Search

A number of epidemiological studies have suggested that diet may affect the etiology of prostate cancer, but few have investigated the impact of phytochemical intakes on this cancer. We conducted a case-control study of diet and prostate cancer in western New York involving 433 men with primary, histologically confirmed prostate cancer and 538 population-based controls, frequency matched to cases on age and county of residence. Diet was assessed with a detailed food-frequency questionnaire. We calculated daily intakes of nutrients and the phytochemicals beta-sitosterol, campesterol, stigmasterol, total phytosterols, total lignan precursors, quercetin, and kaempferol based on published food composition data. Odds ratios (ORs) and 95% confidence intervals (CIs) describing the association of prostate cancer risk with selected nutrients, phytochemicals, and food groups were estimated with unconditional logistic regression. Compared with men in the lowest quartile of intake, reduced risks were observed for men in the highest quartile of intake of vitamin C (OR = 0.49; 95% CI = 0.33-0.74), beta-carotene (OR = 0.53; 95% CI = 0.36-0.79), alpha-carotene (OR = 0.67; 95% CI = 0.47-0.97), lutein (OR = 0.55; 95% CI = 0.37-0.81), lycopene (OR = 0.62; 95% CI = 0.42-0.92), total lignan precursors (OR = 0.66; 95% CI = 0.47-0.94), quercetin (OR = 0.64; 95% CI = 0.44-0.92), and total vegetables (OR = 0.53; 95% CI = 0.36-0.79), but weak increased risks were observed for snacks and sweets (OR = 1.46; 95% CI = 0.95-2.23). Estimates associated with nutrients and phytochemicals were attenuated after adjustment for total vegetable intake. Nevertheless, our results support the hypothesis that a phytochemical-rich, plant-based diet is of importance in reducing risks of hormone-related neoplasms. [ABSTRACT FROM AUTHOR]

The main objective of the study was to evaluate whether passive surveillance methods can be used in cohort studies without a significant distortion of risk estimates when the active follow-up of every participant is not possible. A nested case-control study including 525 lung cancer cases and 525 controls was conducted among participants of the New York State Cohort Study (n = 57,968 men and women), which allowed the active follow-up of a sample of the cohort and the assessment of the effect of losses to follow-up. Although there were some differences with respect to dietary intake between controls lost to follow-up and those located, the results of the nested case-control study including and excluding losses to follow-up were comparable. Moreover, the results derived from the passive and the active follow-up data were similar. Our findings lent credence to passive follow-up methods and suggested that losses to follow-up did not compromise the validity of the study. Although attempts to trace every participant are preferable in a cohort study, passive surveillance may yield unbiased risk estimates when a rare disease is being investigated. [ABSTRACT FROM AUTHOR]

Objectives: We examined diet and risk of endometrial cancer among women in the Western New York Diet Study (1986-1991).Methods: Self-reported frequency of use of 172 foods and beverages during the 2 years before the interview and other relevant data were collected by detailed interviews from 232 endometrial cancer cases and 639 controls, frequency-matched for age and county of residence. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusting for age, education, body mass index (BMI), smoking history, hypertension, diabetes, age at menarche, parity, oral contraceptive use, menopausal status, menopausal estrogen use, and energy.Results: Risks were reduced for women in the highest quartiles of intake of protein (OR 0.4, 95% CI: 0.2-0.9), dietary fiber (OR 0.5, 95% CI: 0.3-1.0), phytosterols (OR 0.6, 95% CI: 0.3-1.0), vitamin C (OR 0.5, 95% CI: 0.3-0.8) folate (OR 0.4, 95% CI: 0.2-0.7), alpha-carotene (OR 0.6, 95% CI: 0.4-1.0), beta-carotene (OR 0.4, 95% CI: 0.2-0.6), lycopene (OR 0.6, 95% CI: 0.4-1.0), lutein + zeaxanthin (OR 0.3, 95% CI: 0.2-0.5) and vegetables (OR 0.5, 95% CI: 0.3-0.9), but unrelated to energy (OR 0.9, 95% CI: 0.6-1.5) or fat (OR 1.6, 95% CI: 0.7-3.4).Conclusions: Our results support previous findings of reduced endometrial cancer risks associated with a diet high in plant foods. [ABSTRACT FROM AUTHOR]

