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. ‍     

Case-Control Study of Alcohol Usage and Fruit Intake and Stomach Cancer in the North Viet Nam

Background: The aim was to examine the association between alcohol usage, fruit intake and stomach cancer treated in hospitals in the Hanoi city during 2018-2019. Methods: A case-control study was performed for 379 newly incidence cases of stomach cancer and matched 1096 hospital controls for sex and age (+/-5). We used the validated semi-quantitative food frequency questionnaire to collect data on the intake of alcohol and fruits and other food groups. The average amount of total fruits intake (grams per week) was estimated. The adjusted Odds ratio and 95% confidence interval (OR (95%CI) were estimated. Results: Intake of alcohol significantly increased the risk of stomach cancer, the mean frequency of intake per year of 345.1 times vs. non-drinkers, OR (95%CI): 1.51 (1.05, 2.17), p_trend=0.026. In contrast, a higher total of fruits intake was associated with a significantly decreased risk of stomach cancer in both sexes, men, and women, (Q5 vs Q1), OR (95%CI): 0.47 (0.30, 0.72), p_trend=0.000, OR (95%CI): 0.45 (0.26, 0.77), p_trend =0.003, OR (95%CI): 0.52 (0.24, 1.12), p_trend=0.026, respectively. Conclusions: We observed alcohol usage increased the risk of stomach cancers. In contrast, a total of fruits intake was associated with a decreased risk of stomach cancer.     

Survival of Stomach Cancer Cases in Khon Kaen,Thailand 2000-2012

Background: Stomach cancer is an aggressive malignancy that is difficult to detect at an early stage and therefore is characterized by poor survival rates. Over the last two decades, there has been no report of gastric cancer survival in Khon Kaen province, Thailand. The aim of this retrospective cohort study was to provide up-to-date information about the survival of gastric cancer patients in this province. Materials and Methods: Data from Khon Kaen population-based cancer registry, Faculty of Medicine, Khon Kaen University were newly obtained on 650 patients who were diagnosed with stomach cancer during the period 1 January, 2000 to 31 December, 2012. These were then followed up until death or the end of the study (31 December 2014). We calculated the observed survival with the actuarial life table method, and relative survival, defined as the ratio of observed survival in the group of the stomach cancer patients to the expected survival in the entire Thai population from the estimated generation life tables for Thailand of five-year birth cohorts from 1900 - 2000. Results: The 5 year observed and 5 year relative survival rates were 17.2 % (95% CI: 13.54-21.14) and 18.2 % (95% CI: 14.3-22.4), respectively. The highest 5 year relative survival rates were demonstrated among patients aged 45-65, with stage I or II lesions, with adenocarcinomas, with a body of stomach location, well differentiated and receiving surgery and/or chemotherapy. Conclusions: The observed and relative survival rates were close to each other. Our findings provide basic information beneficial to development of an effective treatment system and appropriately improved population-based cancer registration.     

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.     

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.     

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.     

Trends in Incidence of Childhood Lymphoma in Khon Kaen,Thailand, 1985-2008

Background: Lymphoma is the second most common of childhood cancer in Thailand, but data on trendsover time are limited. Objective: To perform a statistic assessment of the incidence trend of childhood lymphomain Khon Kaen, Thailand, between 1985 and 2008. Method: All children aged < 15 years newly diagnosed withlymphoma according to International Childhood Cancer Classification (ICCC) during January 1, 1985- December31, 2008 were collected from data base of Khon Kaen Provincial Registry. Aged-adjusted incidence rates (ASRs)were calculated by standard method and trends were calculated using the generalized linear model method, which utilizes incidence-rate-base logarithms. Results: During 1985-2008 there were 72 children (47boys and 25 girls) who were diagnosed with lymphoma in Khon Kaen province. The peak age-group of diseasewas in the 5-9 year olds for both sexes. All cases were pathologically proven. Non-Hodgkin lymphoma (NHL)was more common than Hodgkin disease (ratio 7:1). The overall ASR was 6.04 per million (95%CI: 4.64 to 7.45)and the ASR was 7.64 per million (95%CI: 5.44 to 9.84) in boys and 4.37 per million (95%CI: 2.64 to 6.10) ingirls. Significant increases were observed for boys, since the 2006 to 2008 ASR was 15.3 per million (95%CI:5.73 to 25.0). Trend analyses during 1985 - 2008 showed that incidence among boys for lymphoma increasedby 1.38 percent per year (95%CI:- 4.6-8.3) while the incidence among girl decreased by 2.6 percent per year(95%CI:- 12-6.8). Conclusions: Our data showed that the incidence of childhood lymphoma in Khon Kaenprovince was similar to the one of Thailand but lower than those of western countries. During the past 24 years,the incidence trend seems to be increasing in boys but decreasing in girls. Interpretation is difficult without abetter understanding of what underlies the reported changes.     

