Showing papers in "Cancer Causes & Control in 2005"

The epidemiology of vitamin D and cancer incidence and mortality: a review (United States).

Abstract: In vitro and animal studies indicate that vitamin D may have anti-cancer benefits, including against progression and metastasis, against a wide spectrum of cancers. Supporting an anti-cancer effect of vitamin D is the ability of many cells to convert 25(OH)D, the primary circulating form of vitamin D, into 1,25(OH)2D, the most active form of this vitamin. No epidemiologic studies have directly measured vitamin D concentrations or intakes on risk of total cancer incidence or mortality. However, higher rates of total cancer mortality in regions with less UV-B radiation, and among African-Americans and overweight and obese people, each associated with lower circulating vitamin D, are compatible with a benefit of vitamin D on mortality. In addition, poorer survival from cancer in individuals diagnosed in the months when vitamin D levels are lowest suggests a benefit of vitamin D against late stages of carcinogenesis. The only individual cancer sites that have been examined directly in relation to vitamin D status are colorectal, prostate and breast cancers. For breast cancer, some data are promising for a benefit from vitamin D but are far too sparse to support a conclusion. The evidence that higher 25(OH)D levels through increased sunlight exposure or dietary or supplement intake inhibit colorectal carcinogenesis is substantial. The biologic evidence for an anti-cancer role of 25(OH)D is also strong for prostate cancer, but the epidemiologic data have not been supportive. Although not entirely consistent, some studies suggest that higher circulating 1,25(OH)2D may be more important than 25(OH)D for protection against aggressive, poorly-differentiated prostate cancer. A possible explanation for these divergent results is that unlike colorectal tumors, prostate cancers lose the ability to hydroxylate 25(OH)D to 1,25(OH)2D, and thus may rely on the circulation as the main source of 1,25(OH)2D. The suppression of circulating 1,25(OH)2D levels by calcium intake could explain why higher calcium and milk intakes appear to increase risk of advanced prostate cancer. Given the potential benefits from vitamin D, further research should be a priority.

Body mass, tobacco and alcohol and risk of esophageal, gastric cardia, and gastric non-cardia adenocarcinoma among men and women in a nested case-control study.

Abstract: Objectives: To prospectively assess the influence of body mass index (BMI), tobacco, and alcohol on the occurrence of esophageal, gastric cardia, and non-cardia gastric adenocarcinoma, and to detect any sex differences that could explain the male predominance of these tumors. Methods: A case-control study nested in the General Practitioner Research Database in the United Kingdom, 1994–2001. Odds ratios (ORs) were calculated with 95% confidence intervals (CI), including multivariate analysis. Results: During follow-up of 4,340,207 person-years, we identified 287 esophageal adenocarcinomas, 195 gastric cardia adenocarcinomas, 327 gastric non-cardia adenocarcinomas, and 10,000 controls. A positive association was found between overweight (BMI > 25 kg/m2) and esophageal adenocarcinoma (OR 1.67, 95% CI 1.22–2.30), and gastric cardia adenocarcinoma (OR 1.46, 95% CI 0.98–2.18), but not non-cardia gastric adenocarcinoma. The association between BMI and esophageal and gastric cardia adenocarcinoma were dose-dependent and seemingly independent of reflux. No strong sex differences were identified. Smokers, particularly females, were at increased risk of all studied adenocarcinomas, while no association with alcohol was found. Conclusions: Overweight increases risk of esophageal and gastric cardia adenocarcinoma, while tobacco smoking increases risk of esophageal, gastric cardia, and non-cardia gastric adenocarcinoma. The male predominance is not explained by sex differences in risk factor profiles of the studied exposures.

Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States)

