Lifestyle-related risk factors for stomach cancer in northeast Thailand.

Background: Stomach cancer is not common in Thailand but the life styles of the Thai population are changingto become more Western so that information for planning control programme of stomach cancer is necessary.The highest incidence rates of this neoplasm are found in Eastern Asia, ranging from age-standardized rates of95.5/105 (men) and 40.1/105 (women) in Yamagata, Japan to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen,Northeast of Thailand. In Thailand, the estimated age-standardized incidence rates in 1993, 1996 were 4.9/105,4.1/105 in men and 3.0/105 , 2.6/105 in women. Risk factors for stomach cancer in Thai population are unclear,but possibly include low intake of vegetables and fruits, alcohol drinking, tobacco smoking and high intake ofsalt. Objective: To investigate various aspects of dietary factors, smoking, and alcohol drinking in determiningrisk of stomach cancer in Thai population. Methods: A case-control study was conducted in Khon Kaen, Thailandduring 2002-2006, to study the role of these factors in stomach cancer. 101 stomach cancer cases and 202 matchedcontrols (case : control = 1:2) by sex, age (± 3 years) and region were recruited from Srinagarind Hospital andKhon Kaen Regional Hospital, in Khon Kaen Province. All of cases were histologically confirmed. Controls hada variety of diseases, the main ones being disease of the eye. Information on dietary habits, alcohol drinking andsmoking were collected by a structured questionnaire, blood samples were collected for further study. Results:The distribution of the general characteristics by case-control status, the distribution of age and sex were similarin cases and controls. In the final analysis, the factors that found to be higher risk but not statistically significantwere long-term filter cigarette smoking (OR=1.9, 95%CI: 0.85-4.50), long-term alcohol consumption (OR=1.2,95%CI: 0.51-2.60) and low intake of vegetables and fruits (OR=1.2, 95%CI: 0.74-1.96). A high intake of vegetableoil (OR=4.5, 95%CI: 1.00.-20.17) was found to be associated with increased risk, and similar tendencies werenoted for pork oil (OR=1.4, 95%CI: 0.63-3.01) and jeaw prik (mainly chilly with plara broth) (OR=1.2, 95%CI:0 .76- 2.01). Conclusion: Our study confirmed protective effects of a high intake of fruits and vegetables againststomach cancer development and showed a high intake of sauces to increase risk of stomach cancer as in othercountries in Asia.     

Risk factors for colorectal cancer in northeast Thailand: lifestyle related.

Background: The incidence of colorectal cancer is variable around the world. Hiroshima, Japan had the highest incidence in men in 1997 with an age-standardized rate of 86.7 per 100,000 and New Zealand had the highest, at 40.6 per 100,000, in women. The incidence of colorectal cancer in Thailand is rather low and the latest figures for Northeast of Thailand are 7.1 per 100,000 for men and 4.7 for women. The reasons for these differences between countries are possibly due to variation in dietary habits, alcohol drinking or other cofactors. Methods: A case-control study was conducted in Khon Kaen, Northeast Thailand during 2002-2006 to study risk factors for colorectal cancer in a low risk area. Totals of 253 colorectal cancer cases (males 135, females 118) and 253 age- and sex-matched controls were recruited. Information on dietary habits, alcohol drinking, smoking and other information were collected by a structured questionnaire. Blood samples were collected for further study. Both univariate and multivariate analyses were carried out. Results: In the final model of multivariate analysis, the significant risk factors for colorectal cancer were a family history of cancer (OR=1.9 95%CI=1.2-2.9) and meat consumption (OR=1.0 95%CI=1.0007-1.0026). For BMI, subjects with higher BMI unexpectedly had a lower risk of colorectal cancer (OR=0.5 95%CI=0.3-0.8). Conclusion: Our study confirmed risk factors for colorectal cancer i.e. meat consumption and cancer in the family (genetic problem). However, the results for BMI are the reverse of expected, underlining one limitation of hospital-based case-control studies, in which cases are ill and admitted to the hospital at late stage.     

