Biomedical subjects

R A Goldbohm

Publications and source records attributed to R A Goldbohm.

At least 73 records · Page 4Linked to original sources

PubMed1997

Folate intake and status among adults in the Netherlands.

OBJECTIVE: To assess the adequacy of folate intake and status among adults in the Netherlands. DESIGN AND SUBJECTS: Dietary intake was measured by 3 d diet records among 444 adults, aged 20-79 y, stratified for sex and 10 y age classes, with an overrepresentation of people with a low habitual intake of vitamin B6. Serum folate and other physical, biochemical and lifestyle characteristics were determined, and interrelationships were evaluated by bi- and multivariate regression analysis. RESULTS: Mean folate intake was 325 and 308 microg/d in men aged 20-49 and 50-79 y, respectively. In both younger and older women mean folate intake was 270 microg/d. The prevalence of intakes below the lower limit of the recommended range (200-300 microg/d) was 10-20% among different age-gender groups. No intakes below the average minimum requirement of 100 microg/d were observed. The recommendation of 400 microg folate/d for women who wish to become pregnant was not met by 95% of the women aged 20-49 y. Potatoes, vegetables and fruit provided 36% of folate in the diet; other important sources were bread (18%) and dairy products (16%). Mean serum folate levels were 11.3 and 12.1 nmol/l in younger and older men, respectively. In younger and older women these levels were 12.2 and 14.2 nmol/l, respectively. Serum folate levels below 5 nmol/l (the 2.5 percentile of healthy blood donors) were present in 4% of the older men, but not in the other age-gender-groups. Serum folate levels were clearly influenced by recent folate intake. Furthermore, physiological and lifestyle variables, notably alcohol and tobacco use, were important determinants of serum folate. CONCLUSION: The folate intake among adult men and women was adequate in view of recommended daily intakes. However, the folate intake among women did not meet the recommendation for those who want to become pregnant. According to criteria derived from homocysteine metabolism as related to cardiovascular disease, folate status may not be adequate in 60-79% of adult age-sex groups.

Adult↗

PubMed1996

Cohort studies of fat intake and the risk of breast cancer--a pooled analysis.

BACKGROUND: Experiments in animals, international correlation comparisons, and case-control studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the association, but they have been criticized for involving small numbers of cases, homogeneous fat intake, and measurement errors in estimates of fat intake. METHODS: We identified seven prospective studies in four countries that met specific criteria and analyzed the primary data in a standardized manner. Pooled estimates of the relation of fat intake to the risk of breast cancer were calculated, and data from study-specific validation studies were used to adjust the results for measurement error. RESULTS: Information about 4980 cases from studies including 337,819 women was available. When women in the highest quintile of energy-adjusted total fat intake were compared with women in the lowest quintile, the multivariate pooled relative risk of breast cancer was 1.05 (95 percent confidence interval, 0.94 to 1.16). Relative risks for saturated, monounsaturated, and polyunsaturated fat and for cholesterol, considered individually, were also close to unity. There was little overall association between the percentage of energy intake from fat and the risk of breast cancer, even among women whose energy intake from fat was less than 20 percent. Correcting for error in the measurement of nutrient intake did not materially alter these findings. CONCLUSIONS: We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer. There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. In the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially.

Adult↗

PubMed1996

Consumption of black tea and cancer risk: a prospective cohort study.

BACKGROUND: Tea is one of the most frequently consumed beverages in the world. Antioxidant polyphenol compounds (such as catechins and flavonols) are abundantly present in both green and black teas and have been observed to have anticarcinogenic properties in cell and animal model studies. In black tea, however, most of the catechins have been oxidized to forms that may have reduced anticarcinogenic properties. Despite indications from experimental studies that tea may protect against cancer, epidemiologic evidence has been inconclusive. PURPOSE: The association between black tea consumption and the subsequent risk of stomach, colorectal, lung, and breast cancers was investigated in The Netherlands Cohort Study on Diet and Cancer among 58,279 men and 62,573 women aged 55-69 years. METHODS: Subjects in the cohort completed a self-administered questionnaire on dietary habits and other risk factors for cancer at base line in 1986. Follow-up for cancer was done by means of computerized record linkage with all nine regional cancer registries in The Netherlands and the national pathology database. During 4.3 years of follow-up, 200, 650, 764, and 650 cases of stomach, colorectal, lung, and breast cancers were diagnosed, respectively. The questionnaire data of case subjects and those of a random subcohort (n = 3500) were used to calculate rate ratios (RRs) of cancer in categories of consumers of black tea compared with nonconsumers. RESULTS: Tea was not used by 13% of the subjects in the cohort, whereas 37%, 34%, and 16% consumed one to two, three to four, and five or more cups of tea per day, respectively. No association was observed between tea consumption and risk of colorectal cancer: The risk among tea drinkers in each consumption category was similar to that among nondrinkers. The RR of breast cancer among consumers of five or more cups of tea per day was 1.3 (95% confidence interval = 0.9-2.0); no dose-response association was observed. In age- and sex-adjusted analyses, consumption of tea was inversely associated with stomach (two-sided P for trend = .147) and lung (two-sided P for trend < .001) cancers. However, tea drinkers appeared to smoke less and to eat more vegetables and fruits than nondrinkers. When smoking and dietary factors were taken into account, tea in itself did not appear to protect against stomach and lung cancers: The RRs in all consumption categories were close to unity. Analysis of the tea and cancer relationship in a subgroup that included subjects in the lowest two quintiles of consumption of vegetables and fruits also failed to reveal a protective effect of tea consumption on the risk of three cancer types studied (colorectal, lung, and breast cancers). CONCLUSIONS: This investigation does not support the hypothesis that consumption of black tea protects against four of the major cancers in humans; a cancer-enhancing effect was not evident, either.