The relationship between diet and alcohol and lung cancer was evaluated among participants of the New York State Cohort (United States), comprising 27,544 men (395 cases) and 20,456 women (130 cases) who completed a brief mailed questionnaire in 1980. Participants were followed up through 1987 with the assistance of the New York State Department of Health's Vital Statistics Section and Cancer Registry. Among men, inverse relationships with vitamin C, folate, and carotenoids, and positive associations with total fat, monounsaturated and saturated fat were observed after adjusting for age, education, cigarettes/day, years smoking, and total energy intake. The relationships observed with folate and saturated fat were stronger for heavy smokers. Also, the effect of folate, total fat, and monounsaturated fat seemed to be limited to squamous cell carcinomas. We found no indication that cholesterol or polyunsaturated fat was associated with lung cancer. Diet did not appear to exert a major role on lung cancer risk among women. Although diet modification should never be considered a substitute for smoking cessation, its role as an additional strategy in lung cancer prevention deserves attention. [ABSTRACT FROM AUTHOR]

This case-control study provides individual-based data describing the impact of being a cancer patient on the odds of suicide. 5,009 suicides and 17,064 controls are compared. The data indicate that cancer patients are 50 to 100 percent more likely than nonpatients to commit suicide. This and other studies indicate that health status should be considered in future attempts to relate suicide to social environment. [ABSTRACT FROM AUTHOR]

Few studies have explored the association between diet and adult acute myeloid leukemia (AML). In a hospital-based case-control study among 111 cases and 439 controls, AML risk was negatively associated with milk intake among women (OR 0.25, 95% CI 0.08-0.73) and tea (OR 0.50, 95% CI 0.23-1.09), and positively associated among women with beer (OR 2.48, 95% CI 1.05-5.85), wine (OR 2.32, 95% CI 1.05-5.09), and beef (OR 4.78, 95% CI 1.35-16.94). Our findings support a role of diet in adult AML; however, further research is needed to explore gender differences in risk.

We conducted a nested case-control study of women in the New York State cohort who lived on Long Island. We estimated the historical environmental exposure to pesticides in 105 women diagnosed with breast cancer between 1980 and 1992 and 210 age and race-matched controls in this cohort of long-term residentially stable women who completed a short mailed questionnaire in 1980. Prior agricultural land use was assessed from aerial photographs taken in 1947 and 1950. Pesticides detected in drinking water were estimated from measures taken between 1977 and 1992. Geographic information system software was used to calculate the distance between residences and hazardous waste sites (HWS) containing pesticides. We found an increased breast cancer risk for women residing within 1 mile of HWS containing organochlorine pesticides (odds ratio [OR]=2.8; 95% confidence interval [CI], 1.1-7.1), after adjusting for other risk factors. A significant interaction was shown for women residing on land that was previously used for agriculture and women who were either nulliparous or had an older age at first birth (> or =26 yr old), compared to women who did not live on previously agricultural land and with a younger age (<26 yr old) at first birth (OR=6.4; 95%CI, 2.2-18.2). Study power was limited and confidence intervals were wide. Our findings suggest that exposure to pesticides in the environment needs to be more comprehensively investigated in relation to breast cancer risk.

Background: Contrasting results have been published regarding the risk of breast cancer among teachers and nurses. Confounding by reproductive factors may explain the increased risk observed among women in these occupations as information on those factors were not available in most studies., Methods: We examined the risk of premenopausal breast cancer among teachers and nurses using occupational histories in a case-control study where information on established risk factors was available., Results: Having ever held a teaching job was not related to breast cancer (OR = 0.74, 95% CI = 0.44-1.28) and women who worked for 10 years or less in this occupation had a non-significant deficit of risk (OR = 0.52, 95% CI = 0.27-1.02). No elevation in risk was found in association with having ever been a nurse (OR = 0.85, 95% CI = 0.45-1.61) or with duration of nursing. Although direct comparison of established risk factors among teachers and nurses and other women in the study showed some evidence of differential distribution, especially when comparing teachers to other women, adjustment for reproductive variables and other breast cancer risk factors did not change the results of this study., Conclusion: These findings suggest that teachers and nurses are not at an increased risk of breast cancer. This study also suggests that established risk factors for premenopausal breast cancer may not explain the elevation of risk found in other studies of teachers and nurses. However, this conclusion is limited by the fact that in the present study teachers and nurses had lower than expected breast cancer risk with or without adjustment for established risk factors. Limitations of this study such as low response rates and limited statistical power should be considered in the interpretation of these findings.