Trends in Incidence of Childhood Leukemia,Khon Kaen,Thailand, 1985-2002

Background: The Khon Kaen Cancer Registry (KKCR), providing both hospital and population-based ‍registration, was established in 1984 in the Faculty of Medicine, Khon Kaen University. Leukemia is the most ‍common cancer among Thai children in Thailand, including both curable and preventable types, but no assessment ‍of trends has hitherto been performed. Objective: To perform a statistical assessment of the incidence trend of ‍childhood leukemia in Khon Kaen, Thailand, between 1985 and 2002. Methods: Population-based cases of childhood ‍leukemia registered between 1985 and 2002 were retrieved from the KKCR and cases with an ICD-O diagnosis ‍(coding C42) in children under 15 were selected. Incidence trends were calculated using the Generalized Linear ‍Model method (GLM), which generates incidence-rate-based logarithms. Results: Of the 277 cases of leukemia, ‍boys were affected two times more frequently than girls and half of the cases were 0-4 years of age. Most diagnoses ‍were histologically- or cytologically-proven and the most common type (affecting two-thirds, 65.7%) was acute ‍lymphoblastic leukemia (ALL). The overall, age-standardized rate (ASR) for leukemia was 31.9 per million (95%CI: ‍28.1 to 35.7); 40.3 per million (95%CI: 34.2 to 46.4) in boys and 27.0 (95%CI: 21.8 to 32.2) in girls. Incidence has ‍been increasing by 2.4% per year in boys (95% CI: -0.5 to 5.3) and 4.1% per year in girls (95% CI: 1.1 to 7.2). ‍Conclusions: This incidence-rate-based logarithm indicates that childhood leukemia has been increasing, suggesting ‍further epidemiological research on causes and possible prevention is needed.     

亚甲基四氢叶酸还原酶基因C677T多态性、生活习惯与贲门癌易感性的关系

[目的]研究亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性及其与烟酒茶嗜好相互作用与贲门癌易感性的关系.[方法]在上消化道癌高发区淮安市进行了病例-对照研究(贲门癌89例,对照人群223例),调查研究对象的生活习惯,采用PCR-RFLP技术检测研究对象的MTHFR基因型.应用SAS软件或EPI Info软件进行统计学分析.[结果]①男性吸烟者和女性饮酒者与男性不吸烟者和女性不饮酒者相比患贲门癌的风险增高;不饮茶者与饮茶者相比发生贲门癌的危险性升高.②贲门癌组中MTHFRC/T T/T基因型携带者占82.0%,显著高于对照组的70.3%.与携带MTHFRC/C基因型相比,C/T T/T基因型携带者发生贲门癌的危险性(OR)为2.12(95%CI 1.14～3.95),调整性别、年龄、吸烟、饮酒、饮茶及生蔬菜、水果、肉和豆制品摄取习惯后OR为2.05(95%CI 1.05～2.03).③在吸烟、每周饮酒≥2次和不饮茶者中,携带MTHFRC/T T/T基因型者发生贲门癌的危险性显著上升.[结论]MTHFR基因型与贲门癌的易感性有关;MTHFR基因多态性影响吸烟、饮酒和饮茶与贲门癌之间的关系.     

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. ‍ ‍     

A Population-based Case-control Study of Risk Factors and Genetic Polymorphisms of ALDH2 and P4502E1 for Hepatocellular Carcinoma in Nagoya,Japan

A population-based case-control study was carried out to investigate risk factors for hepatocellular carcinoma ‍(HCC) in Nagoya, Japan, including hepatitis virus infections, drinking and smoking habits and genetic polymorphisms ‍in aldehyde dehydrogenase2 (ALDH2) and cytochrome P4502E1 (CYP2E1). A total of 84 patients with HCC and 84 ‍sex, age and residence pair-matched controls were recruited for this study. By univariate analysis, hepatitis B virus ‍(HBV) (OR=5.14; 95%CI=2.29-11.6) and hepatitis C virus (HCV)(OR=32.00; 95%CI=7.83-130.7) infections, having ‍a history of blood transfusion (OR=5.25; 95%CI=1.80-15.29), and habitual smoking (OR=2.36; 95%CI=1.17-4.78) ‍were significantly linked to cases; by multivariate analysis, HCV infection (OR=23.5; 95%CI=5.07-108.9) and habitual ‍smoking (OR=5.41; 95%CI=1.10-26.70) were still associated with a significantly increased risk. The c1/c1 genotype ‍of CYP2E1 (odds ratio [OR]= 0.45; 95% confidence interval [CI]=0.21-0.99), detected by Pstl and Rsal digestion was ‍significantly more prevalent in the control group, while 1-1 genotype of ALDH2 (OR=1.24; 95%CI=0.70-2.20) did ‍not demonstrate variation. There were no statistically significant interactions between habitual smoking/drinking ‍and genetic polymorphisms of ALDH2/P4502E1 with reference to HCC development. These findings suggest that ‍viruses, especially HCV infection, and habitual smoking are major independent risk factors, while genetic ‍polymorphisms of ALDH2 and CYP2E1 have only limited contribution to the risk of HCC in Nagoya, Japan.     

