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Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada.
J Natl Cancer Inst 1995; 87(9):652-61JNCI

Abstract

BACKGROUND

International and interethnic differences in prostate cancer incidence suggest an environmental, potentially modifiable etiology for the disease.

PURPOSE

We conducted a population-based case-control study of prostate cancer among blacks (very high risk), whites (high risk), and Asian-Americans (low risk) in Los Angeles, San Francisco, Hawaii, Vancouver, and Toronto. Our aim was to evaluate the roles of diet, physical activity patterns, body size, and migration characteristics on risk in these ethnic groups and to assess how much of the interethnic differences in risk might be attributed to interethnic differences in such lifestyle characteristics.

METHODS

We used a common protocol and questionnaire to administer personal interviews to 1655 black, white, Chinese-American, and Japanese-American case patients diagnosed during 1987-1991 with histologically confirmed prostate carcinoma and to 1645 population-based control subjects matched to case patients by age, ethnicity, and region of residence. Sera collected from 1127 control subjects were analyzed for levels of prostate-specific antigen (PSA) to permit comparison of case patients with control subjects lacking serological evidence of prostate disease. Odds ratios were estimated using conditional logistic regression. We estimated the proportion of prostate cancer attributable to certain risk factors and the proportion of interethnic risk differences attributable to interethnic differences in risk-factor prevalence.

RESULTS

A positive statistically significant association of prostate cancer risk and total fat intake was found for all ethnic groups combined. This association was attributable to energy from saturated fats; after adjusting for saturated fat, risk was associated only weakly with monounsaturated fat and was unrelated to protein, carbohydrate, polyunsaturated fat, and total food energy. Saturated fat intake was associated with higher risks for Asian-Americans than for blacks and whites. In all ethnic groups combined, the risk tended to be higher when only case patients with advanced disease were compared with control subjects with normal PSA levels. Among foreign-born Asian-Americans, risk increased independently with years of residence in North America and with saturated fat intake. Crude estimates suggest that differences in saturated fat intake account for about 10% of black-white differences and about 15% of white-Asian-American differences in prostate cancer incidence. Risk was not consistently associated with intake of any micronutrients, body mass, or physical activity patterns.

CONCLUSIONS

These data support a causal role in prostate cancer for saturated fat intake but suggest that other factors are largely responsible for interethnic differences in risk.

Authors+Show Affiliations

Department of Health Research and Policy, Stanford University School of Medicine, Calif. 94305-5092, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7752270

Citation

Whittemore, A S., et al. "Prostate Cancer in Relation to Diet, Physical Activity, and Body Size in Blacks, Whites, and Asians in the United States and Canada." Journal of the National Cancer Institute, vol. 87, no. 9, 1995, pp. 652-61.
Whittemore AS, Kolonel LN, Wu AH, et al. Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. J Natl Cancer Inst. 1995;87(9):652-61.
Whittemore, A. S., Kolonel, L. N., Wu, A. H., John, E. M., Gallagher, R. P., Howe, G. R., ... West, D. W. (1995). Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. Journal of the National Cancer Institute, 87(9), pp. 652-61.
Whittemore AS, et al. Prostate Cancer in Relation to Diet, Physical Activity, and Body Size in Blacks, Whites, and Asians in the United States and Canada. J Natl Cancer Inst. 1995 May 3;87(9):652-61. PubMed PMID: 7752270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. A1 - Whittemore,A S, AU - Kolonel,L N, AU - Wu,A H, AU - John,E M, AU - Gallagher,R P, AU - Howe,G R, AU - Burch,J D, AU - Hankin,J, AU - Dreon,D M, AU - West,D W, PY - 1995/5/3/pubmed PY - 1995/5/3/medline PY - 1995/5/3/entrez SP - 652 EP - 61 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 87 IS - 9 N2 - BACKGROUND: International and interethnic differences in prostate cancer incidence suggest an environmental, potentially modifiable etiology for the disease. PURPOSE: We conducted a population-based case-control study of prostate cancer among blacks (very high risk), whites (high risk), and Asian-Americans (low risk) in Los Angeles, San Francisco, Hawaii, Vancouver, and Toronto. Our aim was to evaluate the roles of diet, physical activity patterns, body size, and migration characteristics on risk in these ethnic groups and to assess how much of the interethnic differences in risk might be attributed to interethnic differences in such lifestyle characteristics. METHODS: We used a common protocol and questionnaire to administer personal interviews to 1655 black, white, Chinese-American, and Japanese-American case patients diagnosed during 1987-1991 with histologically confirmed prostate carcinoma and to 1645 population-based control subjects matched to case patients by age, ethnicity, and region of residence. Sera collected from 1127 control subjects were analyzed for levels of prostate-specific antigen (PSA) to permit comparison of case patients with control subjects lacking serological evidence of prostate disease. Odds ratios were estimated using conditional logistic regression. We estimated the proportion of prostate cancer attributable to certain risk factors and the proportion of interethnic risk differences attributable to interethnic differences in risk-factor prevalence. RESULTS: A positive statistically significant association of prostate cancer risk and total fat intake was found for all ethnic groups combined. This association was attributable to energy from saturated fats; after adjusting for saturated fat, risk was associated only weakly with monounsaturated fat and was unrelated to protein, carbohydrate, polyunsaturated fat, and total food energy. Saturated fat intake was associated with higher risks for Asian-Americans than for blacks and whites. In all ethnic groups combined, the risk tended to be higher when only case patients with advanced disease were compared with control subjects with normal PSA levels. Among foreign-born Asian-Americans, risk increased independently with years of residence in North America and with saturated fat intake. Crude estimates suggest that differences in saturated fat intake account for about 10% of black-white differences and about 15% of white-Asian-American differences in prostate cancer incidence. Risk was not consistently associated with intake of any micronutrients, body mass, or physical activity patterns. CONCLUSIONS: These data support a causal role in prostate cancer for saturated fat intake but suggest that other factors are largely responsible for interethnic differences in risk. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/7752270/Prostate_cancer_in_relation_to_diet_physical_activity_and_body_size_in_blacks_whites_and_Asians_in_the_United_States_and_Canada_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/87.9.652 DB - PRIME DP - Unbound Medicine ER -