Abstract: Background: Few prospective studies have examined the health risks associated with use of snuff and chewing tobacco. Methods: We studied the association between the use of spit tobacco (snuff or chewing tobacco) and mortality among men enrolled in Cancer Prevention Study I (CPS-I) in 1959 or Cancer Prevention Study II (CPS-II) in 1982. Analyses were based on men who reported exclusive use of snuff or chewing tobacco (7745 in CPS-I, 3327 in CPS-II) or no previous use of any tobacco product (69,662 in CPS-I, 111,482 in CPS-II) at baseline. Twelve-year follow-up of CPS-I, and 18-year follow-up of CPS-II identified 11,871 and 19,588 deaths, respectively. Cox proportional hazards models were used to control for age and other covariates. Results: Men who currently used snuff or chewing tobacco at baseline had higher death rates from all causes than men who did not in both CPS-I (hazard ratio [HR]=1.17, 95% CI=1.11–1.23) and CPS-II (HR=1.18, 95% CI=1.08–1.29). In CPS-I, current use of spit tobacco was statistically significantly associated with death from coronary heart disease (CHD), stroke, and diseases of the respiratory, digestive, and genitourinary systems, but not with death from cancer. In CPS-II, use of these products was significantly associated with death from CHD, stroke, all cancers combined, lung cancer, and cirrhosis. The associations with cardiovascular and other non-malignant endpoints were attenuated, but not eliminated, by controlling for measured covariates. Former use of spit tobacco was not associated with any endpoint in CPS-II. No clear dose response was observed with either the frequency or duration of usage for any endpoint. Conclusions: These two prospective studies provide limited evidence that current use of chewing tobacco or snuff may increase mortality from heart disease and stroke.

Life After Cancer Epidemiology (LACE) Study: A cohort of early stage breast cancer survivors (United States)

Abstract: The Life After Cancer Epidemiology (LACE) Study, a cohort of 2321 early stage breast cancer survivors, was established in 2000 to examine how modifiable behavioral risk factors affect quality of life and long-term survival. Women were recruited primarily from the Kaiser Permanente Northern California Cancer Registry (KPNCAL) and the Utah cancer registry (UCR), United States. Baseline data were collected, on average, at two years post-diagnosis through self-administered questionnaires that included information on demographics, medical history, anthropometry, diet, supplements, physical activity and quality of life. The purpose of this paper is to describe the creation and baseline characteristics of the cohort. Forty-six percent of women to whom questionnaires were mailed agreed to participate. The cohort which is 80% white, was diagnosed predominantly with Stage I and II breast cancer (93%), and will have been followed for 5.6 years post-diagnosis, on average, by the end of 2004. Women reported slightly over four daily servings of fruit and vegetables, well below the suggested 5-A-Day national guidelines. Compared to women free of cancer, physical activity patterns were similar, while weight gain, especially in younger women, was higher than is typical. These data suggest that in the early years post-diagnosis, breast cancer survivors exhibit similar patterns to the general population in many health behaviors.

Disparities across the breast cancer continuum.

Abstract: Objective: We performed a structured review of the literature to identify areas of greater and lesser knowledge of the nature of disparities across the breast cancer continuum from risk and prevention to treatment and mortality.

Leisure-time physical activity and lung cancer: a meta-analysis

Abstract: Objective: Several studies have evaluated the relationship between physical activity and lung cancer. To summarize and review these studies, we conducted a meta-analysis of all relevant reports published from 1966 through October 2003. Method: Adjusted odds ratios (ORs) from the original studies were pooled by the inverse of their variance, and all pooled estimates were accompanied by an assessment of heterogeneity across investigations. Test for linear trend across activity categories (low, moderate, high) were applied. Results: The combined ORs were 0.87 (95 confidence interval=0.79–0.95) for moderate leisure-time physical activity (LPA) and 0.70 (0.62–0.79) for high activity (ptrend = 0.00). This inverse association occurred for both sexes, although it was somewhat stronger for women. No evidence of publication bias was found. Several studies were able to adjust for smoking, but none adjusted for possible confounding from previous malignant respiratory disease. Our simulations suggest that this condition is unlikely to entirely explain the inverse association. Conclusion: The findings of this meta-analysis indicate that higher levels of LPA protect against lung cancer. The inverse association is possible remains confounded by inadequately controlled smoking patterns. However on the whole, confounding seems an unlikely explanation for the findings of individual studies on non-smokers.

Defining and investigating social disparities in cancer: critical issues.

Abstract: Research and action to address social disparities in cancer requires clarity about what constitutes and causes these persistent and onerous inequities in health. Currently, both scientific literature and government documents exhibit important disagreements, confused terminology, and considerable, if not deliberate, vagueness about the meaning of the phrase 'cancer disparities' and the related term 'social disparities in health.' This article accordingly reviews critical issues relevant to cohering understanding of what is meant by 'cancer disparities;' offers a definition premised on the causal contention that social disparities in health, by definition, arise from social inequity; and considers its implications for developing a multidisciplinary research agenda on social inequalities in cancer. Tackling this issue will require rigorous and critical frameworks, questions, and methods derived from multiple disciplines, and will necessarily involve epidemiologic, clinical, and intervention research, both quantitative and qualitative. At issue is making conscious research choices: about which types of disparities we study, in relation to which aspect of cancer, so as to improve the likelihood our research will help inform a society-wide discourse about the extent, origins of, and remedies for social injustices in cancer, thereby aiding efforts to eliminate social inequalities in health.

Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences.

Abstract: Objective To examine the demographic and geographic patterns of small bowel cancer incidence in the United States and worldwide.

Social inequities along the cervical cancer continuum: a structured review.

Abstract: ObjectiveTo reveal areas of research/knowledge related to social inequities and cervical cancer. Methods: A Medline search was performed looking for US based research on cervical cancer and social inequities since 1990. The papers found were organized into cells defined by a “cancer disparities grid.” Results: The majority of research published about cervical cancer and social inequities in the US, lies within the social domains of: race/ethnicity and socioeconomic position. Conflicting information exists as to whether race/ethnicity is a good predictor of screening and survival. Some research implied that differentials based on race/ethnicity are likely secondary to differentials in socioeconomic position. Some research about age, insurance status, and immigrant status and cervical cancer was found. Scarce information was found relating to sexuality, language, disability and geography and cervical cancer. Discussion: The “cancer disparities grid” facilitated a systematic and visual review of existing literature on social inequities and cervical cancer. The grid helped to elucidate uncontested existing social inequities, conflicting social inequities, and areas where social inequity data does not exist. The cancer disparities grid can be used as a research tool to help identify areas for future research, clinical programs, and political action related to cervical cancer and social inequities.

Intake of Selenium in the Prevention of Prostate Cancer: a Systematic Review and Meta-analysis*

Abstract: Background Recent studies have suggested that selenium intake may prevent the risk of developing prostate cancer. Results from some of these studies have given conflicting results. Because of these discrepant results we sought to explore the association between selenium intake and prostate cancer by conducting a systematic review and meta-analysis of the literature.

A prospective study of body mass index, hypertension, and smoking and the risk of renal cell carcinoma (United States).

Abstract: Objective:We prospectively investigated the independent association of hypertension, thiazide use, body mass index, weight change, and smoking with the risk of renal cell carcinoma among men and women using biennial mailed questionnaires.

Cancer incidence patterns among adolescents and young adults in the United States

Abstract: Objective The purpose of this study was to examine age-specific cancer incidence patterns among adolescents and young adults (ages 15–49).

Inadequate follow-up of abnormal screening mammograms: findings from the race differences in screening mammography process study (United States)*

Abstract: Objective Despite relatively high mammography screening rates, there are reports of inadequate follow-up of abnormal results. Our objective was to identify factors associated with inadequate follow-up, and specifically, to determine if this outcome differed by race/ethnicity.

Height and body mass index in relation to colorectal and gallbladder cancer in two million Norwegian men and women.

Abstract: Objectives: The present study aimed at exploring the relations between BMI and stature and colorectal and gallbladder cancer in a huge Norwegian cohort with measured height and weight.

Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States).

Abstract: Objective: Although animal studies suggest an inverse association between consumption of plant foods and risk of colorectal cancer, many observational data have failed to support such an association. We prospectively examined the association between dietary intakes of fruit, vegetables, and fiber and colorectal cancer risk in a large female cohort from the Women’s Health Study. Methods: Among 39,876 healthy women aged ≥45 years at baseline, 36,976 with baseline self-reported information on dietary intakes and other risk factors for colorectal cancer were included in the analyses. During an average follow-up of 10 years, 223 women were diagnosed with colorectal cancer. Intakes of fruit, vegetables, and fiber were assessed by a baseline food-frequency questionnaire. The analyses were carried out using the Cox proportional hazards regression and all tests were two-sided. Results: Intakes of fruit, vegetables, and the specific subgroups were not found to be associated with colorectal cancer risk. Multivariate relative risks (RRs) comparing the highest with lowest quintile were 0.79 (95% CI = 0.49–1.27,pfor trend = 0.30) for fruit intake, and 0.88 (95% CI=0.56–1.38,pfor trend=0.30) for vegetables intake. Similarly, intake of total fiber was not associated with colorectal cancer risk; the RR for the highest relative to lowest quintile was 0.75 (95% CI=0.48–1.17,pfor trend=0.12). However, higher intake of legume fiber was associated with a lower risk of colorectal cancer; the RR for the highestversuslowest quintile was 0.60 (95% CI=0.40–0.91,pfor trend=0.02). Conclusions: Our data offer little support for associations between intakes of fruit, vegetables, and fiber, and colorectal cancer risk. However, our data suggest that legume fiber and/or other related sources may reduce risk of colorectal cancer.

