Dietary Patterns and Stomach Cancer among Middle-aged Male Workers in Tokyo

Many epidemiological studies have examined the associations of nutrients and foods with risk of stomach cancer. ‍Few studies have addressed the dietary patterns that reflect various components of food consumption and their ‍interactions. We identified major four dietary patterns; “vegetable and fruit”, “Western breakfast”, “meat”, and ‍“rice/snack” with principal component analysis using food consumption questionnaire in a prospective study of ‍5,765 middle-aged male workers in Tokyo. After 10 years of follow-up between September 1988 and August 1998, 84 ‍incident cases of stomach cancer were documented. Using proportional hazards regression to estimate risk ratios, ‍we found no clear association between each of dietary pattern and stomach cancer risk. After adjustment for age ‍and other potential confounding factors and after exclusion of the cases diagnosed in first follow-up year, the risk ‍ratio(RR) associated with high tertile compared to low tertile was 0.78(95%CI 0.42-1.44) for “vegetable and fruit” ‍pattern and 0.71(95%CI 0.40-1.24) for “Western breakfast” pattern. The V-shaped associations between dietary ‍patterns and stomach cancer risk were appeared in the “meat”(RR=1.00, 0.55, and 1.10) and the “rice/snack”(RR=1.00, ‍0.52, and 1.19) patterns, while the linear trend of these associations was statistically on borderline. The roll of overall ‍dietary patterns in predicting stomach cancer risk requires further investigation.     

No Inhibition of Urinary Bladder Carcinogenesis in Rats with Intravesical Instillation of -Galactosylceramide

Many epidemiological studies have examined the associations of nutrients and foods with risk of stomach cancer. ‍Few studies have addressed the dietary patterns that reflect various components of food consumption and their ‍interactions. We identified major four dietary patterns; “vegetable and fruit”, “Western breakfast”, “meat”, and ‍“rice/snack” with principal component analysis using food consumption questionnaire in a prospective study of ‍5,765 middle-aged male workers in Tokyo. After 10 years of follow-up between September 1988 and August 1998, 84 ‍incident cases of stomach cancer were documented. Using proportional hazards regression to estimate risk ratios, ‍we found no clear association between each of dietary pattern and stomach cancer risk. After adjustment for age ‍and other potential confounding factors and after exclusion of the cases diagnosed in first follow-up year, the risk ‍ratio(RR) associated with high tertile compared to low tertile was 0.78(95%CI 0.42-1.44) for “vegetable and fruit” ‍pattern and 0.71(95%CI 0.40-1.24) for “Western breakfast” pattern. The V-shaped associations between dietary ‍patterns and stomach cancer risk were appeared in the “meat”(RR=1.00, 0.55, and 1.10) and the “rice/snack”(RR=1.00, ‍0.52, and 1.19) patterns, while the linear trend of these associations was statistically on borderline. The roll of overall ‍dietary patterns in predicting stomach cancer risk requires further investigation. ‍     

Gastric Cancer: the Roles of Diet,Alcohol Drinking,Smoking and Helicobacter pylori in Northeastern Thailand

The incidence of gastric cancer in the countries of South East Asia is variable, ranging from age-standardized ‍rates of 20.9/105 (men) and 10.4/105 (women) in Hanoi, Vietnam to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen, ‍Thailand. The reasons for these differences are unknown. Possible explanations are differences in dietary habits, ‍alcohol drinking, smoking and/or the prevalence of infection with Helicobacter pylori (H. pylori). A case-control ‍study was conducted in Khon Kaen, Thailand, to study the role of these factors in gastric cancer carcinogenesis. 131 ‍gastric cancer cases and 262 matched controls were recruited for the study. Information on dietary habits, alcohol ‍drinking and smoking were collected by a structured questionnaire. Blood samples were available from 111 cases ‍and 232 controls for H. pylori assay. Using an unconditional logistic regression model controlling for age and sex, we ‍assessed the effects of dietary habits, alcohol drinking, smoking and H. pylori infection on the risk of gastric cancer. ‍A high intake of salt (OR=1.8; 95%CI 1.1-3.0) and fermented foods (OR=1.9; 95%CI 1.1-3.3) was found to be ‍associated with an increased risk. Preference for spicy food was not associated with gastric cancer risk in this ‍population. Although there were negative associations between gastric cancer and vegetable and fruit intake, they ‍were rather weak (OR 0.8 for both) and non significant. There were also weak (non-significant) associations with ‍smoking and alcohol consumption, and no association with H. pylori infection (OR=0.6; 95%CI 0.4-1.0). Infection of ‍H. pylori was associated with various indicators of crowding. ‍     

