Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content

We investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).     

Association between Low Fruit and Vegetable Consumption and Colorectal Polyps in Thailand

Objective: This study aimed to evaluate the association between low fruit and vegetable consumption and colorectal polyps. Methods: A retrospective study was conducted among 1,228 participants aged 50-65 years who completed 2-time colonoscopy exams at the first and the fifth year of a colorectal screening program. Consuming less than one serving of fruit and vegetable daily was rated as low. Colorectal polyps from colonoscopy findings were recognized in 3 types: hyperplastic, low risk and high risk adenomatous polyps. Results: The findings demonstrated high prevalence of low fruit (93.6%) and low vegetable (85.8%) consumption. Exercising individuals were more likely to consume both fruit (OR 2.28, 95%CI 1.42-3.65) and vegetable (OR 1.40, 95%CI 1.00-1.96), while smoking history individuals tended to consume vegetable (OR 2.08, 95%CI 1.22-3.55). Low fruit consumption was strongly associated with high risk adenomatous polyps (OR 4.39, 95%CI 2.40-8.03), while low vegetable consumption was distinctively associated with low risk (OR 6.26, 95%CI 4.11-9.55) and high risk adenomatous polyps (OR 8.64, 95%CI 5.30-14.09). Conclusion: This study provides additional evidence of the association between low fruit and vegetable consumption and colorectal polyps. Enhancing people fiber eating behavior may help preventing colorectal cancer risk.     

Association between Vegetable,Fruit and Carbohydrate Intake and Breast Cancer Risk in Relation to Physical Activity

Background: Although the nutritional may exert effect on the breast cancer risk, it is not clear whetherthe role diet is the same in sedentary and physically active women. The aim of this study was to evaluate theassociation between fruit, vegetable and carbohydrate intake and the risk of breast cancer among Polish womenconsidering their physical activity level. Materials and Methods: A case-control study was conducted that included858 women with histological confirmed breast cancer and 1,085 controls, free of any cancer diagnosis, aged28-78 years. The study was based on a self-administered questionnaire to ascertain physical activity, dietaryintake, sociodemographic characteristics, reproductive factors, family history of breast cancer, current weightand high, and other lifestyle factors. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimatedin unconditional logistic regression analyses including a broad range of potential confounders. Results: Withcomparison of the highest vs lowest quartile of intake, strong significant associations were observed for totalvegetables (OR=0.37, 95%CI=0.20-0.69 P for trend <0.01 and OR=0.53, 95%CI=0.29-0.96, P for trend <0.02),and total fruits (OR=0.47, 95%CI=0.25-0.87, P for trend <0.05 and OR=0.47, 95%CI=0.24-0.90, P for trend<0.02) among women characterized by the lowest and the highest quartile of physical activity. No associationswere observed for total carbohydrate intake. Additional analysis showed a positive association for sweets anddesert intake among women in the lowest quartile of physical activity (OR=3.49, 95%CI=1.67-7.30, P for trend<0.009) for extreme quartiles of intake comparing to the referent group. Conclusions: The results suggest thata higher consumption of vegetable and fruit may be associated with a decreased risk of breast cancer, especiallyamong women who were low or most physically active throughout their lifetimes. These findings do not supportan association between diet high in carbohydrate and breast cancer. However, a higher intake of sweets anddeserts may by associated with an increased risk of breast cancer among women who were less physically active.     

Dietary Fibre and the Risk of Colorectal Cancer: a Case-Control Study

Background: Colorectal cancer is one of the most commonly occurring cancers in China. Dietary fibre hasbeen thought to decrease the risk of colorectal cancer in Western countries. However, studies investigatingthe association between dietary fibre (particularly soluble and insoluble fibres) and colorectal cancer havehitherto been lacking in China. Objective: This case-control study examined the effect of dietary fibre intakeon the risk of colorectal cancer, stratified by tumour site. Materials and Methods: The study included 265 cases(colon cancer, 105; rectal cancer, 144; colon and rectal cancer, 16) and 252 controls residing in Qingdao. A foodfrequency questionnaire that included 121 food items was used to collect dietary information. Odds ratio (OR)and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis. Results:For food groups, controls in the study consumed more vegetables, soy food and total fibre than did colorectalcancer patients (p<0.05). The intakes of fruit, meat and sea-food did not differ significantly between cases andcontrols. However, we did not find any association between soy food intake and colon cancer. We observed inverseassociations between total fibre intake and colorectal, colon and rectal cancer (Q4 vs Q1: OR=0.44, 95%CI, 0.27-0.73; OR=0.40, 95%CI, 0.21-0.76; OR=0.52, 95%CI, 0.29-0.91). Vegetable fibre intake showed similar inverseassociations (Q4 vs Q1: OR=0.51, 95%CI, 0.31-0.85; OR=0.48, 95%CI, 0.25-0.91; OR=0.53, 95%CI, 0.29-0.97). Inaddition, inverse associations were observed between soluble fibre and insoluble fibre and both colorectal cancerand colon cancer. No relationship was found between colorectal cancer and fruit, soy or grain fibre intakewhenthe results were stratified by tumour site. Conclusions: The present study suggests that vegetable fibre and totalfibre play very important roles in protecting against colorectal cancer. Soluble and insoluble fibres were inverselyassociated with only colorectal cancer and colon cancer.     