Aged↗

PubMed1996

Consumption of onions and a reduced risk of stomach carcinoma.

BACKGROUND & AIMS: Results from case-control studies and laboratory tests indicate that consumption of allium vegetables may considerably reduce the risk of stomach cancer. The association between onion and leek consumption, garlic supplement use, and the incidence of stomach carcinoma was studied. METHODS: The association was investigated in the Netherlands Cohort Study on diet and cancer, which started in 1986 with 120,852 men and women ranging in age from 55 to 69 years. Dietary data were available for 139 stomach carcinoma cases diagnosed during 3.3 years of follow-up and for 3123 subjects of the randomly selected subcohort. RESULTS: The rate ratio for stomach carcinoma in the highest onion consumption category (> or = 0.5 onions/day) was 0.50 (95% confidence interval, 0.26-0.95) compared with the lowest category (0 onions/day) after adjustment for other risk factors. The reduction in risk was restricted to carcinoma in the noncardia part of the stomach (P = 0.002) and was also found among subjects without a history of stomach disorders (P = 0.01). The consumption of leeks and the use of garlic supplements were not associated with stomach carcinoma risk. CONCLUSIONS: The Netherlands Cohort Study provides evidence for a strong inverse association between onion consumption and stomach carcinoma incidence.

Aged↗

PubMed1996

A prospective cohort study on the relationship between onion and leek consumption, garlic supplement use and the risk of colorectal carcinoma in The Netherlands.

The association between onion and leek consumption, garlic supplement use and colon and rectum carcinoma among men and women was evaluated in the Netherlands Cohort Study, a large-scale prospective cohort study on diet and cancer. Onions, leeks, and garlic belong to the Allium genus and contain large amounts of potentially chemopreventive compounds. The Netherlands Cohort Study was started in 1986 among 120 852 men and women, aged 55-69 years. Dietary intake was measured with a 150-item food frequency questionnaire. After 3.3 years of follow-up, 150 and 143 incident male and female cases of colon carcinoma, and 93 and 57 cases of rectum carcinoma, respectively, with complete dietary data were available for analysis. Dietary data were available for 1525 men and 1598 women of a randomly selected subcohort, that was followed up to estimate person-time in the entire cohort. In men, the adjusted rate ratios (RRs) in multivariable analysis for colon and rectum carcinoma in the highest compared to the lowest onion consumption categories were 0.87 (95% confidence interval [CI] = 0.48-1.65), and 0.66 (95% CI = 0.28-1.52), respectively. The RRs for proximal colon carcinoma were lower than for distal colon carcinoma. Leek consumption was not associated with colon and rectum carcinoma incidence in men. None of the RRs were significantly different from unity and no trends in the RRs were detected. A lower risk was found for rectum carcinoma in women consuming less than 0.25 onions per day (RR=0.36, 95% CI = 0.13-0.99), but the trend in the RRs was not statistically significant (P = 0.25). All other RRs for colon and rectum carcinoma associated with onion consumption were slightly higher than one. Leek consumption was not associated with colon and rectum carcinoma incidence. The use of garlic supplements was not associated with colon and rectum carcinoma in men and women combined. This study does not support an inverse association between the consumption of onions and leeks, or the use of garlic supplements and the incidence of male and female colon and rectum carcinoma.

Age Distribution↗

PubMed1996

Epidemiological studies on brassica vegetables and cancer risk.

This paper gives an overview of the epidemiological data concerning the cancer-preventive effect of brassica vegetables, including cabbage, kale, broccoli, Brussels sprouts, and cauliflower. The protective effect of brassicas against cancer may be due to their relatively high content of glucosinolates. Certain hydrolysis products of glucosinolates have shown anticarcinogenic properties. The results of 7 cohort studies and 87 case-control studies on the association between brassica consumption and cancer risk are summarized. The cohort studies showed inverse associations between the consumption of cabbage, cauliflower, and broccoli and risk of lung cancer; between the consumption of brassicas and risk of stomach cancer; between broccoli consumption and risk of all cancers taken together; and between brassica consumption and the occurrence of second primary cancers. Of the case-control studies, 67% showed an inverse association between consumption of total brassica vegetables and risk of cancer at various sites. For cabbage, broccoli, cauliflower, and Brussels sprouts, these percentages were 70, 56, 67, and 29%, respectively. Although the measured effects might have been distorted by various types of bias, it is concluded that a high consumption of brassica vegetables is associated with a decreased risk of cancer. This association appears to be most consistent for lung, stomach, colon, and rectal cancer and least consistent for prostatic, endometrial, and ovarian cancer. It is not yet possible to resolve whether associations are to be attributed to brassica vegetables per se or to vegetables in general. Further epidemiological research should separate the anticarcinogenic effect of brassica vegetables from the effect of vegetables in general.