Risk Factors for Esophageal Cancer: a Case-control Study in South-western China

Esophageal cancer is a crucial cancer in China. Yanting in Sichuan Province was a key area with highest esophageal ‍cancer mortality in China, but little evidence on esophageal cancer risk factors has been reported for this area and ‍the etiology remains unclear. To clarify risk factors, a 1:1 matched case-control study was conducted. Totals of 185 ‍eligible esophageal cancer patients and 185 healthy residents matched for sex and age were recruited. Conditional ‍logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for possible risk/ ‍protective factors. All ORs were adjusted by family history of esophageal cancer and occupation, and then further ‍adjusted by other possible confounding factors. Our results showed that smoking and alcohol drinking were risk ‍factors for esophageal cancer with dose-response. The ORs (95% CI) compared with never smokers and drinkers ‍were 4.06 (1.55-10.6) and 2.49 (1.06-5.85), respectively. The OR was further increased to 8.86 (95%CI, 3.82-20.5) for ‍both smoking and drinking in combination. Eating food rapidly (OR=5.84, 95%CI, 2.05-16.7), drinking shallow ‍ground water (OR=4.18, 95%CI, 1.30-13.4) and frequent intake of picked vegetables (OR=2.12, 95%CI, 1.00-4.49) ‍appeared to increase the risk, while frequent intake of fresh fruit (OR=0.42, 95%CI, 0.19-0.89), fresh vegetables ‍(OR= 0.62, 95%CI, 0.32-1.17) and eggs (OR=0.59, 95%CI, 0.25-1.39) decreased the risk. In conclusion, smoking and ‍alcohol drinking are common in Yanting and main contributors to esophageal cancer. Consumption of fresh fruit ‍and eggs are not common and high consumption of these two foods as well as fresh vegetables may decrease the risk ‍of esophageal cancer in this area. In addition, drinking shallow ground water and eating food rapidly, as well as ‍frequent intake of pickled vegetables, are also factors increasing the risk. ‍ ‍     

Second Primary Cancer after Diagnosis of Stomach Cancer in Osaka, Japan

The risk of developing a second primary cancer following stomach cancer was estimated from data accumulated in the Osaka Cancer Registry. Of the 38,777 male patients and 22,391 female patients newly diagnosed in the period 1966–1986 who were followed up until the end of 1986, 778 and 267 developed a second cancer other than stomach cancer, respectively, whereas the expected numbers had been 928.8 (RR=0.84, 95%CI=0.78-0.90) and 297.7 (RR = 0.90, 95%CI = 0.79-1.01). The risks were higher among younger patients (aged 30–54 at the diagnosis of stomach cancer) than among older patients (aged 55–69 at the diagnosis of stomach cancer). Significantly elevated risks were observed for cancers of the oral cavity & pharynx (RR=l.56), colon (RH = 1.61) and rectum (RR = 1.56) for males, and oral cavity & pharynx (RR = 2.59) for females as second cancers. Results were substantially similar among the localized stomach cancer patients. Among younger male patients with gastrectomy, the risk of developing pancreatic cancer was elevated 10 or more years after stomach cancer diagnosis. The present study suggests the necessity of following up stomach cancer patients in order to enable the early diagnosis of digestive tract cancer.     

