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This study investigated the association between intake of common alcoholic and non-alcoholic beverages and breast cancer risk among Japanese women. This study included 33,396 Japanese women aged 40-79 years from 24 areas in Japan from the Collaborative Cohort study. During the follow-up period (≥20 years), 245 incidents or mortal breast cancers were documented. Multivariable logistic regression analysis was performed to assess the independent association between breast cancer risk and the intake of Japanese green tea, coffee, and alcohol. Japanese green tea was the most commonly consumed non-alcoholic beverage (81.6% of participants), followed by coffee (34.7%) and alcohol (23.6%). No significant associations were identified between the intake of green tea and coffee with breast cancer risk (odds ratio OR 1.15, 95% confidence interval [CI] 0.82-1.60, and OR 0.84, 95% CI 0.64-1.10, respectively). Alcohol intake was associated with significant breast cancer risk (OR 1.46, 95% CI 1.11-1.92), and even infrequent alcohol consumption (.

Objective: Our aim was to estimate whether diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC) mortality in Japan. Methods: The Japan Collaborative Cohort (JACC) Study is a nationwide prospective study, initiated in 1988, which involves 110,585 subjects (age range: from 40 to 79 years; 46,395 males and 64,190 females). Our present analysis population comprised 96,081 (40,510 men and 55,571 women) who provided details on DM history. The questionnaire also included age, sex, weight, height, family history of CRC, smoking, drinking and exercise habits, and education. Cox proportional-hazard regression was used to estimate the hazard ratio (HR). We used SPSS 21 software to analyze all data. Results: Among the participants with DM, we followed up for 71,174 person-years and 640. deaths from CRC were confirmed; and, among the non-diabetic participants, 785 CRC deaths were identified during 1,499,324 person-years. After adjusting for multivariate confounding factors, such as age, sex, body mass index (BMI), family history of colorectal cancer, smoking habit, drinking habit, physical activity (sports and walking) and education, DM was associated with an increased risk of CRC death (HR 1.4, 95% confidence interval [CI] 1.0-2.0). Diabetic women, but not diabetic men, experienced increased mortality from CRC (HR 1.7, 95% CI 1.0-3.0). Conclusion: The risk of CRC mortality is significantly increased in both sexes and women with diabetes, but no significant increase was seen for diabetic men among Japanese., (Creative Commons Attribution License)

Background: The incidence of bladder cancer is lower in Asian than in Western countries. However, the crude incidence and mortality of bladder cancer have recently increased in Japan because of the increased number of senior citizens. We have already reported risk factors for urothelial cancer in a large populationbased cohort study in Japan (JACC study). However, we did not evaluate the cancer risk in the upper and lower urinary tract separately in our previous study., Materials and Methods: Here we evaluated the risk of cancer death in the upper and lower urinary tracts, separately, using the database of the JACC study. The analytic cohort included 46,395 males and 64,190 females aged 40 to 79 years old. The Cox proportional hazard model was used to determine hazard ratios and their 95% confidence intervals., Results: Current smoking increased the risk of both upper and lower urinary tract cancer deaths. A history of kidney disease was associated with an increased risk of bladder cancer death, even after controlling for age, sex and smoking status., Conclusions: The present study confirmed that current smoking increases the risk of both upper and lower urinary tract cancer deaths and indicated the possibility that a history of kidney disease may be a risk factor for bladder cancer death in the Japanese population.

Background: Cigarette smoking is the largest single recognized cause of human cancers. In Western countries, many epidemiologists have reported risk factors for kidney cancer including smoking. However, little is known about the Japanese population., Materials and Methods: We evaluated the association of smoking with the risk of kidney cancer death in the Japan Collaborative Cohort (JACC) Study. Participants included 46,395 males and 64,190 females. The Cox proportional hazards model was used to determine age-and-sex adjusted relative risks., Results: A total of 62 males and 26 females died from kidney cancer during the follow-up of 707,136 and 1,025,703 person-years, respectively. Heavy smokers (Brinkman index >1200), fondness of fatty foods, hypertension, diabetes mellitus (DM), and obesity were suggested to increase the risk of renal cell carcinoma while walking was suggested to decrease the risk. Even after controlling for age, sex, alcohol drinking and DM, heavy smoking significantly increased the risk., Conclusions: The present study suggests that six factors including smoking may increase and/or reduce the risk of kidney cancer in the Japanese population. Because of the small number of outcomes, however, we did not evaluate these factors after adjusting for all possible confounding factors. Further studies may be needed to confirm the findings in this study.