Consumption of Food Groups and the Risk of Pancreatic Cancer: A Case–Control Study

Purpose

The purpose of this study is to investigate whether the consumption of specific food groups predicts the risk of pancreatic cancer, a case–control study of nutrition and pancreatic cancer among French-Canadians was carried out in Montreal, Quebec, Canada.

Methods

A total of 179 pancreatic cancer cases (97 males and 82 females) and 239 population-based control subjects were interviewed. Dietary intake was evaluated via a validated food frequency questionnaire that gathers information on over 200 different food items and beverages. Odd ratios (ORs) and 95% confidence intervals (CIs) were computed by unconditional logistic regression.

Results

After adjustment for age, smoking, diabetes status, proxy interview, gender and total energy intake, a reduced risk of pancreatic cancer was related to vegetables and vegetable products [OR?=?0.47; 95%CI: (0.21–1.06) p-trend?=?0.024], while an increased risk was associated with the consumption of lamb, veal and game [OR?=?2.24; 95%CI: (1.11–4.52) p-trend?=?0.026], when the upper and lower quartiles of intake were compared. Changes in dietary intake over the last decade revealed an elevated risk with augmented consumption of soups, sauces and gravies [OR?=?2.32; 95%CI: (1.20–4.49) p-trend=0.03], beef products [OR?=?2.07; 95%CI: (0.95–4.51) p-trend=0.05] as well as fish and shellfish [OR?=?1.48; 95%CI: (0.78–2.80) p-trend=0.05].

Conclusions

These findings suggest that a diet rich in vegetables and vegetable products may decrease the risk of pancreatic cancer.     

Lung cancer risk and red meat consumption among Iowa women

OBJECTIVE: Some epidemiologic studies suggest that diets high in total fat, saturated fat, or cholesterol are associated with increased risk of lung cancer. Others suggest that diets high in red meat consumption, particularly well-done red meat, are a lung cancer risk factor. In Iowa, we had the opportunity to investigate concurrently the role of meat intake and macronutrients in lung cancer etiology. METHODS: A population-based case-control study of both non-smoking and smoking women was conducted in Iowa. A 70-item food frequency questionnaire (FFQ) was completed by 360 cases and 574 frequency-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression. Multivariate models included age, education, pack-years of smoking, yellow-green vegetable intake, fruit/fruit juice intake, nutrient density calories, previous non-malignant lung disease, alcohol consumption and body mass index (BMI). RESULTS: When comparing the fifth (highest) to the first (lowest) quintile of consumption of total fat, saturated fat and cholesterol, we obtained odds ratios of 2.0 (1.3-3.1), 3.0 (1.9-4.7), and 2.0 (1.3-3.0) respectively. However, when red meat was entered into the model along with total fat, saturated fat or cholesterol, the excess risk for the macronutrients disappeared while an odds ratio of 3.3 (1.7-7.6) was obtained for red meat. The odds ratios for red meat consumption were similar among adenocarcinoma cases, OR=3.0 (1.1-7.9) and non-adenocarcinoma cases, OR=3.2 (1.3-8.3) and among life-time nonsmokers and ex-smokers OR=2.8 (1.4-5.4), and current smokers, OR=4.9 (1.1-22.3). Yellow-green vegetables were protective with an odds ratio of 0.4 (0.2-0.7). CONCLUSIONS: Consumption of red meat, was associated with an increased risk of lung cancer even after controlling for total fat, saturated fat, cholesterol, fruit, yellow-green vegetable consumption and smoking history, while yellow-green vegetables are associated with a decreased risk of lung cancer.     

