Case-Control Study of Diet and Prostate Cancer in a Rural Population of Faisalabad,Pakistan

Background: The effects of diet on epidemiology of prostate cancer are inconclusive. Therefore a hospitalbased,case-control study was conducted in a rural population of Faisalabad, Pakistan, to examine the impact ofdietary factors on risk of cancer development. Materials and Methods: This study was based on 102 confirmedcases of prostate cancer and 204 normal controls. Logistic regression was used to estimate odds ratios and 95%confidence intervals for odds ratios to evaluate the relationship between prostate cancer and diet. Results:Consumption of red meat and fat items significantly increased the prostate cancer risk having odds ratios and 95%confidence intervals of 3.41; 1.46-7.96 and 2.45; 1.17-5.15, respectively. On the other hand, more consumption ofvegetables, fluid intake and fruit significantly decreased the prostate cancer risk (odd ratios and corresponding95% confidence intervals of 0.21; 0.10-0.44, 0.10; 0.05- 0.19 and 0.09; 0.03- 0.23, respectively. Conclusions: Thepresent study supports the hypothesis that frequent consumption of red meat and fat items may increase prostatecancer risk while more intake of fruit, vegetables and fluid intake may protect against prostate cancer in therelatively low risk group in rural Pakistan.     

Weight Gain and Family History of Prostate or Breast Cancers as Risk Factors for Prostate Cancer: Results of a Case-control Study in Japan

The increase in the incidence rate of prostate cancer may be associated with changes in lifestyle in Japanesemen. Accordingly, we conducted a case-control study to assess risk factors. A total of 117 (82.3%) of the 142prostate cancer patients asked filled out the self-administrated questionnaires which included items abouttheir lifestyle habits over the period of one or two years before their diagnosis. Four controls per case, namely468, were randomly selected from resident registries with age and address matched with each case, and 318controls (69.5%) filled out the same questionnaire as the cases. Data for 277 controls were used for the analysis,excluding 41 subjects with a history of previous cancer. The conditional logistic regression model was utilizedfor analyzing the individually age and address-matched data, and odds ratios (ORs) and their 95% confidenceintervals (95%CIs) were calculated for potential risk factors. Higher body mass index at 20 years of age wasmarginally significantly associated with a decreased risk (P for trend=0.051), and larger weight gain in adultage was significantly associated with an increased risk (P for trend=0.041). History of prostate cancer in fathersor brothers was significantly associated with an increased risk (OR=9.71, 95%CI 3.59, 26.27), and history ofbreast cancer in mothers or sisters was also significantly associated with an increased risk (OR=2.70, 95%CI1.12, 6.49). The recent increase in the incidence rate of prostate cancer may possibly be brought about by anincreased proportion of Japanese men with large weight gain in adult age.     

Sun Exposure and the Risk of Prostate Cancer in the Singapore Prostate Cancer Study: a Case-control Study

Background: Most of the epidemiology studies on the effects of sun exposure and prostate cancer wereconducted among the temperate countries of North America and Europe. Little is known about the influenceon Asian populations. The purpose of current study was to evaluate any association of sun exposure with riskof prostate cancer in Chinese, Malays and Indians who reside in the tropics. Methods: The Singapore ProstateCancer Study is a hospital-based case-control study of 240 prostate cancer incident cases and 268 controlsconducted in Singapore between April 2007 and May 2009. Detailed information on outdoor activities in thesun, skin colour, sun sensitivity and other possible risk factors were collected in personal interviews. Cases werefurther classified by Gleason scores and TNM staging. Odds ratios (OR) and 95% confidence intervals (CI) werecalculated using unconditional logistic regression analysis, adjusted for age, ethnicity, education, family historyof any cancers, BMI and skin colour. Results: We found that prostate cancer risk was increased in subjects withblack/dark-brown eyes (OR 5.88, 95%CI 3.17-10.9), darker skin colour e.g. tan/dark brown/black (OR 7.62,95%CI 3.41-17.0), frequent sunburn in lifetime (OR 4.30, 95%CI 1.7-11.2) and increased general sun exposure inadulthood per week (OR 2.03, 95%CI 1.09-3.81). The increased risk was consistent for high grade tumours andadvanced stage prostate cancers. Conclusion: The findings from this study suggest that excessive sun exposureis a risk factor for prostate cancer in Asians.     

