Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: A nationwide case-control study

Giovanni Corrao, Antonella Tragnone, Renzo Caprilli, Giacomo Trallori, Claudio Papi, Arnaldo Andreoli, Mariacarla Di Paolo, Gabriele Riegler, Gian Piero Rigo, Oscar Ferraù, Carlo Mansi, Marcello Ingrosso, Daniela Valpiani, P. Torchio, F. Miglio, G. Elmi, S. Venerato, G. Taddei, A. Viscido, G. D'AlbasioI. Paladini, C. Surrenti, G. Capurso, P. Paoluzi, N. Spimpolo, A. Gioieni, A. Savastano, M. Mastronardi, A. Francavilla, M. Vincenzi

Research output: Contribution to journalArticle

Abstract

Background. Using data from a case-control study carried out in Italy 1989-1992, we estimated the odds ratios (OR) and the population attributable risks (AR) for inflammatory bowel diseases (IBD) in relation to smoking, oral contraception and breastfeeding in infancy. Methods. The study focused on 819 cases of IBD (594 ulcerative colitis: UC; 225 Crohn's disease: CD) originating from populations resident in 10 Italian areas, and age-sex matched paired controls. Results. Compared with non-smokers, former smokers were at increased risk of UC (OR = 3.0; 95% confidence interval [CI]:2.1-4.3), whereas current smokers were at increased risk of CD (OR = 1.7; 95% CI: 1.1-2.6). Females who reported use of oral contraceptives for at least one month before onset of symptoms had a higher risk of CD (OR = 3.4; 95% CI: 1.0-11.9), whereas no significant risk was observed for UC. Lack of breastfeeding was associated with an increased risk of UC (OR = 1.5; 95% CI: 1.1-2.1) and CD (OR = 1.9; 95% CI: 1.1-3.3). Being a 'former smoker' was the factor with the highest attributable risk of UC both in males (AR = 28%; 95% CI: 20-35%) and in females (AR = 12%; 95% CI: 5-18%). Smoking was the factor with the highest attributable risk for CD in males (AR = 31%; 95% CI: 11-50%). Lack of breastfeeding accounted for the highest proportion of CD in females (AR = 11%; 95% CI: 1-22%). Oral contraceptive use accounted for 7% of cases of UC and for 11% of cases of CD. Conclusions. Taken together, the considered factors were responsible for a proportion of IBD ranging from 26% (CD females) to 36% (CD males). It is concluded that other environmental and genetic factors may be involved in the aetiology of IBD.

Original languageEnglish
Pages (from-to)397-404
Number of pages8
JournalInternational Journal of Epidemiology
Volume27
Issue number3
DOIs
Publication statusPublished - 1998

Keywords

  • Attributable risk
  • Breastfeeding
  • Crohn's disease
  • Oral contraceptives
  • Regression models
  • Smoking
  • Ulcerative colitis

ASJC Scopus subject areas

  • Epidemiology

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  • Cite this

    Corrao, G., Tragnone, A., Caprilli, R., Trallori, G., Papi, C., Andreoli, A., Di Paolo, M., Riegler, G., Rigo, G. P., Ferraù, O., Mansi, C., Ingrosso, M., Valpiani, D., Torchio, P., Miglio, F., Elmi, G., Venerato, S., Taddei, G., Viscido, A., ... Vincenzi, M. (1998). Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: A nationwide case-control study. International Journal of Epidemiology, 27(3), 397-404. https://doi.org/10.1093/ije/27.3.397