Insulin,Insulin-like Growth Factor-I and Breast Cancer Risk in Japanese Women

To evaluate the effects of glucose metabolism related factors, such as insulin and insulin-like growth-factors ‍(IGFs), on breast cancer development among Japanese women, we conducted a case-referent study comparing 187 ‍women presenting with operable breast cancer and 190 women of the same age having no breast cancer. Odds ratios ‍(OR) and 95% confidence intervals (95%CI) were determined by multiple logistic regression analysis. ‍ In the present study, no association in risk was observed with increasing levels of IGF-I or IGF binding protein- ‍3 (IGFBP-3), before or after adjustment these factors. However, a suggestion of a positive association of an increased ‍breast cancer risk was evident in postmenopausal women with elevated plasma insulin levels, particularly those with ‍BMI>23.07. The OR for plasma insulin in the top tertile was 4.48 (95%CI:1.07-18.7) compared to the bottom tertile. ‍For C-peptide, there was a similar positive association, with a corresponding OR of 2.28. In addition, we observed ‍strong links between plasma insulin, C-peptide levels and estrogen receptor (ER) negative breast cancer, with ORs ‍of 2.79(95%CI:1.09-7.16), and 2.52 (95%CI:0.91-6.97) respectively, for the top versus bottom tertiles. In conclusion, ‍the present study suggested that plasma insulin level is a predictor of postmenopausal breast cancer in obese women ‍and ER negative breast cancer. Additional studies are needed to clarify the role of glucose metabolism pathways in ‍breast cancer development and interaction of IGF systems.     

Second Primary Cancers Following Female Breast Cancer in Osaka, Japan--A Population-Based Cohort Study

Using the data accumulated in the Osaka Cancer Registry, a cohortstudy was conducted on the occurrence of second primary cancersfollowing the first breast cancer in females. Of the 9, 503breast cancer patients newly diagnosed in the period 1965–1982who were followed up until the end of 1983 (average follow-upperiod, 5.7 years), 344 developed second cancers, whereas theexpected number had been 211 (relative risk (RR) = 1.6; 95%confidence interval (CI) = 1.5–1.8). The increased riskwas observed throughout the observation period, and was higherin patients of less than 45 years of age at diagnosis than inolder women. Significant excess risks were found for secondcancers of the opposite breast (RR = 4.2; 95% CI = 3.4–5.2),buccal cavity (RR = 3.6; 95% CI = 1.6–7.2), stomach (RR= 1.4; 95% CI = 1.2–1.8), colon (RR = 1.8; 95% CI = 1.1–2.1)and thyroid gland (RR = 3.2; 95% CI % 1.5–6.1). The effectsof chemo- and radiotherapy administered for initial breast canceron the increased risk of the above mentioned second cancerswere also examined. These therapeutic measures were found notlikely to be related to the excess risks for cancers of thebuccal cavity, stomach and colon. For second cancer of the oppositebreast, however, both chemotherapy and radiotherapy remainedas possible risk factors. The effect of radiation was proposedas being a likely explanation for the excess risk of secondthyroid cancer.     

Differences in Cancer Risks in the South and North of Viet Nam

Background: As there are few available data regarding cancers in Viet Nam, the aim of the present study was toevaluate cancer risk ratios and geographical differences in cancer incidences between the south and north populationsin the 1990s.Methods: Data for cancer incidences in Ho Chi Minh (HCM) and Hanoi were derived from published reports.The method for comparison of cancer incidence in two groups used in the present study was the Mantel-Haenszeltest.Results: In HCM, all cancers were observed to be lower in males , (RR = 0.87, 95% CI = 0.83-0.91) but higher infemales, (RR = 1.06, 95% CI = 1.01-1.12) than in Hanoi. For males, significantly higher incidences in HCM wereobserved for cancers of the oesophagus (RR = 1.66, 95% CI = 1.19-2.32), liver (RR = 1.22, 95% CI = 1.09-1.36), gallbladder (RR = 5.95, 95% CI = 2.49-14.23), and larynx (RR = 3.54, 95% CI = 2.26-5.55). In contrast, there were muchlower incidences in HCM for cancers of the nasopharynx (RR = 0.5, 95% CI = 0.41-0.61), stomach (RR = 0.76, 95%CI = 0.67-0.86), and lung (RR = 0.7, 95% CI = 0.64-0.78). For females, breast cancer incidence was much lower (RR= 0.65, 95% CI = 0.57-0.73) but that of cervical cancer was significantly higher in HCM than in Hanoi, (RR = 3.94,95% CI = 3.36-4.62), especially for the age group 55-64, (RR = 8.7, 95% CI = 5.9-13.3).Conclusion: The present findings show that cancer risk is quite different in the south and north populationswithin Viet Nam.     