Association between Smoking and Mortality: Khon Kaen Cohort Study,Thailand

Background: Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high,at around 50%. The purpose of this study was to determine the relationship between smoking and mortality ina rural Thai community. Materials and Methods: Subjects enrolled into the Khon Kaen cohort study between1990 and 2001 were followed up for their vital status until 16th March 2012. The death resource was from theBureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used toanalyse the association between smoking and death, controlling for age, education level and alcohol drinking,and confidence intervals were calculated using the floating risk method. Results: The study recruited 5,962 malesubjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely todie than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32-1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there wasno increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (handrolledcigarettes) and manufactured tobacco. Conclusion: Mortality from cancer, particularly lung cancer, andfrom all causes combined is dependent on smoking status among men in rural Thailand, but the relative risksare lower than have been reported from studies in high income countries, where the tobacco epidemic is moreestablished.     

Cancer Incidence in Thailand, 1995-1997

There are five population-based cancer registries in Thailand in different regions of the country. Four of them ‍(Chiang Mai, Khon Kaen, Bangkok, and Songkhla) have been operating since 1988 and the other (Lampang) since ‍the early 1990’s. These registries have published regular 3-year cancer incidence reports since the first in 1993 for ‍the period 1989-1991. The objective of this article is to summarize the figures of cancer incidence in Thailand during ‍1995-1997. The population of Thailand in 1996, at the middle of the period, was 27 million males and 27.5 million ‍females. Information of cancer cases residing in the five provinces was collected and abstracted from different ‍sources. Age-standardized incidence rate (ASR) of cancer in males and females was calculated for each registry and ‍that for the whole country was estimated using the five registries as representatives for the four geographical regions ‍of Thailand. The estimated number of new cancer cases in 1996 for the whole country was 35,539 men and 38,476 ‍women and the ASRs were 149.2 and 125.0 per 105 population in men and women respectively. Cancer incidences ‍greatly differed from region to region. Lung cancer was the commonest in Chiang Mai and Lampang in the Northern ‍region in both sexes. The incidence of liver cancer in Khon Kaen in the Northeastern region outnumbered all the ‍others in both sexes; cholangiocarcinoma was the major type of liver cancer. In Bangkok, lung cancer was the most ‍important cancer in males and breast cancer was in females. Though it was lung and cervix uteri cancer that ranked ‍the first in men and women in Songkhla, the rate of oral and pharyngeal cancer was exceptionally higher than in ‍other registries. The geographical variability in cancer patterns in Thailand reflects exposure of the population to ‍different risk factors unique to the different regions. In the study as a whole, there are some methodological weak ‍points in estimating the ASRs and number of cancer cases for the whole country, but the results are the most reliable ‍cancer statistics from Thailand at the moment. In conclusion, both a country-wide and region-specific cancer control ‍programmes are needed for Thailand. The national one would be for the cancers common to all regions, and the ‍provincial-level emphasis should be on cancers which are the major problems in the area.     

Helicobacter pylori infection on the risk of stomach cancer and chronic atrophic gastritis.

