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Biomedical subjects

L N Kolonel

Publications and source records attributed to L N Kolonel.

At least 91 records · Page 5Linked to original sources
PubMed1993

Migration patterns and breast cancer risk in Asian-American women.

BACKGROUND: Breast cancer incidence rates have historically been 4-7 times higher in the United States than in China or Japan, although the reasons remain elusive. When Chinese, Japanese, or Filipino women migrate to the United States, breast cancer risk rises over several generations and approaches that among U.S. Whites. PURPOSE: Our objective was to quantify breast cancer risks associated with the various migration patterns of Asian-American women. METHODS: A population-based, case-control study of breast cancer among women of Chinese, Japanese, and Filipino ethnicities, aged 20-55 years, was conducted during 1983-1987 in San Francisco-Oakland, California, Los Angeles, California, and Oahu, Hawaii. We successfully interviewed 597 case subjects (70% of those eligible) and 966 control subjects (75%). RESULTS: A sixfold gradient in breast cancer risk by migration patterns was observed. Asian-American women born in the West had a breast cancer risk 60% higher than Asian-American women born in the East. Among those born in the West, risk was determined by whether their grandparents, especially grandmothers, were born in the East or the West. Asian-American women with three or four grandparents born in the West had a risk 50% higher than those with all grandparents born in the East. Among the Asian-American women born in the East, breast cancer risk was determined by whether their communities prior to migration were rural or urban and by the number of years subsequently lived in the West. Migrants from urban areas had a risk 30% higher than migrants from rural areas. Migrants who had lived in the West for a decade or longer had a risk 80% higher than more recent migrants. Risk was unrelated to age at migration for women migrating at ages less than 36 years. Ethnic-specific incidence rates of breast cancer in the migrating generation were clearly elevated above those in the countries of origin, while rates in Asian-Americans born in the West approximated the U.S. White rate. CONCLUSIONS: Exposure to Western lifestyles had a substantial impact on breast cancer risk in Asian migrants to the United States during their lifetime. There was no direct evidence of an especially susceptible period, during either menarche or early reproductive life. IMPLICATIONS: Because heterogeneity in breast cancer risk in these ethnic populations is similar to that in international comparisons and because analytic epidemiologic studies offer the opportunity to disentangle correlated exposures, this study should provide new insights into the etiology of breast cancer.

Adult↗
PubMed1993

Parental smoking and risk of childhood brain tumors.

Data from a large, population-based, case-control study were analyzed to assess the role of parental smoking in childhood brain tumors. Parents of 361 cases, newly diagnosed between January 1, 1977 and December 31, 1981 and ascertained from eight Surveillance, Epidemiology, and End Results (SEER) program registries, and 1,083 controls had been interviewed. No significant differences in risks were found to be associated with maternal or paternal smoking at any time (odds ratio (OR) = 0.92 for mothers and 1.06 for fathers), during the year of birth of the child (which included both the prenatal and postnatal periods) (ORs = 0.84 for < 1 pack/day and 1.0 for > or = 1 pack/day for mothers, and 0.68 for < 1 pack/day and 1.07 for > or = 1 pack/day for fathers), or 2 years before the child was born, i.e., the pre-conception period (ORs = 0.75 for < 1 pack/day and 1.01 for > or = 1 pack/day for mothers, and 0.90 for < 1 pack/day and 1.15 for > or = 1 pack/day for fathers). Mothers were also specifically asked if they smoked during the pregnancy, and no association was found compared with never smokers (OR = 1.08, 95% confidence interval (CI) 0.80-1.45) or for ever-smokers who continued to smoke during pregnancy compared with those who stopped smoking during pregnancy (OR = 1.15, 95% CI 0.75-1.78). Finally, no significant increase in risk of brain tumors was found for the child's passive exposure to parental smoking during the period from birth to diagnosis of the brain tumor in the case. The lack of an effect of parental smoking was observed for both the major histologic types and locations of brain tumors. These findings and those from earlier studies provide no support for the hypothesis that parental cigarette smoking influences the risk of brain tumors in children.