Objective: To determine if N-acetyltransferase 2 (NAT2) polymorphisms result in decreased capacity to detoxify carcinogenic aromatic amines in cigarette smoke, thus making some women who smoke more susceptible to breast cancer., Design: Case-control study with genetic analyses. DNA analyses were performed for 3 polymorphisms accounting for 90% to 95% of the slow acetylation phenotype among whites., Setting and Participants: White women with incident primary breast cancer (n=304) and community controls (n=327)., Results: Neither smoking nor NAT2 status was independently associated with breast cancer risk. There were no clear patterns of increased risk associated with smoking by NAT2 status among premenopausal women. In postmenopausal women, NAT2 strongly modified the association of smoking with risk. For slow acetylators, current smoking and smoking in the distant past increased breast cancer risk in a dose-dependent manner (odds ratios [95% confidence intervals] for the highest quartile of cigarettes smoked 2 and 20 years previously, 4.4 [1.3-14.8] and 3.9 [1.4-10.8], respectively). Among rapid acetylators, smoking was not associated with increased breast cancer risk., Conclusions: Our results suggest that smoking may be an important risk factor for breast cancer among postmenopausal women who are slow acetylators, demonstrate heterogeneity in response to carcinogenic exposures, and may explain previous inconsistent findings for cigarette smoking as a breast cancer risk factor.

Background: Given the international variations in breast cancer incidence rates and the changes in breast cancer incidence among migrant populations, it has been hypothesized that diet is a factor influencing risk of this disease. Many studies indicate that a diet high in vegetables and fruits may protect against breast cancer., Purpose: We conducted a case-control study of diet, including the intake of non-food supplements, and premenopausal breast cancer risk. We evaluated in detail usual intake of vegetables and fruits (each measured as the total reported grams consumed for all queried vegetables and fruit), vitamins C and E, folic acid, individual carotenoids, and dietary fiber with its components., Methods: Case patients (n=297) were identified through pathology records from hospitals in Erie and Niagara counties in western New York. They consisted of premenopausal women 40 years of age or oder who were diagnosed with breast cancer from November 1986 through April 1991. Control subjects (n=311), frequency-matched to case patients on the basis of age and county of residence, were randomly selected from New York State Department of Motor Vehicles records. In-person interviews included detailed reports of usual diet in the period 2 years before the interview. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs)., Results: There was a reduction in risk associated with high intake of several nutrients. With the lowest quartile of intake as the referent, adjusted ORs for the highest quartile of intake for specific nutrients were as follows: vitamin C (OR=0.53; 95% CI=0.33-0.86), alpha-tocopheral (OR=0.55; 95% CI=0.34-0.88), folic acid (OR=0.50; 95% CI=0.31-0.82), alpha-carotene (OR=0.67; 95% CI=0.42-1.08) and beta-carotene (OR=0.46; 95% CI=0.28-0.74), lutein + zeaxanthin (OR=0.47; 95% CI=0.28.0-77), and dietary fiber from vegetables and fruits (OR=0.48; 95% CI=0.30-0.78). No association with risk was found for beta-cryptoxanthin, lycopene, or grain fiber. Fruits were weakly associated with a reduction in risk (fourth quartile OR=0.67; 95% CI=0.42-1.09). No association was found between breast cancer risk and intake of vitamins C and E and folic acid taken as supplements. A strong inverse association between total vegetable intake and risk was observed (fourth quartile OR=0.46; 95% CI=0.28-0.74). This inverse association was found to be independent of vitamin C,alpha-tocopherol, folic acid, dietary fiber, and alpha-carotene. Adjusting for beta-carotene or lutein + zeaxanthin somewhat attenuated the inverse association with vegetable intake., Conclusions: In this population, intake of vegetables appears to decrease premenopausal breast cancer risk. This effect may be related, in part, to beta-carotene and lutein + zeaxanthin in vegetables. It appears, however, that, of the nutrients and food components examined, no single dietary factor explains the effect. Evaluated components found together in vegetables may have a synergistic effect on breast cancer risk; alternatively, other unmeasured factors in these foods may also influence risk.

