E-cigarette Smoking and Colorectal Cancer Screening

Am J Health Promot. 2024 Nov 28:8901171241304726. doi: 10.1177/08901171241304726. Online ahead of print.

Abstract

Purpose: To evaluate how CRC screening practices differ between e-cigarette users and non-users.

Design: Cross-sectional study design.

Setting: National Cancer Institute's Health Information National Trends Survey (HINTS 5).

Subjects: Respondents aged 45 to 75 years.

Measures: Demographics, CRC screening, e-cigarette use, cancer history, presence of comorbidities, and access to a primary care provider.

Analysis: The demographic characteristics of the study participants were evaluated by their e-cigarette smoking status using chi-squared tests. The differences in CRC screening between e-cigarette users and non-users were evaluated using a multivariate logistic regression model.

Results: We identified a total of 6963 participants, of which 181 (2.6%) were e-cigarette users. The prevalence of e-cigarette use was inversely related to age. A significant portion were uninsured (10.7% vs 5.9% of non-users), and almost half (49.9%) were current tobacco smokers. E-cigarette users were as likely to undergo CRC screening compared to non-users [OR 1.40; 95% CI (0.74, 2.66)]. Increasing age, educational level, health insurance, comorbidity, access to a primary care provider, personal history of cancer, and presence of a comorbidity were associated with increased participation in CRC screening. However, e-cigarette use was not associated with increased screening.

Conclusion: Our study found no significant difference in CRC screening rates between e-cigarette users and non-users. While screening behaviors appear unaffected for now, ongoing surveillance is important as more users reach screening age given the uncertainties surrounding the long-term effects of e-cigarette use.

Keywords: colorectal cancer screening; electronic cigarettes; gastrointestinal cancer; smoking.