Helicobacter pylori infection is associated with gastric adenocarcinoma. However, the mechanisms of this interaction are still unclear. This study was conducted to explore the effects of H. pylori infection on early and late stage gastric carcinogenesis. This study included 134 patients with adenocarcinoma of the stomach (ACS), 67 patients with chronic atrophic gastritis (CAG), and 65 normal controls recruited at Memorial Sloan-Kettering Cancer Center (MSKCC) from November 1, 1992 to November 1, 1994. Epidemiologic data were collected by a modified National Cancer Institute Health Habits History Questionnaire. H. pylori infection was diagnosed by pathological evaluation. Risk factors were analyzed using logistic regression. The odds ratio (OR) associated with H. pylori infection was 10.4 [95% confidence interval (CI): 2.6-41.6] for CAG and 11.2 (95% CI: 2.5-50.3) for gastric cancer in comparison with normal controls, with adjustment for pack-years of smoking, alcohol drinking, body mass index, total caloric intake, dietary fat and fiber intake, and Barrett's esophagus. But H. pylori infection was not associated with risk of stomach cancer when patients with stomach cancer were compared with patients with CAG (OR = 0.6, 95% CI: 0.3-1.3) after controlling for potential confounding variables. This association was persistent when only patients with both gastric cancer and chronic gastritis were considered as cases and patients with CAG were considered as controls (OR = 0.7, 95% CI: 0.3-2.0) in the multivariate analysis. Our results suggest that H. pylori infection may be involved in the early stage of development of CAG, but not in the development of stomach cancer from CAG, and indicate that strategies for prevention of stomach cancer should target the early stage to eliminate H. pylori infection in high-risk populations.     

The p53 Codon 72 Polymorphism and Risk of Oral Cancer in Southern Thailand

The codon 72 polymorphism of the p53 tumor suppressor gene has been investigated extensively for its association ‍with various cancers around the world. However, its influence has not been elucidated in the Thai population. ‍Therefore, a case-control study with 97 patients and 97 matched controls was conducted to elucidate the association ‍between the polymorphic p53 and oral cancer risk in a Southern Thai population. The frequencies of the Arg/Arg, ‍Arg/Pro, and Pro/Pro genotypes were 36%, 35%, and 29%, respectively in the controls and 33%, 45% and 22%, ‍respectively in the patients. This study shows that there was no significant association between the p53 codon 72 ‍polymorphism and oral cancer risk. There was also no link with respect to smoking or drinking habits. However, ‍our data suggest that for individuals who were younger than 65 years old, the Pro/Pro genotype may offer some ‍protection against oral cancer (OR = 0.13, 95%CI 0.04-1.10). This is the first report on p53 polymorphism and oral ‍cancer in Thailand.‍ ‍     

Determining Gastric Cancer-Related Risk Factors in Mongolian Population Using ABC(D) Method: A Matched Case-Control Study

Objective: We aimed to identify gastric cancer-related risk factors and evaluate the efficacy of screening ABC(D) method in determining high risk  gastric cancer individuals in Mongolian population. Methods: A total of 240 participants (120 gastric cancer patients and 120 healthy individuals) were included in this study. Data were collecting using a structured questionnaire consisting of 56 questions covering 5 categories. Serum Helicobacter pylori IgG (H. pylori IgG), pepsinogen I (PGI), and pepsinogen II (PGII) were tested in one third of all the participants (40 gastric cancer patients and 40 controls).  PGI, PGII, and H. pylori IgG levels were measured using GastroPanel enzyme-linked immunosorbent assay kit (Biohit, Helsinki, Finland). Results: Habits of having leftover meals (OR 2.22, 95%CI 1.27-3.86, p<0.01), daily consumption of tea with salt (OR 1.97, 95%CI 1.18-3.30, p<0.01), smoking on an empty stomach (OR 2.44, 95%CI 1.11-5.37, p<0.05), daily consumption of vegetables (OR 0.45, 95%CI 0.27-0.76, p<0.01), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p<0.05), family history of gastric cancer (parents OR 2.88, 95%CI 1.07-7.78, p<0.05, siblings (OR 3.09, 95%CI 1.09-8.81, p<0.05), and history of gastric diseases (OR 3.65, 95%CI 2.10-6.35, p<0.0001) were identified as protective factors. A low PGI level (<35.25ng/ml) and low PGI/II ratio (<4) were associated with gastric cancer risk. According to ABC(D) method, groups C and D had higher proportion of gastric cancer cases than group A and B (group C, OR 7.50, 95%CI 1.20-47.05, p<0.05; group D, OR 8.3, 95%CI 1.33-51.26, p<0.05). Conclusion: Our findings suggested that gastric cancer risk was more closely related to eating habits, smoking, family history, and precancerous lesions. ABC(D) method seems to be a plausible alternative or supplementary method for stratifying patients at high risk of gastric cancer in this country.     