This study evaluates the reproducibility of nutrient intake in a 45-item food frequency questionnaire (FFQ). The FFQ was mailed in 1980 to persons eligible to participate in a large cohort study on diet and cancer risk; a follow-up version with 75 food items was mailed in 1988 to selected original participants. A random sample of 500 men and 500 women from the New York State general population was selected from individuals who responded to both waves of the study. The subjects' 1988 responses were compared with their original 1980 responses; Pearson's correlations ranged from 0.25 for retinol to 0.55 for vitamin C with or without supplements and vitamin E with supplements in women. Reproducibility of nutrient intake in this questionnaire indicates that brief FFQs may be a useful tool to study nutrient intake and chronic disease relationships, although they are subject to substantial measurement error and dietary change.

Polycyclic aromatic hydrocarbons, possible human breast carcinogens, are metabolized by cytochrome P4501A1 (CYP1A1) and glutathione S-transferase (GSTM1). A CYP1A1 polymorphism (isoleucine to valine substitution in exon 7) or the null allele for GSTM1 may affect the mutagenic potential of polycyclic aromatic hydrocarbons. We examined polymorphisms in GSTM1 and CYP1A1 in relation to breast cancer risk. Included were 216 postmenopausal Caucasian women with incident breast cancer and 282 community controls. DNA analyses suggested no increased breast cancer risk with the null GSTM1 genotype [odds ratio (OR) = 1.10; CI, 0.73-1.64], although there was some indication that the null genotype was associated with risk among the youngest postmenopausal women (OR = 2.44; CI, 0.89-6.64). Slightly elevated risk was associated with the CYP1A1 polymorphism (OR = 1.61; CI, 0.94-2.75) and was highest for those who smoked up to 29 pack-years (OR = 5.22; CI, 1.16-23.56). Statistical power to detect an effect may be limited by small numbers, and larger sample sizes would be required to corroborate these suggestive findings.

A study of 250 patients with pathologically confirmed testicular cancer diagnosed between January 1977 and June 1980 and 250 population controls matched for age and residence was carried out to investigate risk factors for testicular cancer. This paper reports results of risk associated with occupational exposure to extreme (< or = 60 degrees F or > or = 80 degrees F), high (> or = 80 degrees F), and low (< or = 60 degrees F) temperature. Interviews of approximately 1.5 h duration were conducted by trained male interviewers, using a standardized interview schedule. Mantel-Haenszel methods and logistic regression models were employed to estimate these temperature effects on risk of testicular cancer. The estimated adjusted odds ratios of testicular cancer, when 16 potential confounders were controlled for, were 1.71 (95% Cl: 1.13-2.60) for occupational exposure to extreme temperatures; 1.70 (1.04-2.78) for low temperature; and 1.20 (0.80-1.80) for high temperature. The findings suggest that occupational exposure to extreme, low, and high temperature may increase risk of testicular cancer, independent of other potential risk factors.

This study evaluates the reproducibility of food intake reports in a 45-item self-administered food frequency questionnaire (FFQ) used for a diet study in a large cohort in New York State. The first FFQ was mailed in 1980, and a followup version containing 75 food items was mailed in 1988 to the eligible original participants. Reproducibility was evaluated by comparing the subjects' 1988 responses with their original 1980 responses. Spearman's correlations ranged from 0.27 (nuts other than peanuts) to 0.56 (summer squash) in men and from 0.25 (tomatoes) to 0.51 (summer squash) in women. Analyses stratified by age, education, marital status, body mass index, cigarette smoking, alcohol drinking, and special diet revealed few substantial differences in correlations. The moderate reproducibility of foods in this questionnaire indicates that brief FFQs may be a useful tool to study food intake and chronic disease relationships in this population.