Adult↗
PubMed1992

Comparison of long-term dietary recall between cancer cases and noncases.

A quantitative history of current dietary intake based on 83 food items was administered by interview to a representative sample of 4,809 subjects in Hawaii in 1977-1979. In 1983-1987, this history was readministered to the 131 original respondents who had subsequently developed cancer, as well as 413 randomly selected subjects who remained cancer free. A surrogate was interviewed when the original subject was unavailable. The repeat interview elicited information about diet at the time of the original interview. The authors found that recall values for macronutrients were consistently higher than original levels for both cases and noncases, which may be due in part to a modification in the administration of the repeat questionnaire. Although there were no marked differences overall between cases and noncases in the ability to recall past diet, differences between the two groups were seen in certain subsets of the sample. In the subgroup with the longest recall interval (8-10 years), cases were not able to recall their diets as well as noncases. Also, the difference between original and recall values was larger for cases with colorectal cancer and all cases diagnosed with distant stage disease, compared with noncases. This was not true for cases of breast and prostate cancer and those with localized or regional disease. The following variables were found to have no significant effect on recall for cases or noncases: sex, age, education, and type of respondent (surrogate or subject). Of the five major ethnic groups included in the study, Japanese had the best recall of their past diets, while respondents reporting a diet change between the interviews had poorer recall than did those who reported no change. These results suggest that differential misclassification in dietary case-control studies may pose a significant problem in certain instances, but that these studies can yield meaningful results with certain constraints on the study population.

Aged↗
PubMed1992

Efficiency loss from categorizing quantitative exposures into qualitative exposures in case-control studies.

In the analysis of data from case-control studies, quantitative exposure variables are frequently categorized into qualitative exposure variables, such as quarters. The qualitative exposure variables may be scalar variables that take the median values of each quantile interval, or they may be vectors of indicator variables that represent each quantile interval. In a qualitative analysis, the scalar variables may be used to test the dose-response relation, while the indicator variables may be used to estimate odds ratios for each higher quantile interval versus the lowest. Qualitative analysis, implicitly and explicitly documented by many epidemiologists and biostatisticians, has several desirable advantages (including simple interpretation and robustness in the presence of a misspecified model or outlier values). In a quantitative analysis, the quantitative exposure variables may be directly regressed to test the dose-response relation, as well as to estimate odds ratios of interest. As this paper demonstrates, quantitative analysis is generally more efficient than qualitative analysis. Through a Monte Carlo simulation study, the authors estimated the loss of efficiency that results from categorizing a quantitative exposure variable by quartiles in case-control studies with a total of 200 cases and 200 controls. In the analysis of the dose-response relation, this loss is about 30% or more; the percentage may reach about 50% when the odds ratio for the fourth quartile interval versus the lowest is around 4. In estimating odds ratios, the loss of efficiency for the second, third, and fourth quartile intervals versus the lowest is around 90%, 75%, and 40%, respectively. The authors consider the pros and cons of each analytic approach, and they recommend that 1) qualitative analysis be used initially to estimate the odds ratios for each higher quantile interval versus the lowest to examine the dose-response relation and determine the appropriateness of the assumed underlying model; and 2) quantitative analysis be used to test the dose-response relation under a plausible log odds ratio model.

Case-Control Studies↗
PubMed1992

Attributable risk of breast, prostate, and lung cancer in Hawaii due to saturated fat.

The dietary data from case-control studies of breast, prostate, and lung cancer in Hawaii revealed that saturated fat was a risk factor for these malignancies. The dietary intakes from the three studies were used to calculate the attributable risk (AR) due to saturated fat. For all ethnic groups combined, the ARs for the highest quartiles of intake were 14.9 percent for female breast cancer, 13.0 percent for prostate cancer, and 23.1 percent for male lung cancer. Our results suggested that a reduction of saturated fat to the lowest quartiles of intake could result in a 10 to 20 percent decrease in risk for these three cancers in Hawaii. We also examined the ethnic-specific risks associated with saturated fat consumption among the Japanese and the Caucasians in the three studies. The ARs for the highest quartiles of intake were notably higher among the Caucasians than the Japanese, primarily due to the difference in their dietary patterns. Although the calculated AR due to saturated fat was higher among the Caucasians than among the Japanese, all persons in the population would derive considerable benefit by reducing their intake of this nutrient.