Risk Factors for Prostate Cancer in Universiti Kebangsaan Malaysia Medical Centre: A Case-Control Study

Introduction: In Malaysia, prostate cancer is ranked 6th among male cancer and expected to increase in thefuture. Several factors have shown to be related to prostate cancer such as sociodemographic, lifestyle, diet,occupational exposure, medical and health status. This is the first time a similar study was conducted in Malaysiato recognize the risk factors for prostate cancer patients who came for treatment at Universiti KebangsaanMalaysia Medical Centre (UKMMC). Methods: Prostate cancer cases diagnosed between 2003 and 2008 whichmet with the inclusion criteria were included in the study. One hundred and twelfth (112) pairs of cases andcontrols matched by age and ethnicity were analysed. McNemar Odds Ratios (ORM) were calculated usingMcNemar Calculator software for univariate analysis while conditional logistic regression was used formultivariate analysis, both using SPSS version 12.0. Results: Most of the prostate cancer patients (68.8%) thatcame for treatment in UKMMC were above 70 years old. The majority were Chinese (50.0%) followed byMalay (46.4%) and Indian (3.6%). Multivariate analysis showed cases were more likely to have a first-degreerelative with a history of cancer (OR= 3.77, 95% CI= 1.19-11.85), to have been exposed to pesticides (OR= 5.57,95% CI= 1.75-17.78) and consumed more meat (OR= 12.23, 95% CI= 3.89-39.01). Significantly reduced risks ofprostate cancer were noted among those consuming more vegetables (OR= 0.12, 95% CI= 0.02-0.84), moretomatoes (OR= 0.35, 95% CI= 0.13-0.93) and those who had frequent sexual intercourse (OR= 0.44, 95% CI=0.19-0.96). Conclusion: Some lifestyle and occupation factors are strong predictors of the occurrence of prostatecancer among patients in UKMMC. More importantly, with the identification of the potentially modifiable riskfactors, proper public health intervention can be improved.     

河南林州胃癌危险因素的病例对照研究

「目的」探讨胃癌发病的危险因素及保护因素,为综合防治提供流行病学论据。「方法「采用病例－对照研究方法,对３４６例胃癌病人和１５４１例正常人群对照进行固顾性调查。单因素分析出各因素的比值及其９５％可信限,初选因素（Ｐ〈０．１）进行主成份因子分析、应用非条件Ｌｏｇｉｓｔｉｃ回归模型多因素分析。「结果」胃癌的危险因素主要有：上消化道疾病史、十年内有精神创伤、职业物理接触、癌症家族史、高盐饮食及社会经济地     

Prevalence,Risk Factors and Disease Knowledge of Breast Cancer in Pakistan

Breast cancer is the most common cancer in females all over the world with approximately one million newcases each year as well as one of second leading causes of death among females. In Pakistan, the most frequentlydiagnosed cancer among females is also breast cancer, accounting for nearly one in nine female patients. Itsincidence in Pakistan is 2.5 times higher than that in neighboring countries like Iran and India. The risk factorsassociated with breast cancer are age, family history, early menarche, intake of combined estrogen and progestinmenopausal hormones, alcohol consumption, physical inactivity, low socioeconomic status and lack of awarenessregarding the disease. This mini-review article aims to provide awareness about breast cancer as well as anupdated knowledge about the prevalence, risk factors and disease knowledge of breast cancer in Pakistan.     

Risk Factors and Epidemiology of Gastric Cancer in Pakistan

Gastric cancer is the 2nd most common cause of death among all cancers and is the 4th most common cancerin the world. The number of deaths due to gastric cancer is about 800,000 annually. Gastric cancer is morecommon in men as compared to women and is 3rd most common cancer after colorectal and breast cancers inwomen. A progressive rise in the incidence rate has been observed in females over the last 5 years. The highestincidence of stomach cancer is in China, South America and Eastern Europe. The incidence of gastric cancer has20 fold variation worldwide. Global variation is linked by two factors which play important role in developinggastric cancer. One is infection with Helicobacter pylori and the 2nd is diet. South Asia is a region with low risk,despite a high prevalence of H.pylori. Gastric carcinoma is common in southern region of India. Gastric canceris more readily treated if diagnosed early. This study aims to provide awareness about gastric cancer as well asan updated knowledge about risk factors and epidemiology of gastric cancer in Pakistan.     