Experimental and epidemiologic investigations in alcoholic and nonalcoholic populations have suggested a role of alcohol in lung carcinogenesis. The association between alcohol consumption and lung cancer was investigated among 280 White males with histologically confirmed, primary lung cancer and 564 White male controls, participants in the Western New York Diet Study (United States). Among heavy smokers (over 40 pack-years), total alcohol consumption was associated with an increased risk of lung cancer with adjustment for age, years of education, pack-years of cigarette smoking, and intake of carotenoids and fat. In this group, the odds ratio for drinkers of more than 24 drinks per month was 1.6 compared with those who drank less. Drinkers of more than 12 beers per month were 1.6 times more likely to develop lung cancer than nondrinkers of beer after controlling for age, years of education, and cigarette smoking (95 percent confidence interval = 1.0-2.4, P for trend = 0.003). Occupational and dietary factors did not seem to explain these findings. Although cigarette smoking is the major cause of lung cancer, the role of alcohol, independent or in interaction with cigarette smoking, deserves further investigation.

This matched case-control study was conducted in Western New York. The smoking, alcohol consumption, dental hygiene and diet of 290 cases were compared with those of 290 sex-, age-, and neighbourhood-matched controls. The results confirm earlier findings that cigarette smoking and alcohol consumption impart substantial risk of oral cancer. The results also confirm that poor oral hygiene increases the risk of oral cancer, although this effect is much smaller than those of cigarette smoking and alcohol consumption. The results suggest that, of macronutrients, intake of fat is more likely than those of protein or carbohydrate to be related to risk. Of micronutrients, calcium, sodium, riboflavin and retinol are associated with risk, while thiamin, niacin, and dietary fibre are associated with decreased risk. Although patterns of dietary effects are discernable, these effects are in general much weaker than are those of smoking and alcohol consumption.

Seven dietary patterns were identified among control subjects in the Western New York Diet Study (1975-1986) by application of principal components analysis to data from a 95-item food frequency interview. The results of case-control analyses of colon cancer risk for these patterns are presented. Cases were matched with neighborhood controls on the bases of age and sex; 205 colon case-control male and 223 female pairs were obtained. The dietary patterns and intakes of energy, total fat, and dietary fiber were examined with logistic regression for their individual contributions to risk. In males, three of these dietary patterns were associated positively with fat and energy consumption; they elevated risk for colon cancer and accounted for more risk than did the specific nutrients. Control for energy and fat intakes allowed the protective influences of additional dietary patterns to be expressed. No patterns elevated risk in women; two patterns were protective for colon cancer. Controlling for energy and fat intake enhanced the protection afforded by one of these patterns but had no influence on that of the other. Measures of foods rather than single nutrients may be more inclusive of dietary exposures to risk as well as being related more directly to underlying health behaviors. Therefore they may be better able to account for risk in diseases with multiple causation.

We have previously identified dietary patterns among 1,475 male and 780 female normal healthy control subjects in a case-control study of cancer at various sites. In this paper we examine the presence, among persons exhibiting these dietary patterns, of individual health behaviors that may contribute to risks for cancer. Specifically we examine trimming of separable fat from meats, fats used in cooking and as additions to foods, alcohol consumption, and smoking. Results indicate that men and women differ in possession of these high-risk behaviors. Women are more likely to trim fat from meat, consume less alcohol, and have lower exposures to smoking. Their dietary patterns are more independent of the fats used. Several eating patterns are positively associated with total fat intake but differ in their associations with high-risk behaviors. These data suggest that assessing risk associated with dietary patterns sheds more light on disease relationships than studies of single nutrients.

We developed multidimensional measures of diet by identifying seven gender-specific patterns among 1,475 male and 780 female subjects selected as neighborhood controls in a case-control study of cancer at various sites. The purpose of this study was to examine these patterns for compliance with the National Cancer Institute (NCI) Dietary Guidelines. Diets were scored and each subject assigned tertile ranks for each pattern. Mean values for indicators of compliance were compared across tertiles for each pattern. No one pattern signified compliance with all guidelines. High-fat patterns in both genders and the low-cost pattern in women were the best indicators of poor compliance with NCI guidelines.