Adult↗
PubMed1992

Dietary factors in lung cancer prognosis.

A hypothesis-generating analysis of the role of diet on survival was conducted among a sample of 463 men and 212 women with histologically-confirmed lung cancer. Interview information was obtained from two population-based case-control studies of lung cancer conducted on the Island of Oahu, Hawaii, between 1979 and 1985. The interview consisted of a quantitative dietary history to assess the usual intake of foods 1 year prior to diagnosis, a complete tobacco history, and other demographic and lifestyle information. Records from the Hawaii Tumor Registry were reviewed for data on stage, histology, and follow-up status of these patients. A food group analysis showed a significant reduction in the risk of death with increasing consumption of all vegetables combined among women (P for trend = 0.03), but not among men. The covariate-adjusted median survival times for women from the highest to the lowest quartiles of vegetable intake were 33, 21, 15, and 18 months, respectively. The results also suggested an association of fruit intake and survival among women (P for trend = 0.02), although a similar effect was not found among men. Increased consumption of certain foods, such as tomatoes and oranges among men, and broccoli and, perhaps, tomatoes among women, appeared to improve survival. This exploratory analysis provides mixed indications that certain components of vegetables and fruits may prolong survival in lung cancer patients.

Adult↗
PubMed1992

The association of body size, reproductive factors and thyroid cancer.

A population-based case-control study of the association of diet and other factors and thyroid cancer was conducted between 1980 and 1987 on Oahu, Hawaii. Study participants included 51 men and 140 women with thyroid cancer, and 113 male and 328 female controls matched on age (+/- 5 years) and sex. A significant, positive monotonic dose-response relation of weight in late adulthood (5 years prior to interview) and the risk for thyroid cancer was found for men and women. A greater than five-fold increase in the risk for thyroid cancer among men, and more than a two-fold increase in risk among women, was found for subjects in the highest compared with the lowest quartile of weight in late adulthood. Height was significantly related to the risk for thyroid cancer among men, but not women. Among men, there was a significant dose-response relation of weight in early adulthood (20-29 years of age) and the odds ratios (ORs) for thyroid cancer, although the trend was not significant after adjustment for height. Among women, there was also a positive relation of adult weight gain and thyroid cancer, with an OR of 2.6 associated with more than a 14% increase in weight. The effects of relative weight and weight gain on thyroid cancer risk were stronger in post-menopausal women than in premenopausal women. There was a significant positive interaction between fertility drug use and early adult weight and the risk for thyroid cancer in women. Odds ratios were also significantly elevated for women above the median weight in early adulthood who experienced a miscarriage or stillbirth at first pregnancy. In summary, these data show an association of weight, particularly in late adulthood, and the risk for thyroid cancer in men and women, and further suggest a positive interaction between weight in young adulthood and fertility drug use on thyroid carcinogenesis in women.

Adult↗
PubMed1992

High-fat foods and the risk of lung cancer.

We conducted a population-based case-control study of the association of dietary cholesterol and fat with lung cancer between 1983 and 1985 on Oahu, Hawaii. The study population included 226 men and 100 women with lung cancer, and 597 male and 268 female community controls matched for age (+/- 5 years) and sex. There was a positive dose-response relation between the consumption of processed meats (luncheon meats, bacon, sausage), dairy foods (whole milk, regular ice cream), eggs, and particular desserts (fruit pies, custard/cream pies) and the risk of lung cancer in men. We also found a positive trend in the risk of lung cancer in women with increasing intake of some processed meats (bacon, Spam) and desserts (cakes, custard/cream pies). The dose-response relation tended to be stronger among men who were heavy smokers and who were diagnosed with squamous cell cancer of the lung. A positive trend in risk was found for nitrite intake in men and dimethylnitrosamine intake in men and women. These data indicate that smokers with a high intake of foods rich in fat and animal protein or who have a preference for cured meats are at increased risk of lung cancer.