A prospective study of diet and stomach cancer mortality in United States men and women.

Frequent consumption of fruits, vegetables, and whole grains has been associated with a reduced risk of stomach cancer in the majority of case-control studies of these factors: however, prospective studies have been less consistent. We examined the association between selected major food groups (citrus fruits, vegetables, whole grains, and processed meats) and risk of fatal stomach cancer in the Cancer Prevention Study (CPS) II cohort of 1.2 million United States men and women. During 14 years of follow-up, we documented 439 stomach cancer deaths in women and 910 in men after exclusion of individuals with prevalent cancers, inadequate diet information, and recent weight loss at baseline in 1982. After controlling for other risk factors, none of the food groups examined were associated with risk of stomach cancer except for an unexpected increased risk with vegetable consumption in women [relative risk (RR) = 1.25; 95% confidence interval (CI), 0.99-1.58; highest versus lowest tertile, P = 0.06 for trend]. A high overall plant food intake (a sum of vegetables, citrus fruit, and whole grains) was associated with reduced risk in men (RR = 0.79; 95% CI, 0.67-0.93; highest versus lowest tertile, P = 0.003 for trend), but not in women (RR = 1.18; 95% CI, 0.93-1.50; P = 0.16 for trend). Of individual foods examined, liver consumption greater than twice/week was associated with an increased risk of fatal stomach cancer in women (RR = 1.96; 95% CI, 1.09-3.53) and men (RR = 1.63; 95% CI, 1.02-2.62) compared with nonconsumers. This study supports a modest role for plant foods in reducing the risk of fatal stomach cancer in men, but not in women.     

A Case-control Study of Multiple Myeloma in Japan: Association with Occupational Factors

Recently the incidence rate of multiple myeloma (MM) has increased in Japan. Epidemiologic efforts have suggested ‍that certain occupational and chemical exposures are likely to increase the risk for MM. We therefore performed a ‍case-control study of MM, examining occupational factors. Data for 57 cases and 57 controls were obtained from ‍Sapporo Medical University Hospital and its affiliated hospitals in Hokkaido. Controls were matched to each case ‍by gender, age (+ 5 years) and hospital. Detailed information regarding several factors possibly related to MM was ‍obtained by interviews in hospitals. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated with ‍adjustment for cigarette smoking as confounding factor. The occupational category of agriculture and fishery showed ‍a significant association with increased risk (OR = 5.89, 95%CI = 1.24-28.04). Occupational exposure to chemical ‍products including organic solvents or petroleum showed a significant association with increased risk (OR = 8.05, ‍95%CI = 1.01-64.45). Medical histories of operation for appendicitis and blood transfusion were associated with ‍decreased risk, but not significantly. Our results suggested that occupational exposure to chemicals might play a role ‍in the risk of MM. ‍ ‍     

