Diet and Cancer
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.
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