The increase in the incidence rate of prostate cancer may be associated with changes in lifestyle in Japanese men. Accordingly, we conducted a case-control study to assess risk factors. A total of 117 (82.3%) of the 142 prostate cancer patients asked filled out the self-administrated questionnaires which included items about their lifestyle habits over the period of one or two years before their diagnosis. Four controls per case, namely 468, were randomly selected from resident registries with age and address matched with each case, and 318 controls (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 utilized for analyzing the individually age and address-matched data, and odds ratios (ORs) and their 95% confidence intervals (95%CIs) were calculated for potential risk factors. Higher body mass index at 20 years of age was marginally significantly associated with a decreased risk (P for trend=0.051), and larger weight gain in adult age was significantly associated with an increased risk (P for trend=0.041). History of prostate cancer in fathers or brothers was significantly associated with an increased risk (OR=9.71, 95%CI 3.59, 26.27), and history of breast cancer in mothers or sisters was also significantly associated with an increased risk (OR=2.70, 95%CI 1.12, 6.49). The recent increase in the incidence rate of prostate cancer may possibly be brought about by an increased proportion of Japanese men with large weight gain in adult age.

Superoxide dismutase (SOD) is an antioxidant enzyme that acts to degrade superoxide, a major causitive factor for oxidative stress associated with cancer, cardiovascular disease, and various other ailments. Here, to assess an association between antioxidants and lifestyle factors related to cancer risk, we analyzed serum SOD activity among the subjects within a large-scale cohort study in Japan. As results, significant differences in serum SOD activity were found between the sexes (lower in males), among female age groups (lower in younger individuals), and in males with the BMI (lower in those with a high BMI). Linear increase in serum SOD activity with aging and decrease with BMI were observed in females. Significantly low SOD activity was evident in male heavy smokers. In contrast, elevation was noted in female frequent drinkers. In conclusion, our findings do suggest associations between serum SOD activity and lifestyle factors. However, for further study, establishment of a standard measurement method for SOD activity should be a high priority.

The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was planned in the late 1980s as a large-scale cohort study of persons in various areas of Japan. In the present study, we conducted a nested case-control study and examined associations of breast cancer risk with serum levels of insulin-like growth factors I and II (IGF-I, IGF-II), as well as insulin-like growth factor binding protein-3 (IGFBP-3), among women who participated in the JACC Study and donated blood at the baseline. Sixty-three women who died or suffered from breast cancer were examined. Two or three controls were selected to match each case for age at recruitment and the study area. Controls were alive and not diagnosed as having breast cancer at the diagnosis date of the cases. Associations between the serum IGF-I, IGF-II, IGFBP-3 and breast cancer risk were evaluated using a conditional logistic regression model. In premenopausal Japanese women, IGF-I showed a marginal negative dose-dependent association with the breast cancer risk (trend P= 0.08), but any link disappeared on taking into account IGFBP-3 (trend P= 0.47), which was likely to be inversely associated with the risk. In postmenopausal women, IGFBP-3 showed a marginal dose-dependent association with the risk (trend P= 0.06). Further studies are needed to confirm these findings.

High levels of insulin-like growth factor (IGF)-I are reported to be associated with an increased risk of prostate cancer. On the other hand, the insulin-like growth factor binding protein-3 (IGFBP-3) may decrease the risk. We therefore investigated the influence of serum IGF-I and IGFBP-3 on prostate cancer risk in a case-control study nested within a large-scale cohort in Japan (the Japan Collaborative Cohort Study). Information on lifestyle and sera of the subjects were collected in 1988-90. Serum IGF-I, IGF-II and IGFBP-3 were measured in sera stored at -80 degrees C by immuno-radiometric assay. In 13,508 male subjects of the cohort who donated sera, 40 cases and 120 controls (1:3 matched with age and survey area) were identified. Ages of the cases ranged from 59 to 79 years, with a mean of 69.8. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the highest and middle tertiles compared with the lowest in controls using a conditional logistic model. Non-adjusted ORs for the highest tertiles were 0.99 (95% CI, 0.34-2.91) for IGF-I (trend-P = 0.60), 1.91 (95% CI, 0.68-5.38) for IGFBP-3 (trend-P = 0.23), 1.73 (95% CI, 0.69-3.47) for IGF-II (trend-P = 0.23), and 0.67 (95% CI, 0.26-1.76) for the IGF-I/IGBP-3 ratio (trend-P = 0.83). Serum levels of IGF-I, IGF-II, IGFBP-3, or IGF-I/IGFBP-3 ratio were thus not thought to be associated with risk of prostate cancer.

