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May 2, 1986

The Prevalence and Causes of Colonic Cancer

Author Affiliations

Center for Prevention Services Centers for Disease Control Atlanta

JAMA. 1986;255(17):2295. doi:10.1001/jama.1986.03370170058031

To the Editor.—  Ehrlich and co-workers1 documented the presence of asbestos fibers in the malignant tissue of an asbestos worker with adenocarcinoma of the colon. This strongly suggests a causative role of asbestos in a neoplastic process distant from the original site of exposure (respiratory tract). The most likely mechanism would seem to be the coughing up and swallowing of mucus (or saliva) laden with asbestos fibers. This finding also offers a theoretical basis for the epidemiologic association between cigarette smoking and gastrointestinal tract disease.A number of studies have shown that cigarette smoking is significantly associated with the incidence of and mortality from peptic ulcer disease. There is also suggestive evidence that smoking retards the healing of peptic ulcers. Based on experimental and clinical studies, various effects of smoking on gastric, pancreatic, and duodenal physiology have been suggested as mechanisms by which smoking may cause these disorders.2,3