Epidemiology of Prostate Cancer

Prostate cancer is the most common malignancy among males worldwide, and is the second leading causeof cancer death among men in United States. According to GLOBOCAN (2012), an estimated 1.1 million newcases and 307,000 deaths were reported in 2012. The reasons for the increase of this disease are not known, butincreasing life expectancy and modified diagnostic techniques have been suggested as causes. The establishedrisk factors for this disease are advancing age, race, positive family history of prostate cancer and western diet(use of fat items). Several other risk factors, such as obesity, physical activity, sexual activity, smoking andoccupation have been also associated with prostate cancer risk, but their roles in prostate cancer etiology remainuncertain. This mini-review aims to provide risk factors, disease knowledge, prevalence and awareness aboutprostate cancer.     

女性乳腺癌危险因素的病例对照研究

[目的]探讨江苏女性乳腺癌的危险因素。[方法]用病例对照研究的方法,对经病理确诊的206例乳腺癌患者及经年龄频数匹配（±2．5岁）214例对照资料进行非条件Logistic回归分析。[结果]被动吸烟（OR=2．21,95％CI：1．32～3．701、自然流产史（OR=1．71,95％CI：0．65—4．55）、口服避孕药服用史（OR=3．70,95％CI：2．00～6．82）、有良性乳腺疾病史（OR=2．69,95％CI：1．66～4．36）、肥猪肉（OR=2．39,95％CI：1．34～4．28）及腌制类食品年摄入量高（OR=4．71,95％CI：2．91～7．60）、轻体力活动职业（OR=6．29,95％CI：2．95～13．42）可能是女性乳腺癌发生的危险因素。而经常参加体育锻炼（OR=0．44,95％CI：0．26～0．74）、月经初潮年龄晚（OR=0．19,95％CI：0．06—0．65）、鲜奶（0R=0．32,95％CI：0．20～0．511、新鲜豆类（0R=0．07,95％CI：0．04—0．13）和水果年摄入量高（OR=0．30,95％CI：0．18—0．48）则降低乳腺癌发生的风险。[结论]减少口服避孕药、肥猪肉及腌制类食品的摄入,增加新鲜水果、新鲜豆类摄入,加强体育锻炼,对患有良性乳腺疾病的妇女加强体检。加大乳腺癌预防及健康宣教工作可预防乳腺癌的发生。     

Association of Vitamin D Receptor Gene Polymorphisms with Prostate Cancer Risk in the Pakistani Population

Background: Vitamin D receptor (VDR) gene has been a subject of extensive pharmacogenetic researchrecently. Association studies between different types of cancers including prostate cancer (PCa) and VDR genepolymorphism have also been conducted. The objective of this study was to find possible associations betweenPCa and VDR gene polymorphisms in the Pakistani population. Materials and Methods: A total of 162 subjects,including prostate cancer patients and controls, were genotyped for Apa I, Taq I and Fok I polymorphisms inthe VDR gene using allele specific PCR, PCR-RFLP and direct DNA sequencing. Allelic frequencies were testedfor Hardy-Weinberg equilibrium and associations between the genetic markers and PCa were calculated usinglogistic regression. Results: Apa I CC genotype was found to have strongest association with PCa risk, and “A”genotype was found to have protective effect. Fok I and Taq I did not have appreciable levels of association withPCa, although Taq I “TC” heterozygotes seemed to have some protective effect. Similarly the “C” allele of Fok Ialso seemed to have protective effect. Conclusions: To our knowledge, this is the first report showing associationbetween VDR gene polymorphisms and PCa in Pakistan. Our findings may be somewhat skewed because ofsmall sample size and tendency of consanguineous marriages in Pakistani society; nevertheless, it shows thetrend of association and protective effects of certain VDR gene polymorphisms against PCa.     

Cumulative Risk and Trends in Prostate Cancer Incidence in Mumbai,India

Background: Information relating to cancer incidence trends in a community forms the scientific basis for the ‍planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk ‍and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based ‍Cancer Registry from the year 1986 to 2000. ‍Methods: During the 15 year period, a total of 2864 prostate cancer cases (4.7% of all male cancers and 2.4% of ‍all cancers) were registered by the Bombay Population-based Cancer Registry. For evaluation of the trend, we ‍applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage ‍changes were also computed for the evaluation. Cumulative incidence rates percentages were calculated by adding ‍up the age specific incidence rates at single ages and then expressed as a percentage. ‍Results: Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 ‍showed no statistically significant increase or decrease and the rates proved stable across the various age groups (00- ‍49, 50-69 and 70+) also. The probability estimates indicated that one out of every 59 men will contract a prostate ‍cancer at some time in his whole life and 99% of the chance is after he reaches the age of 50. ‍Conclusion: The stability in age adjusted-incidence rates indicates that there are no changes in the etiological ‍factors for prostate cancer in Mumbai, India. These findings may be of general interest because changes in diagnostic ‍practices are confounded in the time trends of prostate cancer change in many western countries preventing inferences ‍on the changes in risk. ‍     