Roles of Diet,Lifetime Physical Activity and Oxidative DNA Damage in the Occurrence of Prostate Cancer among Men in Klang Valley,Malaysia

Background: There is a paucity of information on risk factors of prostate cancer, especially those relatedto dietary and lifestyle among Asian populations. Objective: This study aimed to determine the relationshipbetween dietary intake (macronutrients, fruits, vegetables and lycopene), lifetime physical activity and oxidativeDNA damage with prostate cancer. Design: A case control study was carried out among 105 subjects (case n=35,control n=70), matched for age and ethnicity. Data on sociodemographic, medical, dietary intake, consumptionof lycopene rich food and lifetime physical activity were obtained through an interview based questionnaire.Anthropometric measurements including weight, height and waist hip circumferences were also carried out onsubjects. A total of 3mL fasting venous blood was drawn to assess lymphocyte oxidative DNA damage using thealkaline comet assay. Results: Cases had a significantly higher intake of fat (27.7±5.5%) as compared to controls(25.1±5.9%) (p < 0.05). Mean intaks of fruits and vegetables (3.11 ± 1.01 servings/d)(p<0.05), fruits (1.23 ± 0.59servings/d) (p<0.05) and vegetables (1.97+0.94 servings/d) were higher in controls than cases (2.53 ± 1.01, 0.91± 0.69, 1.62 ± 0.82 servings/d). A total of 71% of cases did not met the recommendation of a minimum of threeservings of fruits and vegetables daily, as compared to 34% of controls (p<0.05) (Adjusted OR 6.52 (95% CI2.3-17.8)) (p<0.05). Estimated lycopene intake among cases (2,339 + 1,312 mcg/d) were lower than controls (3881± 3120mcg/d) (p< 0.01). Estimated lycopene intake of less than 2,498 mcg/day (50th percentile) increased riskof prostate cancer by double [Adjusted OR 2.5 (95%CI 0.99-6.31)]. Intake of tomatoes, watermelon, guava,pomelo, papaya, mango, oranges, dragon fruit, carrot, tomato sauce and barbeque sauce were higher in controlscompared to cases. Intake of tomato sauce of more than 2.24g/d (25th percentile), papaya more than 22.7g/d(50th percentile) and oranges more than 19.1g/h (50th percentile) reduced prostate cancer risk by 7.4 (AdjustedOR 7.4 (95% CI 1.17-46.77)), 2.7 (Adjusted OR 2.75 (95% CI 1.03-7.39)) and 2.6 times (Adjusted OR = 2.6 (95%CI=1.01-6.67)), respectively (p<0.05 for all parameters). No oxidative damage was observed among subjects.Past history of not engaging with any physical activities at the age of 45 to 54 years old increased risk of prostatecancer by approximately three folds (Adjusted OR 2.9(95% CI = 0.8-10.8)) (p < 0.05). In conclusion, low fatdiet, high intake of fruits, vegetables and lycopene rich foods and being physical active at middle age were foundto be protective. Thus, it is essential for Malaysian men to consume adequate fruits and vegetables, reduce fatintake and engage in physical activity in order to reduce prostate cancer risk.     