Time Trends in the Occurrence of Major GI Cancers in Iran

Objective: The aim of this study was to study the changes in occurrence of esophageal, stomach and colon ‍cancers (cancers of interest) over the last 30 years in Iran. ‍Material and Methods: Cancer cases referred to two main cancer centers in the country (the Shiraz cancer ‍center and the Tehran cancer center) during last 30 years and published by the two centers were utilized. Morbidity ‍odds ratios (MOR) were used to study trend in the occurrence of each cancer site in each center. For this purpose ‍the cancers of interest were considered as cases; childhood cancers as controls; and calendar year as exposure. A ‍regression line was fitted to morbidity odds ratios over years and the slope of the regression line was considered to ‍indicate the overall trend. MORs and 95% CIs comparing the last five and first five years were computed to ‍measure the magnitude of the change over time. ‍Result: The overall trend for esophageal cancer was decrease (slopes = -0.02 for Shiraz and -0.03 for Tehran); for ‍stomach was increase (slopes = 0.04 for Shiraz and 0.08 for Tehran), and for colon cancer was sharp increase (slopes ‍= 0.02 for Shiraz and 0.10 for Tehran). The magnitude of changes showed stomach cancer to increase by 35% in ‍Shiraz (MOR = 1.35 with 95% CI 1.1, 1.65) and 13% in Tehran (MOR = 1.13 with 95% CI 0.96, 1.38), esophageal ‍cancer to decrease by 20% in Shiraz (MOR = 0.82 with 95% CI 0.62, 1.11) and 50% in Tehran (MOR = 0.52 with ‍95% CI 0.45, 0.60), and colon cancer to increase by 65% in Shiraz (MOR = 1.65 with 95% CI 1.26, 2.16) and 82% in ‍Tehran (MOR = 1.82 with 95% CI 1.52, 2.25). ‍Conclusion: During the last thirty years the occurrence of major GI cancers has changed in Iran with sharp ‍increase in colon cancer, slight to moderate increase in stomach cancer and sharp decrease in esophageal cancer. ‍     

Second primary cancer after treatment for cervical cancer. Late effects after radiotherapy

Using data from the population-based Danish Cancer Registry, the relative risk (RR) of second primary cancer was assessed among 24,970 women with invasive cervical cancer (1943-1982) and 19,470 women with carcinoma in situ of the cervix. The analysis was stratified according to treatment with (+) and without (-) radiation. For all second primaries combined, a RR+ = 1.1 (95% confidence interval (CI) = 1.06-1.18) and a RR- = 1.3 (95% CI = 1.13-1.40) was observed after invasive cervical cancers and a RR+ = 3.5 (95% CI = 1.4-7.2) and RR- = 1.1 (95% CI = 0.7-1.6) following in situ cancer. The small overall excess of second primary cancer is accounted for by an increase of some cancers such as lung, bladder, and a concurrent decrease in others such as breast. Although not statistically different from nonirradiated, the RR increased with time since treatment among irradiated invasive cervical cancer patients in organs close to and at intermediate distance from the cervix, reaching a maximum after 30 or more years of follow-up (RR = 1.9; 95% CI = 1.4-2.5). Altogether, for these sites an excess of 64 cases per 10,000 women per year were attributable to radiation among survivors of 30+ years. The highest risks among long-term survivors were observed for the following: other genital organs (RR = 5.8; 95% CI = 1.8-13.0) bladder (RR = 5.5; 95% CI = 2.8-9.5), connective tissue (RR = 3.3; 95% CI = 0.4-12.0), stomach (RR = 2.5; 95% CI = 1.1-4.7) and rectum (RR = 2.4; 95% CI = 1.1-4.6). A significant deficit of risk for breast cancer (RR = 0.7, 95% CI = 0.6-0.8) was observed for 10+ years, may be attributable to the effect of ovarian ablation by radiotherapy. It is speculated that the same effect also may explain the observed deficits of brain tumors (RR = 0.6; 95% CI = 0.4-1.0) and skin melanomas (RR = 0.6; 95% CI = 0.3-1.0). It is concluded that cancers attributable to radiation, apart from acute nonlymphocytic leukemias, tend to appear late (10 or more years after radiotherapy), and that the risk remains elevated for more than 30 years.     

Cancer incidence and mortality and vitamin D in black and white male health professionals.