Fruit and vegetable intakes and prostate cancer risk

BACKGROUND: There is extensive and consistent evidence that high fruit and vegetable intakes are associated with decreased risks of many cancers, but results for prostate cancer risk have been inconsistent. We studied the associations of fruit and vegetable intakes with prostate cancer risk in a population-based, case-control study of men under 65 years of age. METHODS: Case participants were 628 men from King County (Seattle area), WA, who were newly diagnosed with prostate cancer. Control participants were 602 men recruited from the same underlying population and frequency matched to case participants by age. Self-administered food-frequency questionnaires were used to assess diet over the 3- to 5-year period before diagnosis or recruitment. Daily nutrient intakes were calculated by use of a nutrient database with recently updated analytic values for carotenoids. Odds ratios for prostate cancer risk associated with foods and nutrients were calculated by use of unconditional logistic regression. RESULTS: No associations were found between fruit intake and prostate cancer risk. The adjusted odds ratio (ORs) for the comparison of 28 or more servings of vegetables per week with fewer than 14 servings per week was 0.65 (95% confidence interval [CI] = 0.45-0.94), with a two-sided P for trend =.01. For cruciferous vegetable consumption, adjusted for covariates and total vegetable intake, the OR for comparison of three or more servings per week with less than one serving per week was 0.59 (95% CI = 0.39-0.90), with a two-sided P for trend =.02. The OR for daily intake of 2000 microg or more lutein plus zeaxanthin compared with an intake of less than 800 microg was 0.68 (95% CI = 0.45-1.00). CONCLUSION: These results suggest that high consumption of vegetables, particularly cruciferous vegetables, is associated with a reduced risk of prostate cancer.     

Dietary Fat and Physical Activity in Relation to Breast Cancer among Polish Women

Background: Dietary fat has been inconsistently associated with the risk of breast cancer. The purpose ofthis study was to examine the relationship between meat and animal and plant fat intake and breast cancer riskin subgroups by total lifetime physical activity, using data from a case-control study conducted in the Region ofWestern Pomerania, Poland. Materials and Methods: The study included 858 women with histological confirmedbreast cancer and 1,085 controls, free of any cancer diagnosis. The study was based on a self-administeredquestionnaire including questions about socio-demographic characteristics, current weight and height,reproductive factors, family history of breast cancer and lifestyle habits. Unconditional logistic regression wasperformed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: High animal fat intakesignificantly increased OR from 1.7 times (OR=1.66, 95%CI=1.07-3.59) to 2.9 times (OR=2.9, 95%CI=1.37-6.14) independent of physical activity level, comparing the third versus the lowest quartile. Women with a highintake of red meat or processed meat and low physical activity showed increased risk of breast cancer: OR=2.70,95%CI=1.21-6.03 and 1.78, 95%CI=1.04-3.59, respectively. The plant fat dietary pattern was negatively associatedwith breast cancer in sedentary women (OR=0.57, 95%CI=0.32-0.99). Conclusions: These results indicatedthat a diet characterized by a high consumption of animal fat is associated with a higher breast cancer risk insedentary women, while consumption of plant fat products may reduce risk in the same group.     

Food groups and risk of oral and pharyngeal cancer

The role of specific food groups and diet variety on the risk of oral and pharyngeal cancer has been considered using data from a case-control study conducted between 1992 and 1997 in the Swiss Canton of Vaud. Cases were 156 patients (126 males, 30 females) aged under 75 (median age 56) years with incident, histologically confirmed cancer of the oral cavity and pharynx, and controls were 284 subjects (246 males, 38 females, median age 57 years), admitted to the same university hospital for a wide spectrum of acute, non-neoplastic conditions unrelated to tobacco and alcohol consumption or to long-term modification of diet. After allowance for education, alcohol, tobacco and total energy intake, significant trends of increasing risk with more frequent intake emerged for eggs (OR = 2.3 for the highest tertile), red meat (OR = 2.1) and pork and processed meat (OR = 3.2). Inverse trends in risk were observed for milk (OR = 0.4 for the highest tertile), fish (OR = 0.5), raw vegetables (OR = 0.3), cooked vegetables (OR = 0.1), citrus fruit (OR = 0.4) and other fruits (OR = 0.2). The addition of a serving per day of fruit or vegetables was associated with an about 50% reduction in oral cancer risk. The most favourable diet for oral cancer risk is therefore given by infrequent consumption of red and processed meat and eggs and, most of all, frequent vegetable and fruit intake. Diet diversity was inversely related to oral and pharyngeal cancer: ORs were 0.35 for the highest tertile of total diversity, 0.24 for vegetable and 0.34 for fruit diversity. In terms of attributable risk, high meat intake accounted for 49% of oral and pharyngeal cancers in this population, low vegetable intake for 65% and low fruit intake for 54%. Int. J. Cancer 77:705–709, 1998. © 1998 Wiley-Liss, Inc.     