Health Insurance and Colorectal Cancer Survival in Khon Kaen,Thailand

Background: Evidence from healthcare studies demonstrates that patients’ health insurance affects serviceaccessibility and the outcome of treatment. However, assessment on how colorectal cancer survival relates to healthinsurance is limited. Objective: The study examined the association between health insurance and colorectal cancersurvival in Khon Kaen, Thailand. Methods: The retrospective cohort study was conducted with 1,931 colorectal cancerpatients from Khon Kaen cancer registry between January 1, 2003 and December 31, 2012, and was followed-up untilDecember 31, 2015. Relative survival was used to estimate the survival rate. Cox proportional hazard regression wasused to estimate the relationship between health insurance and colorectal cancer survival, represented with the hazardratio. Result: Most of the participants were males, and the median age was 62 years. The median survival time was2.25 years (95% CI: 2.00-2.51). The five-year observed survival rate and relative survival rate were 36.87 (95% CI:34.66-39.08) and, 42.28 (95% CI: 39.75-44.81), respectively. The factors that showed significant associations withpoorer survival after adjustment for gender and age were non-surgical treatments (HRadj=1.88;95%CI=1.45-2.45),advanced stage (III+IV) (HRadj=2.50; 95%CI=2.00-3.12), histological grading in poorly differentiated (HRadj=1.84;95%CI=1.32-2.56), and Universal Coverage Scheme (HRadj=1.37;95%CI=1.09-1.72). Conclusion: The survival ofcolorectal cancer patients in the Universal Coverage Scheme was likely to be poorer than in the Civil Servant MedicalBenefit Scheme. This indicates an urgent need for a national program for colorectal cancer screening in the generalpopulation and access to health insurance.     

Coffee Consumption and Lung Cancer Risk: A Prospective Cohort Study in Khon Kaen Thailand

Background:  Lung cancer is a major cause of cancer death worldwide. The incidence of lung cancer in Thailand increasing, but risk factors are rarely reported. Objective: To investigate the effect of coffee consumption on lung cancer in Thai population. Methods: Between 1990 and 2001, lifestyle and demographic data were collected from 24,528 participants in the Khon Kaen Cohort Study (KKCS), who were followed through 2016, by linking to the Khon Kaen Population-based Cancer Registry. A total of 12,668 eligible participants (68.8% females, mean age 51.0 years at baseline) having complete datasets (239,488 person-years of follow up with 138 incident cases of lung cancer observed) were analyzed using a multi-variable adjusted Cox proportional hazard models. Results: Coffee consumption was associated with reduced risk for lung cancer (adj. HR = 0.54; 95% CI: 0.35-0.84) after adjusting for age and gender.  Cigarette smoking (adj. HR = 2.76; 95% CI: 1.32-5.78) and family history of cancer (adj. HR = 1.65; 95% CI: 1.10-2.48) were associated with higher risk. Conclusion: This study suggests coffee consumption may be a protective factor for lung cancer in among this cohort.     

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. ‍ ‍     

Fruits,Vegetables and the Risk of Cancer: a Multisite Case-Control Study in Uruguay

Introduction: Previous studies have suggested that high intake of fruit and vegetables may decrease the riskof a wide range of cancers, but this evidence has been challenged by the results of recent studies. Methods: Tofurther explore the association between fruit and vegetable intake and cancer risk we conducted a case-controlstudy of 11 cancer sites in Uruguay between 1996 and 2004, including 3,539 cancer cases and 2,032 hospitalcontrols. We used unconditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs)of cancer associations. Results: In the multivariable model higher intake of fruits and vegetables combined wasassociated with a decreased risk of cancers of the esophagus (odds ratio, OR=0.63, 95% CI: 0.42-0.97), lung(OR=0.75, 95% CI: 0.57-0.98), breast (OR=0.47, 95% CI: 0.31-0.71), prostate (OR=0.63, 95% CI: 0.44-0.92)and all sites combined (OR=0.73, 95% CI: 0.61-0.87). When evaluated separately, fruit intake was more stronglyassociated with decreased cancer risk than vegetables. These inverse associations were mainly observed in men,among persons with high intake of meat, alcohol drinkers and among smokers. Conclusion: Our results providesome evidence that high intake of fruits and vegetables and particularly fruit may decrease the risk of cancer.However, because of the possibility that these findings could be due to residual confounding from intake ofmeat, alcohol drinking and tobacco smoking, further studies in populations with a large number of participantswith low or no exposure to these potential confounding factors are warranted.     

Risk Factors for Cholangiocarcinoma in Khon Kaen,Thailand: A Nested Case-Control Study

The present nested case-control study within the Khon Kaen cohort study was conducted to assess riskfactors for cholangiocarcinoma (CCA) development. Cases were 108 subjects with proven CCA by ultrasoundat least and controls also numbered 108, matched by sex, age (not more than 3 years difference) and period ofrecruitment to the cohort (not more than 3 months difference). A questionnaire was constructed based on thatemployed for the Khon Kaen cohort study recruitment. McNemar’s chi-square test and conditional logisticregression were used for crude analysis and multivariables analysis. Results revealed a sex ratio of 2:1 formales:females. The current study found a statistically significant association when adjusted for other potentialcovariate factors between cholangiocarcinoma and the consumption of total fruits 1.0-2.08 times per day (OR0.32; 95%CI: 0.12-0.88) and history of Opisthorchis viverrini (OV) eggs in stools at recruitment plus consumptionof meat < 0.45 times per day (OR 2.99; 95%CI: 1.04-8.62). The findings suggest that OV infestation is thestrongest risk factor for development of cholangiocarcinoma and also suggests decrease in risk among individualswho consume more fruit.     