This study assessed the association of multiple myeloma (MM) with age, body mass index (BMI, kg/m(2)), physical activity, occupational history, and medical history for a Japanese cohort of 46,157 men and 63,541 women aged 40-79 years followed during 1988-2003 years. Cox proportional hazard model was mainly used to estimate the age and sex adjusted hazard ratio (HR) of MM including 95% confidence interval (CI) for both sexes. Same model, adjusted for age, was also used for each sex. In total, 98 MM deaths (men=49 and women=49) was observed for both sexes. Higher age groups (60-69 and 70-79 years) experienced significantly higher unadjusted HR of MM than the age group of 40-49 years. Men revealed significantly higher age-adjusted MM than women (HR=1.5; 95% CI=1.0-2.2). For both sexes, higher BMI of >or=30 kg/m(2)) (HR=2.8; 95% CI=1.0-7.7), walking

Objectives: To examine associations of ever-use of sex hormones (EUSH) and other factors with endometrial cancer (EC) mortality through a nation-wide Japan Collaborative Cohort Study., Methods: A total of 63,541 women aged 40-79 years, enrolled in 1988-90 from 45 municipalities of Japan, were followed until 2003 to record their vital status. Using baseline data, the Cox proportional hazard model (age adjusted and multivariate) was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for EC mortality by selected factors, including EUSH. Bivariate analysis was also conducted to establish associations between EUSH and other factors., Results: The mortality rate from EC was 2.6 per 100,000 person-years during the mean follow-up period of 13.3 years. Prevalence rate of EUSH was 5.2%. Significantly increased risk of EC mortality was found for EUSH with both age adjusted (HR=6.43, 95%CI=2.10-19.67) and multivariate (HR=5.33; 95%CI=1.51-18.82) analyses. Bivariate analysis indicated that history of diabetes mellitus, smoking, drinking, and age at first delivery were positively associated with EUSH, whereas age, number of delivery, number of pregnancy, and age at menarche demonstrated inverse links., Conclusions: Our results imply that EUSH may increase the risk of EC mortality among Japanese women. However, further studies with more deaths are needed to validate the results.

The study examined the association of diabetes mellitus (DM) history with total and common site-specific cancers using a large cohort of 23,378 men and 33,503 women, extracted from 127,477 healthy participants of the JACC Study who were aged 40-79 years and living in 24 municipalities in Japan. At enrollment during 1988-90, each subject completed a self-administered questionnaire including items for age, sex, body mass index (BMI), smoking, drinking, past history of DM and cancer. Adjusting for age, BMI, smoking, and drinking in the Cox's proportional hazard model, incidence rate ratios (IRR) with 95% confidence intervals (95%CIs) were estimated for both sexes. During the follow-up period, total cancers and site-specific cancers were identified. A history of DM was reported by 7.5% of men and 4.6% of women. DM significantly increased the risk of liver cancer for both men (IRR=2.30; 95%CI=1.47-3.59) and women (IRR=2.70; 95%CI=1.20-6.05). Significant increased and reduced risk due to DM for men were also found for non-Hodgkin lymphoma (IRR=2.77; 95%CI=1.04-7.38) and stomach cancer (IRR=0.67; 95%CI=0.46-0.99) respectively. For females, a reduced risk of stomach cancer due to DM (IRR=0.49; 95%CI=0.23-1.04) was also revealed. Since a history of DM here demonstrated significant associations with some site-specific cancers, their relationships should be studied further in Japan for validation.

Evidence now suggests that epigenetic abnormalities, particularly altered DNA methylation, play a crucial role in the development and progression of human gastrointestinal malignancies. Two distinct DNA methylation abnormalities are observed together in cancer. One is an overall genome-wide reduction in DNA methylation (global hypomethylation) and the other is regional hypermethylation within the CpG islands of specific gene promoters. Global hypomethylation is believed to induce proto-oncogene activation and chromosomal instability, whereas regional hypermethylation is strongly associated with transcriptional silencing of tumor suppressor genes. To date, genes involved in regulation of the cell cycle, DNA repair, growth signaling, angiogenesis, and apoptosis, are all known to be inactivated by hypermethylation. Recently developed techniques for detecting changes in DNA methylation have dramatically enhanced our understanding of the patterns of methylation that occur as cancers progress. One of the key contributors to aberrant methylation is aging, but other patterns of methylation are cancer-specific and detected only in a subset of tumors exhibiting the CpG island methylator phenotype (CIMP). Although the cause of altered patterns of DNA methylation in cancer remains unknown, it is believed that epidemiological factors, notably dietary folate intake, might strongly influence DNA methylation patterns. Recent studies further suggest that polymorphisms of genes involved in folate metabolism are causally related to the development of cancer. Identifying epidemiological factors responsible for epigenetic changes should provide clues for cancer prevention in the future.