Risk Factors for Endometrial Cancer: Results from a Hospital-Based Case-Control Study

Objectives: The purpose of this investigation was to examine the association between endometrial cancer and possible etiological agents. Methods: A case-control study was conducted in Iran between March 2012 and May 2016. The demographic and reproductive factors of 205 women with endometrial cancer were compared, and 590 healthy cases were participated in the control group. For each endometrial cancer case, there were three controls, who were matched in terms of age and residence. The data were considered significant at p ≤0.05. Results: After adjusting the variables, the nulliparity (OR 6.23, 95% CI 2.86-13.59), the nulligravidity (OR 5.94, 95% CI 2.51-14.06), the positive family history of reproductive cancer (OR 4.97, 95% CI 2.33-10.59), the infertility history (OR 2.38, 95%CI 1.32-4.31), the obesity (BMI ≥25) (OR 1.71, 95% CI 1.16-2.52), the early menarche age (and the hormonal contraception use (OR 1.69, 95% CI 1.15-2.49) were found to be associated with an increased risk of endometrial cancer. Nevertheless, the education level, the job of women, the marital age, the leisure activities, and the breast feeding were not found to be associated with the endometrial cancer after adjusting the variables. Conclusion: Scheduling of the screening program is vitally indispensable to identify endometrial cancer in women with nulliparity, nulligravidity and the positive family history of cancer. In addition, women with early menarche, those with the history of infertility, the obese ones, and those who use contraception pills need to be particularly aware of the potential risks.     

Comparison of Lifestyle Risk Factors by Family History for Gastric,Breast, Lung and Colorectal Cancer

To assess the theoretical impact of lifestyle of a cancer family history in first-degree relatives (CFH) and clarify ‍interactions between CFH and lifestyle factors, hospital-based comparison and case-reference studies were conducted ‍in Nagoya, Japan. Totals of 1988 gastric, 2455 breast, 1398 lung and 1352 colorectal cancer patients, as well as 50,706 ‍non-cancer outpatients collected from 1988 to 1998, were checked for lifestyle factors, which included dietary and ‍physical exercise habits, as well as smoking/drinking status. General lifestyle factors with non-cancer outpatients ‍did not differ by the CFH status. Case-reference analyses showed that frequent intake of fruits, raw vegetables, ‍carrots, pumpkin, cabbage and lettuce, as well as frequent physical exercise, were associated with decreased risk for ‍all four sites of cancer, while habitual smoking increasing the risk of gastric, and more particularly, lung cancer. ‍Interestingly, the study revealed the magnitude of odds ratios for the above lifestyle factors obtained from CFH ‍positives to be similar to those from CFH negatives for these four sites of cancer. There were no significant interactions ‍between CFH and any particular lifestyle factor. In conclusion, our results suggest no appreciable influence of CFH ‍on lifestyle related risk factors for gastric, breast, lung, and colorectal cancer. Habitual smoking increased, while ‍frequent physical exercise and raw vegetables intake decreased cancer risk, regardless of the CFH status. ‍     

Elevated Fasting Blood Glucose is Associated with Increased Risk of Breast Cancer: Outcome of Case-control Study Conducted in Karachi,Pakistan