Adult↗
PubMed1992

[Cancer in Japanese migrants to Hawaii: interaction between genes and environment].

This paper describes the progressive changes in cancer incidence that have been observed among Japanese after their migration to Hawaii. It reviews descriptive and analytic epidemiologic data suggesting a role for genetic susceptibilities in explaining the high risk of Japanese for colon cancer and their low risk for lung cancer, when compared to Caucasians. Differences in certain pharmacogenetic polymorphisms may explain these risk patterns. This research may lead to a better characterization of cancer risk at the individual level and, consequently, to improved methods of prevention.

Colonic Neoplasms↗
PubMed1991

Relationship between dietary, serum, and tissue levels of carotenoids.

A study was undertaken to assess the utility of the buccal scrape technique for measuring tissue levels of carotenoids in short-term intervention trials and epidemiologic studies. In 14 healthy volunteers a good correlation was found between serum beta-carotene levels and recent dietary intake of beta-carotene as estimated from measured food records. Supplementation with 30 mg/day of beta-carotene for 1 week resulted in a sixfold increase in average serum levels, while serum lycopene concentrations remained constant. Presupplementation levels of beta-carotene and lycopene in the buccal mucosa cells were not correlated with dietary intakes or with serum levels. After supplementation, levels of both carotenoids were found to increase in buccal cells, however, most of this increase was found to be an artifact due to repeated sampling. After correcting for this artifact, beta-carotene was found to increase less than twofold in tissue after supplementation.

Adult↗
PubMed1991

Dietary factors in cancer of the lower urinary tract.

This dietary study was based on 195 male and 66 female cases of lower urinary tract cancer, identified in Hawaii between 1977 and 1986. Each case was matched for sex, age, and ethnic group (Caucasian or Japanese) to 2 population-based controls. There was a decrease in risk with increasing levels of consumption of vitamin C in women (p = 0.03) and dark green vegetables in men (p = 0.02). When examined by quartile, the odds ratios for the highest quartile of intake compared to the lowest quartile were 0.4 for women and 0.6 for men, respectively. Although dark green vegetables are a source of carotenoids, the intake of total carotenoids, retinol and total vitamin A was weakly and inconsistently related to risk in both sexes. Among women only, there was also an inverse association with the consumption of regular ground coffee (p = 0.02) but not with other types of coffee. Finally, there were no statistically significant or consistent differences between cases and controls in the intake of artificial sweeteners and tea.

Adult↗
PubMed1991

Validation of a quantitative diet history method in Hawaii.

The validity of a quantitative diet history method was evaluated among 262 men and women from the five major ethnic groups of Hawaii (Japanese, Caucasian, Chinese, Filipino, and Hawaiian) in 1984-1987. The reference data included four 1-week food records obtained at approximately 3-month intervals. The diet history was administered 6 months after the fourth week of food records and included 47 foods that were major sources of protein, fat, cholesterol, vitamins A and C, and beta-carotene. Photographs showing three portion sizes were utilized for quantifying intakes in the food records and the diet history. Generally, among all ethnic-sex groups, intakes from the diet history were greater than those from the record sets, particularly for the vitamins. Agreement was measured by the intraclass correlation coefficient (rl) and the weighted kappa statistic (kappa w), and consistency was measured by Spearman's rank correlation (rho). For the total group, the rl's ranged from 0.48 for vitamin A to 0.61 for cholesterol. The kappa w's were generally lower than the rl's, whereas the rho's were higher, ranging from 0.52 for vitamin C to 0.64 for cholesterol. Agreement among the ethnic-sex groups varied, with the Chinese females and the Japanese males having the higher rl's, and the Hawaiian males and females having the lowest values. The results provide evidence that the quantitative diet history gives reasonably accurate estimates of the usual dietary intakes among the major ethnic groups of Hawaii.

Aged↗
PubMed1991

Vegetable and fruit consumption in relation to prostate cancer risk in Hawaii: a reevaluation of the effect of dietary beta-carotene.