Recently the incidence rate of multiple myeloma (MM) has increased in Japan. Epidemiologic efforts have suggested that certain occupational and chemical exposures are likely to increase the risk for MM. We therefore performed a case-control study of MM, examining occupational factors. Data for 57 cases and 57 controls were obtained from Sapporo Medical University Hospital and its affiliated hospitals in Hokkaido. Controls were matched to each case by gender, age (+/- 5 years) and hospital. Detailed information regarding several factors possibly related to MM was obtained by interviews in hospitals. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated with adjustment for cigarette smoking as confounding factor. The occupational category of agriculture and fishery showed a significant association with increased risk (OR = 5.89, 95% CI = 1.24-28.04). Occupational exposure to chemical products including organic solvents or petroleum showed a significant association with increased risk (OR = 8.05, 95% CI = 1.01-64.45). Medical histories of operation for appendicitis and blood transfusion were associated with decreased risk, but not significantly. Our results suggested that occupational exposure to chemicals might play a role in the risk of MM.

Dietary factors are thought to be closely associated with the development of human cancers and hence numerous studies in this area have already been conducted in the United States and other Western countries. Comparatively few prospective studies have been published in Japan, especially for Hokkaido people. The present investigation was therefore performed to assess links between four leading cancers and some of the Japanese common dietary factors through a cohort study (1984-2002) in Hokkaido by analyzing 1,524 men and 1,634 women separately aged 40 and over. Adjusted Cox proportional hazard regression was used to calculate the relative risk (RR) for each dietary factor. For men, two dietary factors, miso soup (RR=0.2, 95% confidence interval (95%CI)=0.1-0.8) and pickled vegetables (RR=0.2, 95%CI=0.1-0.8) were associated with lower risk for stomach and colorectal cancer respectively. For women, three factors, namely salty confectionary (RR=3.5, 95%CI=1.1-10.9), black tea (RR=3.8, 95%CI=1.1-13.6), and carbonated drink/juice (RR=3.9, 95% CI=1.4-11.1) appeared related to an elevated risk of stomach cancer. However, further analysis simultaneously with all other adjusted factors indicated only carbonated drink/juice (RR=3.1, 95%CI=1.1-8.9) to present a significant risk factor for stomach cancer. One factor, namely wild edible plants (RR=3.3, 95%CI=1.1-9.8), increased the risk for colorectal cancer in women. None of the dietary components were significantly associated with lung or pancreatic cancers. This study also indicated a wide variation in the impact of dietary factors by sex and cancer site, in line with earlier work, pointing to a necessity for careful interpretation. Further epidemiological investigations by sex with more study subjects and confounding factors will be useful for determining the contribution of individual dietary factors to development of human cancers in Hokkaido, Japan.

Background: Our previous case-control study revealed that Japanese living in Japan and Koreans living in Korea can be divided into equol producers who have an ability to metabolize daidzein to equol and non-producers, and that the incidence of prostate cancer is higher in the latter group. In the present study, we examined relationships between type of food intake and the capacity for equol production in Japanese subjects., Methods: The subjects were the individuals analyzed for the ability to produce equol in our previous study and newly registered cases. From December 2000 to December 2002, 276 hospitalized patients were interviewed face-to-face and blood samples were collected before breakfast. These included 122 patients with prostate cancer and 154 age-matched controls., Results: The frequency of equol producers (0.5 ng/ml or more) among cases and controls was 29% and 45%, respectively (p = 0.004). The consumption of soybeans and green tea were significantly higher in equol producers than in the non-producers (p<0.05). By contrast, the consumption of selenium and fiber was significantly lower in equol producers (p<0.05)., Conclusions: Our results suggest that higher consumption of soybean and green tea are strongly related to the establishment of a capacity for equol production.