Zinc and prostate cancer: a critical scientific, medical, and public interest issue (United States).

Abstract: The role of zinc in the development and progression of prostate malignancy and its potential application in the prevention and treatment of prostate cancer (PCa) are contemporary critical issues for the medical/scientific community and the public-at-large. The overwhelming clinical and experimental evidence provides a compelling rational basis for the expectation and concept that prostate zinc accumulation is an important factor in the development and progression of prostate malignancy; and that zinc could be efficacious in the prevention and treatment of PCa. In contrast, various epidemiologic studies have produced divergent and conflicting results regarding the efficacy of dietary and supplemental zinc against PCa. Before reaching any definitive conclusions regarding this complex issue, one should have a complete understanding of the clinical and experimental evidence associated with the involvement of zinc in the normal and malignant prostate. Also, an understanding of interacting effects of confounding factors on the absorption, assimilation, and bioavailability of supplemental dietary zinc is important. The purpose of this review is to present the current state of the clinical and experimental information regarding zinc relationships in the normal prostate and in the pathogenesis PCa. The evidence in support of a potential beneficial effect of zinc supplement versus potential harmful effects on PCa is assessed. A discussion of the divergent results of the epidemiologic studies is presented along with a description of important factors and conditions that impact or mask the effects of dietary zinc on PCa development and progression. We also hope to bring more attention to the medical and research community of the critical need for concerted clinical and basic research regarding zinc and PCa, for the development of appropriate human prostate models to investigate these relationships, for further appropriately designed epidemiologic studies, and for future well-controlled clinical trials.

Hereditary colorectal cancer syndromes

Abstract: The purpose of this article is to review the genetic colorectal cancer syndromes including Hereditary Nonpolyposis Colorectal Cancer (HNPCC), Family Polyposis (FAP) and the hamartomatous polyposis syndromes. HNPCC is the most common of the hereditary colorectal cancer syndromes, and is the result of defects in the mismatch repair genes. Individuals with HNPCC have an 80 lifetime risk of colorectal cancer, and in females a 30–50% risk of endometrial cancer, as well as predisposition for a number of other malignancies. Early screening and interval surveillance for colorectal and endometrial cancer are recommended. In FAP, mutations in the Adenomatous Polyposis Coli (APC) tumor suppressor gene give rise to hundreds to thousands of colorectal polyps, some of which will inevitably progress to cancer. Early diagnosis and timely prophylactic colectomy prevent this outcome. Chemoprevention with nonsteroidal anti-inflammatory drugs can reduce adenoma number and size in FAP, but the effect is incomplete. In addtion, surveillance for upper gastrointestinal tract malignancies is necessary. Attenuated forms of FAP may be the result of mutations in the APC gene, or in the recently described MYH gene. Mutations in the MYH gene should be considered in individuals with multiple adenomas whose family history does not reflect an autosomal dominant pattern of inheritance. The hamartomatous polyposis syndromes are uncommon but distinctive disorders in which multiple hamartomatous polyps develop at a young age. Our understanding of the genetic basis of these disorders is improving, and a predisposition for gastrointestinal and other malignancies has recently been recognized. This article summarizes the genetics, clinical manifestations and clinical management of each of these syndromes with an emphasis on genetic testing and prevention.

A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors.

Abstract: Maternal dietary exposure to N-nitroso compounds (NOC) or to their precursors during pregnancy has been associated with risk of childhood brain tumors. Cured meat is one source of exposure to dietary NOC and their precursors. Most epidemiological studies that have examined the role of maternal consumption of cured meats during pregnancy have found a significant positive association between maternal intake of cured meat and the risk of childhood brain tumor (CBT). NOC consist of two main groups, N-nitrosamines and N-nitrosamides. The carcinogenicity profiles of NOC suggest that N-nitrosamides rather than N-nitrosamines are the compounds that may be associated with CBT and that they should be investigated more closely in epidemiological studies. We present a review of the chemical and carcinogenic properties of NOC in connection with the findings of case–control studies. This approach may be helpful in determining the essential information that must be collected in future epidemiological studies on CBT.