Clinical Characteristics and Helicobacter pylori Status of Gastric Cancer in Thailand

Background: Gastric cancer is the second leading course of cancer death worldwide and H. pylori infectionis an important risk factor for gastric cancer development. This study was design to evaluate the clinical,pathological features, survival rate and prevalence of H. pylori infection in gastric cancer in Thailand. Materialsand Methods: Clinical information, histological features, endoscopic findings and H. pylori status were collectedfrom gastric cancer patients from Thammasat university hospital during June 1996-December 2011. H. pyloriinfection was assessed by histological evaluation, rapid urease test and serological test. Clinical information,endoscopic findings and histopathology of all patients were recorded and compared between patients with activeor non-active H. pylori infection. Results: A total of 100 gastric cancer patients (55 men and 45 women withmean age of 55±16.8 years) were enrolled in this study. Common presenting symptoms were dyspepsia (74%),weight loss (66%), anemia (63%) and anorexia (38%). Mean duration of symptoms prior to diagnosis was 98days. Overall prevalence of H. pylori infection was 83% and active H. pylori infection was 40%. 1-year and5-year survival rates were 43% and 0%. There was no significant difference between active H. pylori infectionin different locations (proximal vs non-proximal: 47.1% vs 48.5%; P-value = 0.9, OR=0.9; 95%CI =0.3-3.1) andhistology of gastric cancer (diffuse type vs intestinal type: 47.4% vs 50%; P-value= 0.8, OR=0.9, 95%CI=0.3-2.7).However, linitis plastica was significantly more common in non-active than active H. pylori infection (27.9% vs0%; P-value <0.0001, OR =13.3, 95%CI=3.2-64.5). Moreover, gastric cancer stage 4 was higher in non-active thanactive H. pylori infection (93% vs 50%, P-value<0.001). Conclusions: Prevalence of H. pylori infection in Thaigastric cancer patients was high but active infection was low. Most gastric cancer patients presented in advancestage and had a grave prognosis. Screening for gastric cancer in high risk individuals might be an appropriatetool for early detection and improve the treatment outcome for this particular disease in Thailand.     

A Population-based Case-control Study on Risk Factors for Gastric Cardia Cancer in Rural Areas of Linzhou

Gastric cancer is the second most common cause of cancer-related deaths in the world. Although certaindietary factors and lifestyles have been suggested to be associated with gastric carcinogenesis, there have beenfew investigations focusing on rural areas. A case-control study was therefore carried out to investigate the riskfactors of gastric cardia cancer (GCC) in rural areas of Linzhou. A total of 470 newly diagnosed cases of GCCand 470 healthy controls were included. Face-to-face interviews were conducted, using a uniform questionnairecontaining questions on demographics, per capita income, living habits, dietary habits and family history oftumors. The relationship between putative risk factors and GCC was assessed by odds ratios (OR) and their 95%confidence intervals (95%CI) derived from conditional logistic regression model by the COXREG commandusing SPSS 12.00. Multivariate logistic regression analysis was used to evaluate simultaneously the effects ofmultiple factors and other potential confounding factors. Multivariate logistic analysis showed that smoking(OR=1.939, 95%CI:1.097-3.426), alcohol drinking (OR=2.360, 95%CI: 1.292-4.311), hot food consumption(OR=2.034, 95%CI: 1.507-2.745), fast eating (OR=1.616, 95%CI: 1.171-2.230), mouldy food (OR=4.564, 95%CI:2.682-7.767), leftover food (OR=1.881. 95%CI: 1.324-2.671), and family history of tumor (OR=2.831, 95%CI:1.588-5.050) were risk factors for GCC. High per capita income (OR=0.709, 95%CI: 0.533-0.942), high educationlevel (OR=0.354, 95%CI: 0.163-0.765), consumption of fresh fruits (OR=0.186, 95%CI: 0.111-0.311) and vegetables(OR=0.243, 95%CI: 0.142-0.415), and high BMI (OR=0.367, 95%CI: 0.242-0.557) were protective factors forGCC. Our data indicate that unhealthy lifestyle and dietary habits might be important contributors to GCC inthis population.     