Blacks have been documented to have low vitamin D levels. We thus examined whether total cancer incidence and mortality rates differ between Blacks and Whites in a population of male health professionals, and particularly for digestive system cancers (oral, esophagus, stomach, pancreas, and colorectum), which have been most consistently linked to poor vitamin D status. Second, we examined whether Blacks might be more susceptible to these cancers if they concurrently had other risk factors for hypovitaminosis D. In the Health Professionals Follow-up Study, from 1986 to 2002, 99 of 481 Black men and 7,019 of 43,468 White men were diagnosed with cancer. Adjusting for multiple dietary, lifestyle, and medical risk factors, using Cox modeling, Black men were at higher risk of total cancer incidence [relative risk (RR), 1.32; 95% confidence interval (95% CI), 1.08-1.61; P = 0.007] and total cancer mortality (RR, 1.89; 95% CI, 1.40-2.56; P < 0.0001) and especially digestive system cancer mortality (RR, 2.24; 95% CI, 1.35-3.70). Compared with Whites with relatively few risk factors for hypovitaminosis D, Blacks also with few risk factors for hypovitaminosis D were not at appreciably higher risk of total cancer incidence (RR, 0.95; 95% CI, 0.60-1.51) or mortality (RR, 1.55; 95% CI, 0.91-2.62), but Black men with additional risk factors for poorer vitamin D status had a much higher cancer incidence (RR, 1.57; 95% CI, 1.16-2.11) and mortality risk (RR, 2.27; 95% CI, 1.57-3.28). This pattern was even more pronounced for digestive system cancer. Our results suggest that the high frequency of hypovitaminosis D in Blacks may be an important, and easily modifiable, contributor to their higher risk of cancer incidence and mortality.     

Report: 15th Asian Pacific Cancer Conference

To promote a cancer prevention program at hospital, we started the hospital-based epidemiologic research program at ‍Aichi Cancer Center (HERPACC) in 1988. Because patients visiting hospitals are very concerned not only about their ‍own health condition but also practical way of disease prevention, we consider outpatients, especially those free of ‍cancer, as ideal targets to make a model program and a practical cancer prevention strategy for general people. To ‍confirm risk and protective effects of lifestyle factors like dietary habits, smoking and drinking, and exercise on cancer ‍in Japanese, we have been undertaking large-scale case-referent comparative studies of main cancer sites (stomach, ‍colorectal, lung, breast and uterine cancers) using the data generated by HERPACC. The risk of respiratory tract cancer ‍was definitely elevated by habitual smoking and that of upper digestive tract cancer by combined habitual smoking and ‍drinking. Frequent intake of raw vegetables and/or fruit in contrast reduced the risk of lung cancer among smokers. ‍Current obesity was positively associated with risk of post-menopausal breast cancer, recently on the increase in Japan. ‍However, all sites of cancer were linearly decreased with frequency of exercise in both males and females. Based on ‍these pieces of evidence and other main results obtained from the HERPACC studies, prevention trials with provision ‍of information about protective and risk factors for main sites of cancers to outpatients have been planned in parallel to ‍continuation of HERPACC.     

Decreasing Trend in the Incidence of Stomach Cancer in Mumbai,India, during 1988 to 1999

The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 to 1999 was ‍estimated using data collected by the Bombay Population-based Cancer Registry. During the 12-year period, a total ‍of 3657 stomach cancer cases (3.9% of all cancers) were registered by the Bombay Population-based Cancer Registry ‍of which 2467 (5.1% of all male cancers) were in males and 1184 (2.6% of all female cancers) in females. For evaluation ‍of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual ‍percentage changes were also computed for the incidence rates for evaluating the time trend. A statistically significant ‍decreasing trend in the overall age-adjusted incidence rates of stomach cancer was observed during the period 1988 ‍to 1999, with an yearly decrease of 4.44% in males and 2.56% in females. This decrease was most striking in males ‍in the age groups 40-59 and 60+, and in females only in the age group 40-59. The probability estimates indicated that ‍one out of every 92 men and one out of every 187 women will contract a stomach cancer at some time in their whole ‍life and 95% of the chance is after his or her 40th birthday. The decreasing trend in the age-adjusted incidence rates ‍of stomach cancer in both the sexes indicates that there is a critical change in the etiology of this cancer. The findings ‍may provide clues relating to various life-style and environmental changes impacting on stomach cancer incidence.     