Background: There are several validated risk factors for breast cancer. However the legitimacy of elevatedfasting blood glucose (FBG) is not well established. This study was designed to assess this parameter as a riskfactor for breast cancer among pre- and post-menopausal women. Materials and Methods: This case-controlstudy was conducted at Department of Biochemistry, University of Karachi from June 2010 to August 2014.Simple random sampling technique was used to collect data of study subjects comprising 175 diagnosed breastcancer patients with positive histopathology from Breast Clinic, surgical unit-1, Civil Hospital, Karachi and 175healthy controls from various screening programs. Blood samples were analyzed for FBG and serum insulin.Results: FBG, HOMA-IR, systolic and diastolic blood pressure were significantly raised in breast cancer caseswhen compared to control subjects. Cases and controls were further categorized in to two groups using cutoffvalue of 110mg/dl to distinguish subjects into normal fasting glucose (<110mg/dl) and having impaired fastingglucose (≥110-≤125 mg/dl) or diabetes (≥126 mg/dl). Odds ratios were found to be 1.57, 2.15 and 1.17 in overall,pre-menopausal and post-menopausal groups, respectively. (all p < 0.05). Conclusions: A statistically significantrisk of breast cancer exists in women having elevated fasting blood glucose levels, corresponding to prediabetesand diabetes, among pre and postmenopausal ages, with comparatively greater effects in the premenopausalgroup.     

Epidemiology and Prevention of Prostate Cancer in Vietnam

Prostate cancer is the second most common cancer in men worldwide and a leading cause of mortality.Incidences continues to rise and vary substantially between populations. Although the prevalence of prostatecancer is relatively low in Vietnam, some hospital-based reports have shown an upward trend in recent years.While certain non-modifiable factors such as age, race and genetics are known to be mainly responsible, theliterature has also suggested that environmental exposures can delay the onset of this disease. The present studyprovides a review of the epidemiology of prostate cancer in Vietnam by systematically searching several electronicdatabases. The results confirm an increasing trend of prostate cancer over the past decade, with age-standardisedrate more than doubled from 2.2 per 100,000 men in 2000 to 4.7 per 100,000 men in 2010. However, no study hasbeen found on modifiable risk factors, with the exception of one in vitro experiment that showed the inhibitoryeffect of garlic on the growth of prostate cancer cells. The lack of epidemiological information poses a difficultyto develop public health interventions to prevent this emerging malignant disease in Vietnam.     

Risk Factors for Cervical Cancer in Rural Areas of Wuhan China: a Matched Case-control Study

Cervical cancer is a serious public health problem in developing countries. We investigated possible riskfactors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 womendiagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. Aquestionnaire, which included questions about general demography conditions, environmental and geneticfactors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child’s age, femalepersonal health history, social psychological factors, dietary habits, smoking and alcohol status and other livinghabits was presented to all participants. At the same time, HPV infection of every participant was examined inlaboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child’s age (P<0.000,OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor againstcervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide,disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training,sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickledfood) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer inChinese rural women may be associated with HPV infection, menopause and the pregnancy first child’s age.     

A Case-control Study of Risk Factors for Lung Cancer in Mumbai,India

In the year 2010, it is estimated that nearly 1.35 million new cases and 1.18 million deaths with lung canceroccurred. In India, among males, lung cancer rates vary across the country which has encouraged us to conduct acase-control study to study the risk factors. The present unmatched hospital-based case-control study conductedat Tata Memorial Hospital included subjects registered between the years 1997-99. There were 408 lung ‘cancercases’ and 1383 ‘normal controls. Data on age, tobacco habits, occupational history, dietary factors, tea, coffeewere collected by the social investigators. Univariate and regression analysis were applied for obtaining theodds ratio for risk factors. In the study, cigarette smoking (OR=5.2) and bidi smoking (OR=8.3), as well asalcohol consumption (OR=1.8), demonstrated dose-response relationships with lung cancer risk. Among thedietary items, only red-meat consumption showed 2.2-fold significant excess risk. Consumption of milk showeda 60% reduction in risk; while coffee showed a 2-fold excess risk for lung cancer. In addition, exposure to useof pesticides showed a 2.5-fold significant excess risk for lung cancer.     

Prostate Cancer: A Hospital-Based Survival Study from Mumbai,India

Background: Prostate cancer is common in elderly men, especially in western countries, and incidencesare rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Underthese circumstances we have estimated the survival of prostate cancer patients based on age, family history,diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materialsand Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai,India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH wereconsidered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR)method were estimated. Results: The patient population was distributed uniformly over the three age groups. Alarger proportion of the patients were diagnosed at ‘metastatic stage’ and hormone treatment was most common.20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%.Survival was 55%, 74% and 52% for ‘<59 years’,’60-69 years’ and ‘>70 years’ respectively. Non-diabetic (70%),hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery,either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostatecancer patients with localized disease at diagnosis experience a better outcome. Local treatment with eithersurgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help inunderstanding the prognostic indicators for survival especially with the newer treatment technologies availablenow.