Factors Associated with Decisions to Attend Cervical Cancer Screening among Women Aged 30-60 Years in Chatapadung Contracting Medical Unit,Thailand

Background: This study aimed to identify factors associated with women’s decisions to attend cervical cancer screening and to explore those linked with intention to attend in the coming year and to continue regular screening. Materials and Methods: A community based case-control study was conducted among woman 30-60 years of age in catchment area of Chatapadung Contracting Medical Unit (CCMU), networking of Khon Kaen Center Hospital, Thailand. Self-administered questionnaires were used to collect data, and in-depth interviews were then performed to explore in greater detail. Results: There were 195 participants. Only one third (32.3 %) had been screened for cervical cancer within the past 5 years. Some 67.7% reported that they had not been screened becausethey had no abnormal symptoms, single marital status, and no children. Only 10.6% of those never had screening intent to be screened within the next 12 months. High family income (adjusted OR=2.16, 95%CI=1.13-4.14), good attitude towards a Pap test (OR=1.87, 95%CI=1.09-4.23), and having received a  recommendation from health care providers were important factors associated with decisions to attend cervical cancer screening (OR=1.73, 95%CI=1.01-4.63). From in-depth interviews, there were five reasons of their decisions to attend cervical cancer screening including yearly check-up, postpartum check-up, having abnormal symptom, encouragement by health care providers, and request from workplace. Conclusions: High family income, good attitude towards a Paptest, and receiving proper recommendation by health care providers, were important factors associated with decision to have cervical cancer screening among women 30-60 years old. Trying to enhance these factors and reduce barriers regarding screening, may increase the coverage rate for cervical cancer screening in Thailand.     

Alcohol Dehydrogenase-2 and Aldehyde Dehydrogenase-2 Genotypes,Alcohol Drinking and the Risk for Stomach Cancer in Chinese Males

Objective: To investigate the relationship among alcohol dehydrogenase-2 (ADH2) and aldehyde dehydrogenase-2 (ALDH2) genetic polymorphisms, alcohol consumption, and the susceptibility of stomach cancer in Chinese males. Methods: Three hundred and eighty-two stomach cancer patients and 382 healthy controls from Taixing and Changshu city of Jiangsu province were enrolled in this study. ADH2 and ALDH2 genotypes were examined by PCR and denaturing high-performance liquid chromatography (DHPLC). Unconditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (95% CI). Results: (1) In no drinkers, compared with ALDH2G/G carriers, ALDH2 G/A (OR=1.67, 95%CI: 1.01-2.78) carriers showed a significantly elevated risk of developing stomach cancer. No association was found between ADH2 genotypes and risk of stomach cancer. (2) ALDH2 A allele carriers with cumulative amount of alcohol consumption ≥2.5 (Kg * years) were at a higher risk of developing stomach cancer compared with those with cumulative amount of alcohol consumption <2.5Kg (Kg * years) (OR=2.72, 95%CI:0.89-8.31) and ALDH2 G/G carriers with cumulative amount of alcohol consumption <2.5 (Kg * years) (OR=2.46, 95%CI=0.90-6.72) or ≥2.5 (Kg * years) (OR=2.53, 95%CI=0.86-7.49). (3) Compared with individuals with ADH2 A/A and ALDH2 G/G genotypes, ADH2 G and ALDH2 A allele carriers were not at a high risk of developing stomach cancer, with regard to the status of alcohol consumption, and even cumulative amount of alcohol consumption ≥1.5 (Kg * years) (OR =1.65, 95%CI:0.56-4.82). Conclusion: ADH2 and ALDH2 polymorphisms and alcohol drinking may not play an important role in the development of stomach cancer in Chinese males.     

