–70 years. In the youngest (31–40 years), single ACF appear first (ACF <5) ACF in the number of 5–10 appear a little later (around 50 years of age) and dynamically increase, reaching a maximum at the age of 60–65.ACF in the number >10 appear at the latest age (55 years old) and their number gradually increases with age (linear growth). The probability of occurrence of ACF in all groups is greater in smokers, and the difference for the ACF group 5-10 and ACF >10 is statistically significant with a significance level of p < 0.05. Apart from ACF normal, all types of ACF are more likely in this group than in non-smokers and these differences are statistically significant with p < 0.05. Conclusions: Smoking has a significant impact on the number and type of rectal ACF. Smokers have a greater number of ACFs in the rectum than non-smokers, and the most common type is hyperplastic ACF. Smokers are more likely to develop polyps in all sections of the colon compared to non-smokers. View Full-Text
Keywords: rectal aberrant crypt foci (ACF); colorectal cancer (CRC); smoking rectal aberrant crypt foci (ACF); colorectal cancer (CRC); smoking
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MDPI and ACS Style

Kowalczyk, M.; Klepacki, Ł.; Zieliński, E.; Kurpiewski, W.; Zinkiewicz, K.; Dyśko, Ł.; Pesta, W. The Effect of Smoking on the Number and Type of Rectal Aberrant Crypt Foci (ACF)—First Identifiable Precursors of Colorectal Cancer (CRC). J. Clin. Med. 2021, 10, 55. https://doi.org/10.3390/jcm10010055

AMA Style

Kowalczyk M, Klepacki Ł, Zieliński E, Kurpiewski W, Zinkiewicz K, Dyśko Ł, Pesta W. The Effect of Smoking on the Number and Type of Rectal Aberrant Crypt Foci (ACF)—First Identifiable Precursors of Colorectal Cancer (CRC). Journal of Clinical Medicine. 2021; 10(1):55. https://doi.org/10.3390/jcm10010055

Chicago/Turabian Style

Kowalczyk, Marek, Łukasz Klepacki, Ewa Zieliński, Waldemar Kurpiewski, Krzysztof Zinkiewicz, Łukasz Dyśko, and Wiesław Pesta. 2021. "The Effect of Smoking on the Number and Type of Rectal Aberrant Crypt Foci (ACF)—First Identifiable Precursors of Colorectal Cancer (CRC)" Journal of Clinical Medicine 10, no. 1: 55. https://doi.org/10.3390/jcm10010055

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