This is a further analysis of a case-control study of 452 prostate cancer cases and 899 population controls that was conducted in 1970-1983 among the multiethnic population of Hawaii. Because a previous analysis had shown a positive association with intake of beta-carotene, a nutrient presently being tested for chemoprevention, the authors reexamined the data for consistency among the main food sources of beta-carotene. Vegetables and fruits containing other phytochemicals suspected to be cancer inhibitors were also examined. With the exception of papaya, which was positively associated with risk among men aged 70 years and older, consumption of other yellow-orange fruits and vegetables, tomatoes, dark green vegetables, and cruciferous vegetables was not associated with prostate cancer risk. These results suggest that: 1) the positive association with beta-carotene intake among older men that the authors previously reported was essentially due to the greater papaya consumption of cases compared with controls; and 2) intake of beta-carotene, lycopene, lutein, indoles, phenols, or other phytochemicals is not associated with prostate cancer risk.

Aged↗
PubMed1991

Lifetime occupational physical activity and prostate cancer risk.

The authors compared the lifetime occupational physical activity of 452 prostate cancer cases identified through the population-based Hawaii Tumor Registry and 899 population controls interviewed from 1981 to 1983. Each job reported was classified into one of five levels of physical activity using published sources. Among men aged 70 years or older, a negative association was found between prostate cancer risk and proportion of life spent in jobs involving only sedentary or light work. Compared with men never employed in such jobs, men who spent more than 54% of their life in these jobs had an odds ratio of 0.5 (95% confidence interval 0.3-0.9). This negative association was dose-dependent, consistent across ethnic groups, and unrelated to socioeconomic status, dietary risk factors, or job-related chemical exposures. The findings for younger men were less clear, but not inconsistent with those for older men. Surprisingly, no association was found with years spent in moderately active or very active jobs in either age group. Although inconclusive, these results suggest that physical activity may be positively associated with the risk of prostate cancer, but this association is likely to be weak and indirect.

Age Factors↗
PubMed1991

The effect of dietary fat on breast cancer survival among Caucasian and japanese women in Hawaii.

182 Japanese and 161 Caucasian breast cancer patients participated in an epidemiologic case-control study from 1975-1980. They were subsequently followed until the end of 1987 to determine their survival status. Among the Japanese, patients with regional or distant disease had a relative risk (RR) of death of 13.0 (95% Confidence Interval (CI), 4.3-39.1) compared to those with in situ or localized disease, and obese patients had a RR of death of 3.5 (95% CI, 1.3-10.0) compared to non-obese subjects. Among the Caucasians, patients with advanced disease had a RR of death of 4.3 (95% CI, 1.8-10.5) compared to those with in situ or localized disease, and patients with a high fat intake had a RR of 3.2 (95% CI, 1.2-8.6) compared to subjects with a low fat intake. Menopausal status (pre- or postmenopausal) and replacement estrogen use were not related to survival from breast cancer in either ethnic group. When Japanese and Caucasian patients were compared with each other, there was no significant difference in survival between them.

Aged↗
PubMed1990

Smoking history and survival among lung cancer patients.

Two population-based case-control studies of lung cancer were conducted on the Island of Oahu, Hawaii, between 1979 and 1985. Interview information concerning smoking habits and other characteristics was obtained from a total of 463 men and 212 women with histologically confirmed lung cancer. Records from the Hawaii Tumor Registry were reviewed for information on the stage, histology, and follow-up status of these patients. Cigarette smoking was found to be positively related to the age-adjusted risk of death among women (relative risk (RR) = 1.6; 95 percent confidence interval (CI) = 1.0-2.4), but not among men (RR = 0.8; 95 percent CI = 0.5-1.2). Among women, the age-adjusted median survival time for never smokers was 33 months (n = 53) compared with a median survival of 18 months (n = 159) for smokers. Both past and current female smokers were at greater risk of death than never-smokers, and there was a significant trend in the risk of death by the number of cigarettes smoked per day (P = 0.04), and the age at which the subjects started smoking (P = 0.01). The effects of tumor stage and histology upon the association between tobacco smoking and survival were also explored.

Adenocarcinoma↗