Betel Quid Chewing and Upper Aerodigestive Tract Cancers: A Prospective Cohort Study in Khon Kaen,Thailand

Background: This study aimed to determine the association between betel quid chewing and the occurrenceof upper aerodigestive tract (UADT) cancers. Methods: A cohort of 17,388 subjects, recruited and interviewedover the 1990-2001 period, in Khon Kaen, Thailand, was followed up until 2011. The data were linked to theKhon Kaen Population-Based Cancer Registry. Results: The prevalence of betel quid chewing was 15.9%, with afemale predominance (97.7%); the mean age of chewers was 57.7 years (SD 6.6). The overall incidence of UADTcancers from the cohort was 14.7 per 100,000 person-years, whereas the incidence among the chewers was 45.7.Betel nut chewing was the only major risk factor for UADT cancers in this population (HR=5.26, 95%CI=2.51-11.0), while weak associations were found for tobacco smoking and alcohol (HR=1.16, 95%CI=0.45-3.01 and 1.47,95%CI=0.72-3.03 respectively). Conclusions: We found betel quid chewing to be a main risk factor for UADTcancers, resulting in a higher incidence in females. However, further study is required to explore the potentialr isk factors among non-chewers, non-smokers, and non-drinkers     

Diet and Cancer Risk in the Korean Population: A Metaanalysis

Many studies have found links between diet and cancer. The summary estimates of the association betweendietary factors and cancer risk were investigated using previously reported studies of the Korean population.Gastric cancer risk was inversely associated with the high intake of soy foods [OR (95% CI): 0.32 (0.25-0.40)for soybean, 0.56 (0.45-0.71) for soybean curd, and 0.67 (0.46-0.98) for soymilk], allium vegetables [OR (95%CI): 0.37 (0.26-0.53) for green onion, 0.54 (0.40-0.73) for garlic, and 0.54 (0.35-0.85) for onion], fruits [OR (95%CI): 0.61 (0.42-0.88)], and mushrooms [OR (95% CI): 0.43 (0.21-0.88)]. Salt and Kimchi were associated with anincreased gastric cancer risk [OR (95% CI): 1.92 (1.52-2.43) and 2.21 (1.29-3.77), respectively]. Colorectal cancerrisk was positively associated with meat intake [OR (95% CI): 1.25 (1.15-1.36)]. Total soy products, soybeancurd, and soymilk showed an inverse association with breast cancer risk [OR (95% CI): 0.61 (0.38-0.99), 0.47(0.34-0.66), and 0.75 (0.57-0.98), respectively]. Green/yellow and light colored vegetables were associated witha reduced risk of breast cancer [OR (95% CI): 0.34 (0.23-0.49) and 0.44 (0.21-0.90), respectively]. Mushroomintake was inversely associated in pre-menopausal women only [OR (95% CI): 0.47 (0.26-0.86)]. In conclusion,soy foods, fruits and vegetables might reduce cancer risk in the Korean population. High salt food might be riskfactor for gastric cancer, and intake of high amount of meat might cause colorectal cancer.     

Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project

A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.     

饮酒与膀胱癌关系的全人群病例对照研究

目的探讨饮酒与膀胱癌发生的关系。方法采用全人群为基础的病例对照研究,共调查1996年1月1日~1998年12月31日期间确诊的上海市区膀胱癌新发病例608例,健康人群对照607例。采用非条件logistic回归分析,调整吸烟等可能的混杂因素,以估计饮酒对膀胱癌发生的危险度及其95%可信区间。结果与不饮酒者相比,男、女性饮酒者患膀胱癌相对危险度分别是1.22(95%CI0.94~1.59)、0.50(95%CI0.13~1.90)。男性随总酒精摄入量增加患膀胱癌的危险有增加趋势,OR值分别为1.10(1~80g/d)和1.56(>80g/d)(趋势检验P=0.043)。男性总酒精摄入量与饮酒年限的联合作用分析表明,与不饮酒者相比,总酒精摄入量超过80g/d、饮酒年限超过40年者患膀胱癌危险度为2.11(95%CI1.11~4.01)。将饮酒分3层、吸烟分4层进行男性饮酒与吸烟的联合作用分析,结果显示总酒精摄入量>80g/d且吸烟≥35包年者的OR值为2.78(95%CI1.46~5.28)。未发现各饮酒种类与男性膀胱癌有显著关联。在不吸烟男性组中的分析显示,饮酒习惯的OR值均没有统计学意义。结论饮酒可能与男性膀胱癌有一定联系,但作用较弱,似乎主要表现为对吸烟男性的作用。