Evaluation of dietary and life-style habits of patients with gastric cancer: a case-control study in Turkey

Objective: Gastric cancer is an important public health problem in the world and Turkey. In addition toHelicobacter pylori (H. pylori), smoking, alcohol consumption and family history, certain dietary factors havebeen associated with its occurrence. The impact of dietary habits and life-style factors on the risk of gastriccancer in Turkey were evaluated in this study. Design: A questionnaire was applied to 106 patients with gastricadenocarcinoma and 106 controls without cancer matched for age (range 28-85 years) and gender selected froma hospital based population. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated withlogistic regression analysis. Results: The incidence of H. pylori was 81.3% in patients. Frequent consumption ofsalty dishes, very salty foods like pickles, soup mixes, sausages, foods at hot temperature (ORs = 3.686, 7.784,5.264, 3.148 and 3.273 respectively) and adding salt without tasting (OR = 4.198) were associated with increasedgastric risk. Also heavy smoking and high amount of alcohol consumption (p = 0.000) were risk factors. Frequentconsumption of green vegetables, onion, garlic and dried fruits (ORs = 0.569, 0.092, 0.795 and 0.041) was nonsignificantlyassociated with decreased risk. Conclusion: Improved dietary habits, reducing salt consumptionand eradication of H. pylori infection may provide protection against gastric cancer in Turkey.     

Serum Antioxidant Vitamin Levels of People in Khon Kaen,Northeastern Thailand

Three antioxidant vitamins, the á- and â-carotenes as well as vitamin E, were measured in sera of a normal ‍population in Northeastern Thailand using HPLC. The mean serum â-carotene level of females was significantly ‍higher than the value for males, i.e, 37.55 (95%CI=34.59-40.51) versus 32.97 (95%CI=30.01-35.93) ìg/dl. The â- ‍carotene level tended to decrease as age increased, particularly in the male population. The mean serum á-carotene ‍level was also higher in females than in males, i.e., 7.08 (95%CI=6.57-7.59) and 6.26 (95%CI=5.77-6.75) ìg/dl, ‍respectively. The average serum á-tocopherol (Vitamin E) level of the whole population was 1.08 (95%CI=1.04-1.12) ‍ìg/dl and did not show age or sex differences. In general, the serum antioxidant vitamins of smokers were lower than ‍those of the non-smokers but a significant difference was observed only for á-tocopherol. Alcohol drinking resulted ‍in slightly lower serum â-carotene values, whereas coffee or tea drinking and betel nut chewing did not cause any ‍differences with these three antioxidant vitamins. However, we report higher in serum á-carotene levels of people in ‍Ban Fang district than in Chonnabot district. The results from our study give the base line data of serum antioxidant ‍vitamins in a Thai population and also suggest future intensive study on the relationship of dietary intake and ‍cancer prevention. ‍     

Salt Taste Preference,Sodium Intake and Gastric Cancer in China

Aim: The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pyloriand diet. By using a case-control study among residents in China, we examined the association between sodiumintake, presence of H,pylori, and gastric cancer risk. Methods: A population-based case-control study including235 cases and 410 controls were used. Potential risk factors of gastric cancer were interview for cases and controlsby questionnaire, salt taste preference was measured for all subjects, and IgG antibodies to H,pylori was usedfor H.pylori infection. Risk measures were calculated using unconditional logistic regression. Results: H.pyloriinfection and smoking increased the risk of gastric cancer, with the OR(95%CI) of 1.91(1.32-2.79) and 1.47(1.05-2.05), respectively. Dietary sodium intake independently increased the risk of gastric cancer. Participants withthe highest sodium intake(>5g/day) had a high gastric cancer risk [OR(95%CI)= 3.78(1.74-5.44)]. Participantswith the salt taste preference at 7.3g/L and ≥14.6g/L showed higher risk of gastric cancer [OR(95%) for 7.3g/Land ≥14.6g/L were 5.36(2.72-10.97) and 4.75(2.43-8.85), respectively]. A significantly interaction was foundbetween salt taste preference and H.pylori infection (p=0.037). Salt taste preference was significantly correlatedwith sodium intake (Correlation coefficient=0.46, p<0.001). Conclusion: Salt taste preference test could be asimple way to evaluate an inherited characteristic of sodium intake, and our study confirms the gastric canceris associated with sodium intake and H.pylori.     