Fruit and Vegetable Intake and Stomach Cancer among Male Adults: A Case-Control Study in Northern Viet Nam

Objective: This study investigated the association between fruit and vegetable intake and stomach cancer, with considering the impacts of Helicobacter pylori (H. pylori) infection and tobacco smoking. Methods: A case-control study featuring 80 male incident stomach-cancer cases and 126 male controls was conducted in a general hospital in Viet Nam. A semi-quantitative food frequency and demographic lifestyle questionnaire were used; and venous blood samples were collected to determine H. pylori status by IgG ELISA. The respective associations between fruit and vegetable intake and stomach cancer were examined using unconditional logistic regression analysis with adjustments for possible cofactors. Results: Fruit intake and stomach cancer showed a weak inverse association when this became non-significant after adjusting for H. pylori infection (OR = 0.50, 95%CI: 0.22–1.12, p trend = 0.094). Stratifying by H. pylori status returned a negative trend for fruit intake and stomach cancer among H. pylori-negative participants (OR = 0.21, 95%CI: 0.06–0.69, p trend = 0.010), but no significant interaction for H. pylori-positive participants (OR = 0.76, 95%CI: 0.21–2.68, p trend = 0.670). Vegetable intake and stomach cancer showed no association, regardless of H. pylori status. Compared to ever-smokers with low intake, never-smokers with high vegetable (OR = 0.25, 95% CI: 0.06–0.95) and fruit intake (OR = 0.20, 95%CI: 0.06–0.65) showed the lowest odds of stomach cancer. Conclusions: Fruit, but not vegetable, intake showed a weak inverse association with stomach cancer. H. pylori infection and tobacco-smoking status may influence the protective effects of fruit and vegetable intake on stomach cancer.     

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.     

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.     

Fried, well-done red meat and riskof lung cancer in women (United States)

Objective: Some epidemiological studies suggest that diets high in fat, saturated fat, or cholesterol are associated with increased risk of lung cancer. Since meat consumption is correlated with the intake of saturated fat and cholesterol, we investigated the role of meat intake and cooking practices in relation to lung cancer risk.Methods: A population-based case-control study of both non-smoking and smoking women was conducted in Missouri. A 100-item food frequency questionnaire (FFQ) with detailed questions on meat consumption was completed by 593 cases and 623 frequency matched controls. We estimated quantity of meat eaten (grams/day) according to cooking method, and doneness level. Odds ratios (ORs) and 95% confidence intervals (C.I.s) were calculated using logistic regression. Multivariate models included age, packyears of smoking, body mass index (BMI, kg/m2), education, and intake of calories, fat, fruit/fruit juices, and vegetables.Results: When comparing 90th and 10th percentiles, lung cancer risk increased for total meat consumption (OR=1.6, C.I. 1.1-2.4), red meat (OR=1.8, C.I., 1.2-2.7), well-done red meat (OR=1.5, C.I.s, 1.1-2.1) and fried red meat (OR=1.5, C.I., 1.1-2.0). The odds ratios for 5th vs. 1st quintiles using the categorical variable for well-done red meat and fried red meat were essentially the same as reported above; however, the increase in risk was associated mainly with the 5th quintile. The ORs for a 10-gram increase in consumption were, 1.04 for total meat, 1.06 for red meat, 1.08 for well done red meat, and 1.09 for fried red meat.Conclusions: Consumption of red meat, especially fried and/or well-done red meat, was associated with increased risk of lung cancer.     