Allium Vegetables and Stomach Cancer Risk in China

Although the incidence of stomach cancer has been declining, it remains the second leading cause of cancer death ‍worldwide. Potential protective effects of allium vegetables against cancer have been reported by a few epidemiologic ‍studies in Chinese populations, but the sample sizes of these studies were relatively small. We examined the associations ‍between allium vegetable consumption and stomach cancer in a large population-based case-control study in Shanghai ‍(750 cases and 750 age- and gender-matched controls) and Qingdao (128 cases and 128 age- and gender-matched ‍controls). Epidemiological data were collected by a standard questionnaire, and odds ratios (ORs) and 95% confidence ‍intervals (CIs) were estimated using conditional logistic regression in SAS. After adjusting for matching variables, ‍education, body mass index, pack-years of smoking, alcohol drinking, salt intake, and fruit and vegetable intake, ‍inverse relationships with dose response pattern were observed between frequency of onion intake and stomach ‍cancer in Qingdao (P for trend=0.02) and Shanghai (P for trend=0.04) populations. In Shanghai, negative doseresponse ‍relationships were observed between monthly intake of onions (P=0.03), monthly intake of garlic stalks ‍(P=0.04) and distal cancer (but not with cardia cancer). Negative association was also noted between intake of garlic ‍stalks (often vs. never) and risk of stomach cancer in Qingdao (OR=0.30; 95% CI: 0.12-0.77). Our results confirm ‍the protective effect of allium vegetables (especially garlic and onions) against stomach cancer.     

Polymorphisms in Thymidylate Synthase and Methylenetetra-hydrofolate Reductase Genes and the Susceptibility to Esophageal and Stomach Cancer with Smoking and Drinking Habits

Thymidylate synthetase (TS) and methylenetetrahydrofolate reductase (MTHFR) are major enzymes in the ‍metabolism of folates, involved in DNA ‘breaks’, instability and hypomethylation.To investigate the possible relations ‍between the TS 3’-UTR and MTHFR C677T polymorphisms and environmental factors impacting on risk of ‍esophageal and stomach cancers, we conducted a case-control study in a high incidence region of China for these ‍cancers. We recruited 138 esophageal and 155 stomach cancer cases, and 223 controls. The TS 3’-UTR and MTHFR ‍C677T genotypes were detected by RFLP assay, using PCR products. The frequency of the -6 bp homozygous TS 3’- ‍UTR genotype was 37.7 % in controls, higher than in Caucasians, although the present distribution was not in ‍Hardy-Weinberg equilibrium. Ever-smoking with the -6 bp/-6 bp TS genotype elevated the ORs (2.61, 1.24-5.49; ‍3.54, 1.60-7.82) for cases of esophageal and stomach cancers, respectively, when compared with never-smoking with ‍the +6 bp/+6 bp and +6 bp/-6 bp genotypes. No combination between the TS and MTHFR genotypes gave increased ‍ORs. The present results suggest that TS polymorphism may modify the risk of esophageal and stomach cancer with ‍smoking, pointing to the necessity for further investigations with information on folate and methionine intake with ‍a larger population. ‍     

Dietary Patterns in Relation to Prostate Cancer in Iranian Men: A Case-Control Study