C-peptide, IGF-I, sex-steroid hormones and adiposity: A cross-sectional study in healthy women within the European Prospective Investigation into Cancer and Nutrition (EPIC)

Abstract: Objectives: The risk of some cancers is positively associated with body weight, which may influence circulating levels of sex-steroid hormones, insulin and IGF-I. Interrelationships between these hormones and the associations with adiposity were evaluated in healthy women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: A cross-sectional analysis was performed on anthropometric and hormonal data from 743 pre- and 1217 postmenopausal women. Body mass index (BMI) and waist circumference were used as indicators of adiposity. C-peptide, Insulin Growth Factor (IGF)-I, Insulin Growth Factor binding protein (IGFBP)-3, androgens, estrogens and sex hormone binding globulin (SHBG) were measured by immunoassays; free sex steroid concentrations were calculated. Results: BMI and waist circumference were positively correlated with estrogens in postmenopausal women and with C-peptide, free testosterone and inversely with SHBG in all women. C-peptide and IGF-I were inversely correlated with SHBG, and positively with free sex steroids in postmenopausal women. IGF-I was positively associated with postmenopausal estrogens and androgen concentrations in all women. Conclusions: Sex-steroid concentrations appear to be regulated along several axes. Adiposity correlated directly with estrogens in postmenopausal women and with insulin, resulting in lower SHBG and increased levels of free sex steroids. Independent of adiposity and insulin, IGF-I was associated with decreased SHBG levels, and increased concentrations of androgens and postmenopausal estrogens.

Socio-economic factors and breast cancer survival - : a population-based cohort study (Sweden)

Abstract: Objective: To assess the influence of socio-economic factors on breast cancer survival in Sweden, a country with population-based mammography screening and a uniform health care system aiming to provide care to all on equal terms.

Colorectal screening is associated with reduced colorectal cancer risk: a case-control study within the population-based Ontario Familial Colorectal Cancer Registry*

Abstract: Objective: This is the first study to evaluate the association between colonic screening and colorectal cancer risk among Canadians.

Lifestyle factors and the risk of adult leukemia in Canada.

Abstract: Objectives: To evaluate the impact of active smoking, obesity, and dietary intakes on the risk of adult leukemia.

Age at menarche and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers.

Abstract: Age at menarche is a strong and consistent predictor of breast cancer risk in the general population, but has not been well studied in women with a family history of breast cancer. We conducted this study to examine whether the presence of a deleterious BRCA1 or BRCA2 mutation influences age at menarche and to investigate whether or not there is an association between age at menarche and the risk of breast cancer in BRCA1 or BRCA2 mutation carriers. The presence of a deleterious BRCA1 or BRCA2 mutation did not appear to influence a woman's age at menarche. A matched case-control study was conducted on 1311 pairs of women who have been identified to be carriers of a deleterious mutation in either the BRCA1 (n = 945 pairs) or the BRCA2 gene (n = 366 pairs). Information about age at menarche was derived from a questionnaire routinely administered to carriers of a mutation in either gene. Among women who carried a deleterious BRCA1 mutation, age at menarche was inversely associated with the risk of breast cancer (p trend = 0.0002). This association was not observed among BRCA2 mutation carriers (p trend = 0.49). Compared with BRCA1 carriers whose age at menarche was < or =11 years, women with a menarcheal age between 14 and 15 years old had a 54% reduction in risk (OR = 0.46; 95% CI 0.30-0.69). This study implicates early age at menarche as a determinant of breast cancer among women with a BRCA1 mutation.

Social disparities across the continuum of colorectal cancer: a systematic review.

Abstract: Objective:The purpose of this review is to evaluate the published literature to assess social inequalities in colorectal cancer using the ‘cancer disparities grid.’ Methods: Three computerized databases were searched from January 1990 to January 2004 to identify published English language articles that collected data from study participants living in the United States. Abstracts were reviewed and articles that dealt with social inequality and colorectal cancer were selected. A total of 46 articles were identified and classified into the appropriate cell of the cancer disparities grid. Results: The majority of research identified for the grid has focused primarily in one domain of inequality, race/ethnicity and racism, and within one column of the cancer continuum, cancer screening. About one-third of the articles focused on multiple aspects of social inequalities. There were few or no published research articles within many of the domains of social inequality along the continuum of colorectal cancer prevention, treatment, and outcomes. Conclusions: This review found only a modest amount of research has been conducted that has examined the influence of social inequalities on colorectal cancer. Findings suggest that a multidisciplinary approach is needed to measure and remedy these social inequalities.