Fruit consumption reduces the effect of smoking on bladder cancer risk. The Belgian case control study on bladder cancer

We have hypothesized that consumption of fruit and vegetables may be associated with reduced risk of bladder cancer and that this may interact with cigarette smoking and metabolic genetic polymorphisms. A population-based case-control study was performed in the Belgian province of Limburg among 200 cases and 385 controls. Logistic regression was performed to calculate odds ratios (ORs) for bladder cancer occurrence with corresponding 95% confidence intervals (95% CI). Effect modification by smoking was investigated. We also evaluated interaction between fruit intake and GSTM1, GSTT1, NAT2 and SULT1A1 amongst "ever-smokers." Total vegetable intake was not significantly associated with the risk of bladder cancer (OR 1.15, 95% CI: 0.70-1.88 for the highest compared to the lowest tertile). However, total fruit intake was negatively associated with bladder cancer risk (OR 0.61, 95% CI 0.37-0.99 comparing the same tertiles). Among individuals with low daily fruit consumption, ever smokers had a highly increased risk of bladder cancer risk (OR: 4.23, 95% CI: 1.91-9.40). By increasing the daily fruit consumption, the risk of "ever-smokers" for developing bladder cancer decreased, however it remained significant (OR: 2.15; 95CI%: 1.15-4.05). No interaction was identified between the different genotypes and fruit consumption. We conclude that fruit consumption may decrease the effect of smoking on developing bladder cancer. Antioxidants, found in fruit, may protect against the damage caused by free radicals found in cigarette smoke. Metabolic polymorphisms appear not to modify this relation.     

Fat, fiber, fruits, vegetables, and risk of colorectal adenomas

A case-control study was conducted at the National Naval Medical Center (Maryland, USA) from 1994 to 1996 to investigate the possible association between dietary factors and colorectal adenomas. Cases (n = 239) were subjects diagnosed with adenomas (146 new and 93 recurrent) by sigmoidoscopy or colonoscopy. Those with no evidence of adenomas found by sigmoidoscopy were recruited as controls (n = 228). Dietary variables, assessed by a 100-item food frequency questionnaire, were analyzed by the logistic regression model, which was adjusted for age, gender and total energy intake. Variables of fat intake were further adjusted for red meat intake. An increased risk of 7% [odds ratio (OR): 1.07; 95% confidence interval (95% CI): 0.94-1.22] per 5% energy/day from total fat was observed. Every additional 5% unit of oleic acid intake/day significantly increased the adenoma risk by 115% (OR: 2.15; 95% CI: 1.05-4.39). Red meat fat increased the risk by 20% (OR: 1.20; 95% CI: 0.71-2.04), and white meat fat decreased the risk by 67% (OR: 0.33; 95% CI: 0.19-0.95) for every additional 5% unit of respective intake/day. Risk decreased by 41% (OR: 0.59; 95% CI: 0.41-0.86) for every additional 5% unit of fiber intake/day. Vegetable [OR per 100 g of vegetable intake/day: 0.83, 95% CI: 0.67-1.04] and fruit (OR per 100 g of fruit intake/day: 0.92, 95% CI: 0.82-1.03) intake showed an inverse association, and the results are suggestive of an association with the risk for adenomas. In conclusion, a strong positive association between oleic acid intake and colorectal adenoma risk was observed. This is likely to be an indicator of "unhealthy" food (meat, dairy, margarine, mayonnaise, sweet baked food) consumption in this population. Increased intake of dietary fiber was associated with a moderately decreased risk of adenomas.     

Septin9甲基化及膳食因素对结直肠癌发病的影响

目的:探讨Septin9甲基化与膳食因素对结直肠癌(colorectal cancer,CRC)发病的影响。方法:采用病例-对照研究分析,收集CRC病例60例,根据年龄进行1∶1匹配收集健康人群60例作为对照组。采用χ2检验比较病例和对照组的基本特征、膳食和Septin9甲基化分布,采用非条件Logistic回归分析比较不同的Septin9基因甲基化和膳食对CRC发病的影响。结果:病例组和对照组的年龄、性别、民族、家庭人均月收入、文化程度和一级亲属肿瘤史,均无显著统计学差异（P＞0.05）;病例组中Septin9基因甲基化阳性24例（40.0%）,显著高于对照组（P＜0.05）,但病例组和对照组的平均每日蔬菜摄入量和家畜肉类摄入量无显著统计学差异（P＞0.05）;通过单因素分析所有变量,并将有统计学意义的变量纳入多因素逻辑回归中,最后确定CRC的独立危险因素包括Septin9甲基化（OR=1.88,95%CI:1.56~2.27）和平均家畜肉摄入量≥300 g/d（OR=1.30,95%CI:1.24~1.37）;以Septin9甲基化阳性且平均蔬菜摄入量<400 g/d（OR=4.650,95%CI:1.393~15.518）为参照组,Septin9甲基化阳性且平均蔬菜摄入量≥400 g/d显著降低CRC的发病风险（OR=4.650,95%CI:1.393~15.518）;以Septin9甲基化阳性且平均家畜肉摄入量<300 g/d（OR=4.500,95%CI:1.463~13.843）为参照组,Septin9甲基化阳性且平均家畜肉摄入量≥300 g/d显著增加CRC的发病风险（OR=7.333,95%CI:2.195~24.501）。结论:Septin9甲基化阳性人群蔬菜摄入量≥400 g/d降低CRC的发病风险,Septin9甲基化阳性且平均家畜肉摄入量≥300 g/d显著增加CRC的发病风险,对此人群减少脂肪肉类摄入并增加蔬菜摄入量具有降低CRC发病风险的可能。     

