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Diet and Cancer - Landmark Studies

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The contents of this section were published in 2003 as part of SEER's 30th Anniversary celebration.

Hawaii has been the setting for numerous successful diet-related studies, using the Hawaii Tumor Registry (HTR) as the primary resource for identifying individuals with cancer. Previously, studies of dietary effect on cancer risk were few and inconsistent, usually based on estimates derived from per capita food consumption data. SEER data, with its breadth and depth of content and chronology, combined with the careful design and implementation of the study methods, gave strength to the results of these investigations and laid a foundation for future research in this provocative field.

In-person interviews were conducted by trained interviewers using detailed questionnaires on pertinent habits (e.g., smoking) and food consumption–types of food, frequency of consumption, and portion sizes, over time. Appropriate variables were adjusted for, and standard methods were used to analyze the resulting data.

Based on a selection of thirteen studies, the following increased risk associations were suggested: dietary cholesterol with lung and laryngeal cancers; alcohol consumption with rectal and lung cancers; fat consumption with endometrial, breast, prostate, and stomach (fish fat only) cancers; well done red meat with colorectal cancer, but only among smokers with a certain genetic susceptibility; low serum pepsinogen I level with stomach cancer; hepatitis B surface antigen with primary hepatocellular carcinoma; and infection with Helicobacter pylori (gram-negative spiral bacteria that are associated with chronic gastritis) with gastric carcinoma. The following decreased risk associations were suggested: fiber, soy products, and other legumes with endometrial cancer; dairy calcium and lactose with ovarian cancer; beta-carotene, overall vegetable consumption, and vitamin A with lung cancer; and carbohydrate intake with breast and corpus-uteri cancers. No associations were found for dietary vitamin C and cancer.

Selected References

Kolonel LN, Hankin JH, Lee J, Chu SY, Nomura AM, Hinds MW. Nutrient intakes in relation to cancer incidence in Hawaii. Br J Cancer 1981;44:332-339.

Le Marchand L, Yoshizawa CN, Kolonel LK, Hankin JH, Goodman MT. Vegetable consumption and lung cancer risk: a population-based case-control study in Hawaii. J Natl Cancer Inst 1989;81:1158-1164.

Nomura A, Stemmermann GN, Chyou PH, Kato I, Perez-Perez GI, Blaser MJ. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med 1991;325:1132-1136.

Goodman MT, Wilkens LR, Hankin JH, Lyu LC, Wu AH, Kolonel LN. Association of soy and fiber consumption with the risk of endometrial cancer. Am J Epidemiol 1997;146:294-306.

Le Marchand L, Hankin JH, Wilkens LR, Pierce LM, Franke A, Kolonel LN, Seifried A, Custer LJ, Chang W, Lum-Jones A, Donlon T. Combined effects of well-done red meat, smoking, and rapid N-acetyltransferase 2 and CYP1A2 phenotypes in increasing colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 2001;10:1259-1266.

Goodman MT, Wu AH, Tung K-H, McDuffie K, Kolonel LN, Nomura AM, Terada K, Wilkens LR, Murphy S, Hankin JH. Association of dairy products, lactose, and calcium with the risk of ovarian cancer. Am J Epidemiol 2002;156;148-157.

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