Social disparities and prostate cancer: mapping the gaps in our knowledge

Abstract: To evaluate the current state of our knowledge regarding social disparities and prostate cancer and to map the domains where substantial knowledge has been acquired as well as those where little is known, with the purpose of identifying important areas for future research. A Medline research was conducted to identify published papers regarding social disparities in prostate cancer since 1990. The results of this review are presented in a social disparities and prostate cancer grid designed to highlight which domains of social disparities have been researched and which neglected. The major social disparity in prostate cancer concerns the extremely high prostate cancer incidence and mortality seen among black Americans. This is also the area where the most research has been performed. Low socioeconomic position is associated with poorer prostate cancer outcomes but not with higher prostate cancer incidence. It remains poorly defined to what extent racial/ethnic differences in prostate cancer result from differences in socioeconomic position (SEP). Understanding the causes of the high prostate cancer mortality seen among black men remains the major challenge in the area of social disparities and prostate cancer.

Cancer survivorship: a new challenge in comprehensive cancer control.

Abstract: Cancer survivors are a growing population in the United States because of earlier cancer diagnosis, the aging of society, and more effective risk reduction and treatment. Concerns about the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public, private, and non-profit organizations. The purpose of this paper is to discuss how survivorship fits within the framework of comprehensive cancer control. We summarize three national reports on cancer survivorship and highlight how various organizations and programs are striving to address the needs of cancer survivors through public health planning, including the challenges these groups face and the gaps in knowledge and available services. As cancer survivorship issues are being recognized, many organizations have objectives and programs to address concerns of those diagnosed with cancer. However, better coordination and dissemination may decrease overlap and increase the reach of efforts and there is limited evidence for the effectiveness and impact of these efforts.

What do cancer survivors believe causes cancer? (United States).

Abstract: Objective: To describe cancer survivors’ beliefs about the causes of prostate, colorectal or breast cancers.

Translating research into improved outcomes in comprehensive cancer control.

Abstract: A key question in moving comprehensive cancer control (CCC) plans into action is, to what extent should the knowledge gained from investments in cancer prevention and control research influence the actions taken by states, tribes, and territories during implementation? Underlying this ‘should’ is the assumption that evidence-based approaches (i.e., a public health or clinical intervention or policy that has resulted in improved outcomes when scientifically tested), when implemented in a real-world setting, will increase the likelihood of improved outcomes. This article elucidates the barriers and opportunities for integrating science with practice across the cancer control continuum. However, given the scope of CCC and the substantial investment in generating new knowledge through science, it is difficult for any one agency, on its own, to make a sufficient investment to ensure new knowledge is translated and implemented at a national, state, or local level. Thus, if greater demand for evidence-based interventions and increased resources for adopting them are going to support the dissemination initiatives described herein, new interagency partnerships must be developed to ensure that sufficient means are dedicated to integrating science with service. Furthermore, for these collaborations to increase both in size and in frequency, agency leaders must clearly articulate their support for these collaborative initiatives and explicitly recognize those collaborative efforts that are successful. In this way, the whole (in this context, comprehensive cancer control) can become greater than the sum of its parts.

Body mass index, body height, and subsequent risk of colorectal cancer in middle-aged and elderly japanese men and women : Japan public health center-based prospective study

Abstract: To investigate the association of body mass index (BMI) or body height with colorectal cancer incidence in a population-based prospective study. We identified 986 (626 men and 360 women) newly diagnosed cases of colorectal cancer during the 9.4-year follow-up of a cohort consisting of 102,949 (49,158 male and 53,791 female) middle-aged and elderly Japanese. Lower BMI groups (lower than 23) were not associated with colorectal cancer compared with the 23–24.9 BMI group. Any categories of 25–26.9, 27–29.9, or 30 or more BMI were associated with an increased risk of colorectal cancer compared with the lower than 25 BMI (RR, 1.2 for 25–26.9, 1.4 for 27–29.9, and 1.5 for 30 or more; p for trend, 0.004) in men. These associations were more evident only in invasive-type cancer analysis. BMI was not associated with the risk of colorectal cancer in women. No significant association with height was obtained for either men or women. The association of BMI with colorectal cancer was confirmed in a Japanese population as well as Western populations. Only invasive-cancer analysis suggested that BMI was important for tumor growth and proliferation. Approximately 6.7% of colorectal cancer was attributable to a BMI of 25 or higher in middle-aged and elderly Japanese men.

Lymphohematopoietic Cancers in the United Farm Workers of America (UFW), 1988–2001

Abstract: Objective: Agricultural risk factors for lymphohematopoeitic cancers (LHC) in Hispanic farm workers in California were examined in a nested case–control study embedded in a cohort of 139,000 ever members of a farm worker labor union in California.