Objectives: The burden of tobacco-induced cancer is so heavy that every country should give the highest priority to tobacco control in its fight against cancer. The purpose of the present study was to investigate the actual conditions of tobacco smoking among boys in Japan., Methods: A self-administered questionnaire survey. Two thousand and fourteen high school boys in Fukuoka City, Japan, answered unsigned self-administered anonymous questionnaires about tobacco smoking., Results: Among 2014 students, 10.9% were current smokers. The rates of current smokers increased with the school age: 6.3% in the first grade; 11.3% in the second grade; and 15.5% in the third grade (P(trend)<0.01). A total of 35.1% of students had the experience of smoking and 30% experienced smoking before entering high school. Of the students with smoking experience, 28.6% answered that they started smoking because their friends had offered them cigarettes and 52.5% of current smokers bought cigarettes from vending machines., Conclusions: Health education for anti-smoking in all primary and secondary schools as well as restriction of cigarette vending machines should be strongly recommended.

Only after a decade from 1993, arsenic contamination of groundwater in Bangladesh has been reported as the biggest arsenic catastrophe in the world. It is a burning public health issue in this country. More than 50 percent of the total population is estimated at risk of contamination. Already thousands of people have been affected by the disease arsenicosis. Many more may be on the way to manifest lesions in future. We conducted a review of previous studies and published articles including MEDLINE database on this issue. We found that 59 districts out of 64 have been already affected by arsenic in underground drinking water, where this particular source of drinking water is the main source for 97 percent of the rural people. The water is unfortunately now a great threat for the human being due to high level of arsenic. Continuous arsenic exposure can lead people to develop arsenicosis, which in turn elevates the risk of cancer. Skin lesions are the most common manifestations in arsenicosis patients. Relatively poor rural people and other socio-economically disadvantaged groups are more affected by this exposure. Until now cancer patients have been relatively limited in Bangladesh. One of the reasons may be that several years are needed to show cancer manifestations from the beginning of arsenic exposure. But it is suspected that after some years a large number of patients will appear with cancer in different sites for arsenic exposure in drinking water. Various studies have been conducted in arsenic affected countries - notably in Argentina, Chile, China, Japan, and Taiwan -to find the potential of arsenic exposure to cause development of cancer. Among the arsenic related cancers, liver, lung, skin, bladder and kidney cancers are reported to be prevalent in these countries. Unfortunately no scientific study has been yet conducted in Bangladesh to find the relationship between arsenic exposure and cancers in different sites of the body. So our aim is to conduct an ecological as well as a case-control study in the country in the future.

Epidemiological studies of cancer of the ovaries, among the leading sites for cancer incidence and mortality in women in very many countries of the world, have pointed to high saturated fat and carbohydrate intake, postmenopausal hormone replacement therapy and use of cosmetic talc as risk factors. Conversely, vegetable consumption, parity, lactation and generally appear to confer protection. Genetic influence also clearly plays a role, women with mutations in the BRCA1 or BRCA2 genes having an elevated risk, for example. Overall there appear to be shared risk factors for breast cancer. However, there are many types of epithelial ovarian cancer and cross-country comparisons of incidence data from various cancer registries in Europe and North America published in the IARC Cancer Incidence in Five Continents Vol VII suggest that only the serous type is linked to mammary tumour development. Thus future studies should concentrate more attention on the individual subtypes of ovarian cancer in order to better establish preventive measures.

We conducted a review of previous cohort studies on the association between a history of diabetes mellitus (DM) and the occurrence of cancer. We limited the papers to those concerning cohort studies on 9 cancer sites, i.e. the kidney, liver, biliary tract, pancreas, colon or rectum, prostate, breast, endometrium, and ovary, in addition to all cancers. With regard to kidney, liver, biliary tract, pancreatic, colorectal, breast, and endometrial cancers, the risk of cancer development has been consistently reported to be positively associated with DM by two or more cohort studies. In contrast, DM was shown to relate negatively to the risk of prostate cancer by two cohort studies. However, there were no cohort studies which showed an either significantly positive or negative association of DM with ovarian cancer. Elevated levels of insulin or IGFs among DM patients have been proposed as a causal mechanism of increased risk for most of the reviewed cancers. In addition, increased estrogen levels in DM patients have been suggested to explain the casual mechanism of increased risk for kidney, breast and endometrial cancers, and decreased risk for prostate cancer. On the other hand, the possibility of detection bias has been suggested in the association of DM with the risk of most of these cancers. Obesity and heavy consumption of alcohol have been indicated as confounding factors in the relationship of DM to the risk for some of them. Thus, further studies are necessary for firm conclusions regarding the association of DM with cancer risk.