Background: Prostate cancer is the most frequently occurring cancer among males in economically developedcountries. Among the several risk factors that have been suggested, only age, ethnicity, diabetes, and familyhistory of prostate cancer are well-established and primary prevention of this disease is limited. Prior studieshad shown that dietary intake could be modified to reduce cancer risk. We conducted a hospital-based, casecontrolstudy to examine the association between dietary patterns and prostate cancer risk in Iran. Materials andMethods: A total of fifty patients with prostate cancer and a hundred controls underwent face-to-face interviews.Factor analysis was used to determine the dietary patterns. Multivariate logistic regression was used to estimateodds ratios (ORs) and 95% confidence intervals (CIs). Results: We defined two major dietary patterns in thispopulation: ‘western diet’(high in sweets and desserts, organ meat, snacks, tea and coffee, French fries, salt,carbonated drinks, red or processed meat) and ‘healthy diet’ (high in legumes, fish, dairy products, fruits andfruit juice, vegetables, boiled potatoes ,whole cereal and egg). Both Healthy and western pattern scores weredivided into two categories (based on medians). Higher scores on Healthy pattern was marginally significantlyrelated to decreased risk of prostate cancer (above median vs below median, OR =0.4, 95%CI=0.2-1.0). Anincreased risk of prostate cancer was observed with the higher scores on the Western pattern (above median vsbelow median, OR=4.0, 95%CI=1.5-11.0). Conclusions: The results of this study suggested that diet might beassociated with prostate cancer among Iranian males.     

Site-specific Cancer Risk Due to Diabetes Mellitus History: Evidence from the Japan Collaborative Cohort (JACC) Study

The study examined the association of diabetes mellitus (DM) history with total and common site-specific cancersusing a large cohort of 23,378 men and 33,503 women, extracted from 127,477 healthy participants of the JACCStudy who were aged 40-79 years and living in 24 municipalities in Japan. At enrolment during 1988-90, eachsubject completed a self-administered questionnaire including items for age, sex, body mass index (BMI), smoking,drinking, past history of DM and cancer. Adjusting for age, BMI, smoking, and drinking in the Cox’s proportionalhazard model, incidence rate ratios (IRR) with 95% confidence intervals (95%CIs) were estimated for both sexes.During the follow-up period, total cancers and site-specific cancers were identified. A history of DM was reported by7.5% of men and 4.6% of women. DM significantly increased the risk of liver cancer for both men (IRR=2.30;95%CI=1.47-3.59) and women (IRR=2.70; 95%CI=1.20-6.05). Significant increased and reduced risk due to DM formen were also found for non-Hodgkin lymphoma (IRR=2.77; 95%CI=1.04-7.38) and stomach cancer (IRR=0.67;95%CI=0.46-0.99) respectively. For females, a reduced risk of stomach cancer due to DM (IRR=0.49; 95%CI=0.23-1.04) was also revealed. Since a history of DM here demonstrated significant associations with some site-specificcancers, their relationships should be studied further in Japan for validation.     

Risk of multiple squamous cell carcinomas both in the esophagus and the head and neck region

While multiple squamous cell carcinomas are often observed in the esophagus and the head and neck region and confound us about the favorable treatments, the reason why some patients are more likely to develop multiple cancers remains obscure. We statistically analyzed clinical factors in 203 patients with newly diagnosed squamous cell carcinoma, to assess the risk of multiple cancers for the establishment of an effective prevention and screening programs. Widespread epithelial oncogenic alterations were assessed as multiple lugol-voiding lesions (multiple LVL) using lugol chromoendoscopy. Genetic polymorphisms of alcohol dehydrogenase type 3 (ADH3) and aldehyde dehydrogenase type 2 (ALDH2) were identified by PCR-restriction fragment length polymorphism analysis. Forty patients had synchronous multiple cancers and the remaining 163 had solitary cancer. Presence of multiple LVL was the only independent risk factor for multiple cancers [relative risk (RR) = 67; 95%CI, 15-310]. Multiple LVL was observed in only smoking drinkers. Among them, a multivariate analysis demonstrated that the ALDH2 deficiency allele (RR = 5.7; 95%CI, 2.8-11.6) and the slow metabolizing ADH3 allele (RR = 1.9; 95%CI, 1.1-7.9) were the independent risk factors for multiple LVL. Combination of these alleles lead to increase the risk of multiple LVL. In conclusion, an episode of multiple LVL is a remarkable high risk for multiple cancers both at the esophagus and the head and neck region. The interaction between drinking and the ALDH2 deficiency allele increases the risk. In addition, the slow metabolizing ADH3 allele enhances the risk. Prohibiting the use of alcohol and early detection of cancer are strongly recommended for such individuals.