Case-Control Study of Diet in Patients with Cervical Cancer or Precancerosis in Wufeng,a High Incidence Region in China

Purpose: To investigate the diet of patients with cervical cancer and precancerosis in the Wufeng area, a highincidenceregion in China. Methods: In the case group, 104 patients diagnosed with cervical cancer or cervicalintraepithelial neoplasias (CINⅡ/Ⅲ) were recruited from the Wufeng area. Nine hundred thirty-six healthywomen were selected from the same area as the matched controls. A questionnaire, which included questionsabout general lifestyle conditions, smoking and alcohol status, source of drinking water, green tea intake, anddiet in the past year, was presented to all participants. Results: Green tea intake (P=0.022, OR=0.551, 95%CI=0.330-0.919) and vegetable intake (P=0.035, OR=0.896, 95% CI=0.809-0.993) were identified as protectivefactors against cervical cancer or CINⅡ/Ⅲ. There was no indication of any associations of other lifestyle factors(smoking status, alcohol status, source of drinking water) or diet (intake of fruit, meat/egg/milk, soybean food,onion/garlic, staple food and pickled food) with cervical cancer. Conclusions: The results suggest that eatingmore fresh vegetables and drinking more green tea may help to reduce the risk of cervical cancer or CINⅡ/Ⅲin people of the Wufeng area.     

Adverse Effects of Preserved Vegetables on Squamous CellCarcinoma of Esophagus and Precancer Lesions in a HighRisk Area

Introduction: Squamous cell carcinoma of esophagus (ESCC) is one of the most common cancers in China.Preserved vegetables are processed foods and consumed in high amounts in the high risk areas for ESCC. Thisstudy aimed to investigate the relationships of preserved vegetable consumption with ESCC and precancerlesions. Methods: Cases from Yanting cancer hospital with pathological diagnosis of primary cancer, along withcontrols and individuals diagnosed with precancer lesions by endoscopy with iodine staining were interviewed.Trained staff collected data on dietary habits 1 year before the interview. An unconditional logistic regressionmodel was used to estimate odds ratios of preserved vegetable consumption for precancer lesions and cancer.Results: Adjusting for potential confounders, intake of preserved vegetables (OR=2.92, 95%CI 1.32~6.47) andlonger intake period (OR=5.78, 95%CI 2.26~14.80) were associated with higher risk of ESCC. Compared withlowest intake frequency, the highest was associated with a 3.0-fold risk for precancer lesions and 3.59-fold riskfor ESCC (both p<0.05). Conclusion: Consumption of preserved vegetables is a risk factor for esophageal lesionsin high risk areas. The carcinogenicity of preserved vegetables needs investigation in further studies and thepublic health strategies for reducing the consumption might be initiated in high risk areas     

Processed Meat Consumption and Squamous Cell Carcinoma of the Oesophagus in a Large Case-Control Study in Uruguay

Background: The role of processed meat in the aetiology of squamous cell oesophageal cancer has been exploredin detail. Methods: In the time period 1990-2005, a case-control study was conducted in Montevideo, Uruguayincluding 2,368 participants (876 cases of oesophageal cancer and 1,492 controls). Relative risks, approximatedby the odds ratios, were estimated by multiple unconditional logistic regression. Results: Processed meat waspositively associated with oesophageal cancer (upper quartile vs lower quartile OR 2.30, 95%CI 1.72-3.07),whereas salted meat intake was positively associated with squamous cell oesophageal cancer (OR 3.82, 95%CI2.74-5.33). Finally other cured meats were positively associated with oesophageal cancer (OR 1.65, 95%CI 1.22-2.22). Conclusions: It could be concluded that processed meat consumption could be an important risk factorfor the aetiology of squamous cell oesophageal cancer in Uruguay.