We examined the nutritional epidemiology of gastric cancer in 293 cases and neighborhood-, age-, and sex-matched controls in communities throughout the counties of Niagara, Monroe, and Erie in western New York. The interview was highly detailed, requiring two and one-half hours to complete; it attempted to provide an estimate of total calories ingested as well as of macro- and micronutrients and behaviors that could affect alimentary exposures, such as the use of refrigeration. We found that risk was enhanced by sodium, fat, and retinol. Substantial reductions in risk were associated with ingestion of carotene, especially raw vegetables (including celery, cucumbers, carrots, green peppers, tomatoes, and onions), as well as with increased use of low-temperature food storage. Both refrigeration and carotene could inhibit oxidation products that could act as carcinogens in the stomach.

The study describes the smoking habits of student nurses and determines the correlates of smoking initiation, continuation, and cessation. The sample included 1,163 students attending 10 nursing schools in Buffalo, NY. Data were gathered by means of a self-administered questionnaire. Approximately 30 percent of the students were current smokers, 25 percent were exsmokers, and 45 percent had never smoked. More than half of the smokers (57 percent) expressed the desire to quit, and 81 percent had tried to do so in the past. Major reasons for trying to quit were to protect future health, save money, self-discipline, and pressure from significant others. Most (90 percent) of the students who had tried to quit had attempted to do so on their own and all at once. Knowledge of the health consequences of smoking was not significantly related to smoking behavior. These data suggest the need for health educators to promote personal health practices among their students that are congruent with the goals of the nursing profession of health promotion and disease prevention.

This study of 513 white cervical cancer patients and 490 white hospitalized controls considered, with adjustment for marital history and parity, the effects of smoking and dietary characteristics on the relative risk of developing cervical cancer. Although smoking was shown to be positively associated with risk, no dose-response relationship was evident. The frequency of consumption of cruciferous vegetables was positively associated with risk. Respondent reports of the frequency of prior ingestion of several food items were used in constructing crude indices of exposure to basic nutrients; the index of beta-carotene exposure was negatively associated with risk, whereas the index of fat consumption was positively associated with risk.

Cancer epidemiologists rely heavily on the frequency of food use technique to assess dietary risk factors. We found that the accepted procedures for arraying individuals along a continuum, based on their positions within distributions of intakes of specific nutrients, simultaneously array them on other dietary characteristics. A unidimensional approach to dietary assessment could confound cancer risk assessments, and the effects could differ for men and women. We found that men consumed more calories and energy-containing nutrients than women, who were more likely to consume larger amounts of vitamins A and C. Dietary variety was similar for men and women, despite compositional differences in diet. Diets of men contained proportionately more meats, grains and nuts, and alcohol. Diets of women contained more fruits, vegetables, and poultry and fish. Among men, we found stronger intercorrelations among energy intake and intakes of fat, fiber, and vitamin C and among fat intake and intakes of fiber and vitamins A and C. Compositional differences in diet across quartiles of nutrient intake were not consistent for men and women, suggesting that the constellation of dietary risk factors may differ for the two sexes. Men in the lowest quartiles of energy, fiber, and vitamin A intakes had the greatest percent contribution of alcohol to the diet. This pattern was not observed for fat intake levels. Measures of dietary patterns may be needed for more accurate descriptions of the associations of cancer risk and diet.

This study describes the health practices of nursing students from several nursing programs in western New York. Findings from a sample of 1,081 female students who responded to a questionnaire showed considerable variability in the extent to which students engage in health-related practices. While the majority obtain six to eight hours of sleep per night, exercise regularly, and have annual dental and physical examinations, less than half those surveyed eat breakfast everyday, over three-quarters eat between meals, and less than one-half limit fat, salt, and sugar in their diets. Most do not wear seat belts consistently; less than one-third perform breast self-examination monthly; and 90% consume alcoholic beverages and one-quarter have five or more drinks per occasion. Analyses demonstrated a statistically significant relationship between preventive-health orientation scores and age and type of basic nursing education. These data suggest that nurse faculty and health educators need to influence students' health-promoting and disease-preventing behaviors. This need is particularly salient since these students are expected to act as exemplars when they complete their education and assume positions in the health-care system.