Smoking Behavior and Risk of Helicobacter Pylori Infection,Gastric Atrophy and Gastric Cancer in Japanese

Although many studies have shown that smoking is an established risk factor for gastric cancer, relatively few studies have investigated on which step smoking has effects in Helicobacter pylori (H. pylori) related gastric carcinogenesis. In this study we investigated the association of smoking with risk of three steps leading to gastric cancer: H. pylori infection, gastric atrophy, and gastric cancer. Among the participants who visited Aichi Cancer Center Hospital from year 2001 to 2005, 583 cases diagnosed as gastric cancer and age-and sex-frequency-matched 1,742 cancer free controls were sampled, from whom those without serum samples or without information about smoking habit were excluded, leaving 576 cases and 1,599 controls eligible for the analyses. Anti- H. pylori IgG antibody and serum pepsinogens (PG) were measured to detect H. pylori infection and gastric atrophy. Smoking status was asked by a self-administered questionnaire. The odds ratio (OR) of H. pylori infection, as well as the OR of gastric atrophy among the H. pylori seropositive controls was not significant for smokers. The age- and sex-adjusted OR of gastric cancer was significantly elevated relative to the subjects with gastric atrophy: OR=1.62 (95% confidence interval (CI), 1.19-2.22; P=0.002) for ever smokers and 2.52 (1.75-3.64; P<0.001) for current smokers, relative to never smokers. This study revealed that smoking behavior contributed to the increased risk of gastric carcinogenesis from gastric atrophy, but had little influence on H. pylori infection or gastric atrophy development.     

Re-examination of Opisthorchis viverrini Infection in Northeast Thailand

Background: Liver fluke infection caused by the parasite Opisthorchis viverrini (O. viverrini), a humancarcinogen, is endemic in north-eastern Thailand and remains a major health problem. Objectives: The objectivesof the study were to (1) resurvey the prevalence of O. viverrini infection in a field site from the Khon Kaen CohortStudy (in newly recruited subjects as well as previous cohort subjects surveyed in 1992); (2) investigate howsubjects’ lifestyle habits and their exposure to health promotion initiatives influence changes in prevalence ofO. viverrini infection. Materials and Methods: The prevalence of O. viverrini infection in the cohort subjects (aswell as new subjects) was investigated using faecal egg counts. Information on demographic factors, lifestyle andawareness of health promotion initiatives were obtained through questionnaires. Results: O. viverrini infectionrates in the same individuals of the cohort were lower in 2006 than in 1992. Also, by studying the period effect, thecurrent 35-44 year olds had a 12.4% (95% CI 3.9% to 20.9%) lower prevalence of O. viverrini infection than the35-44 year olds in 1992 (24.2% versus 11.8%). Lifestyle choices showed that smoking and alcohol consumptionwere associated with an increased chance of acquiring O. viverrini infection with adjusted odds ratios of 10.1(95%CI 2.4-41.6) and 5.3 (95%CI 1.2-23.0), respectively. Conclusions: Our study has demonstrated that althoughthe prevalence of O. viverrini infection over a 14-year period has decreased, unhealthy lifestyle was commonwith smoking and alcohol consumption being associated with increased chances of infection, emphasising thedouble burden of disease which developing countries are facing.     

The ACE Gene Polymorphism is Associated with the Incidence of Gastric Cancer among H. pylori Seropositive Subjects with Atrophic Gastritis

Studies of the angiotensin converting enzyme (ACE) I/D polymorphism have provided evidence that the D/D ‍genotype is associated with gastric tumor progression and numbers of lymph node metastases, but not with the ‍overall risk of gastric cancer. The highest levels of circulating and tissue ACE activity were found in carriers of the ‍D/D genotype. Here, we further investigated the association using 454 Japanese subjects undergoing a health checkup ‍and 202 gastric cancer patients. The ACE polymorphism was not found to be linked with H. pylori seropositivity or ‍gastric atrophy. However, among H. pylori seropositive subjects with atrophy, those with the I/D genotype had an ‍increased risk of gastric cancer (OR=1.59; 95% CI, 1.02-2.48). We also established that the polymorphism did not ‍lower the age at diagnosis of gastric cancer. Confirmation of the association between ACE polymorphisms and ‍development of gastric cancer requires much larger studies, and the biological role also needs to be fully elucidated.