Anticarcinogenic Agents↗

PubMed1995

Alcohol and breast cancer: results from The Netherlands Cohort Study.

Although the results of cohort studies on the association between alcohol and breast cancer are rather consistent, the current evidence is based solely on North American cohorts. Therefore, this association was evaluated in the Netherlands Cohort Study on diet and cancer, conducted since 1986 among 62,573 women aged 55-69 years. After 3.3 years of follow-up (1986-1989), 422 incident breast cancer cases for which there were complete alcohol consumption data were available for analysis. In multivariate case-cohort analyses, the rate ratio for breast cancer in drinkers versus nondrinkers was 1.31 (95 percent confidence interval 1.00-1.71). When separate alcohol intake categories were compared with nondrinking, the rate ratios were 1.30, 1.29, 1.28, and 1.72 for women who consumed < 5, 5-14, 15-29, and > or = 30 g of alcohol per day, respectively (trend p = 0.047). Whereas beer consumption was not associated with breast cancer risk, increased risks were found at higher levels of both wine and liquor consumption. The alcohol-breast cancer association was found to be stronger among women with a history of benign breast disease, women with a history of breast cancer among sister(s), and women with an early menopause, and it varied considerably according to age at first birth. These results support a positive association between alcohol and breast cancer among postmenopausal women. The increased risk was particularly found among women who consumed 30 g or more of alcohol daily.

Aged↗

PubMed1995

Exogenous hormone use and the risk of postmenopausal breast cancer: results from The Netherlands Cohort Study.

The association between the use of exogenous hormones as either oral contraceptives (OC) or hormone replacement therapy (HRT) in relation to postmenopausal breast cancer incidence was examined in the Netherlands Cohort Study (NLCS) among 62,573 women aged 55 to 69 years. Information on these types of exogenous hormone use and other risk factors was collected by mailed questionnaire. During 3.3 years of follow-up, 471 incident breast cancer cases were identified. After adjustment for traditional breast cancer risk factors, the relative risk (RR) of breast cancer was 1.09 (95 percent confidence interval [CI] = 0.79-1.48) for women who ever used OCs cf women who never used OCs. The relative rates (with CIs) for women who used OCs for a period < 5 years, 5-9 years, 10-14 years, and 15+ years were 0.97 (0.61-1.55), 1.20 (0.69-2.07), 1.03 (0.60-1.77), and 1.96 (0.99-3.89), respectively. The test for trend was not significant (P = 0.13). There was no evidence of any association between the number of years between the first and the last use of OCs and breast cancer incidence. In the subgroup of women with first-degree relatives with breast cancer, the RR for breast cancer associated with ever use of OCs was 1.51 (CI = 0.67-3.41), whereas in the remaining women, the RR was 0.97 (CI = 0.73-1.27). Ever-use of HRT compared with never-use was not associated with an increase in breast cancer risk in the multivariate analysis (RR = 0.99, CI = 0.68-1.43).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1995

Allium vegetable consumption, garlic supplement intake, and female breast carcinoma incidence.

The risk of female breast carcinoma in relation to onion and leek consumption and the use of garlic supplements was evaluated in the Netherlands Cohort Study on diet and cancer. Onions, leeks, and garlic contain specific compounds which might act as antimutagens. Animal experiments also suggest a possible role for these compounds in inhibition of mammary carcinogenesis. The Netherlands Cohort Study was started in 1986 among 120,852 Dutch men and women, aged 55-69 years, with collecting information on usual diet and important lifestyle characteristics. After 3.3 years of follow-up, 469 incident female breast carcinoma cases and 1713 female members of a randomly sampled control subcohort were available for analysis. Intake of onions or leeks was not associated with breast carcinoma risk after controlling for dietary and nondietary risk factors: the rate ratios in the highest intake categories were 0.95 (95% confidence interval 0.61-1.47) and 1.08 (95% confidence interval 0.79-1.48), respectively, compared with the lowest intake categories. The tests for trend in the rate ratios were neither significant. Garlic supplement use was also not associated with breast carcinoma incidence (rate ratio = 0.87, 95% confidence interval 0.58-1.31). In conclusion, we found no association between the consumption of onions or leeks, or garlic supplement use, and the incidence of female breast carcinoma.

Aged↗

PubMed1995

Epidemiologic evidence for beta-carotene and cancer prevention.

In 1981 it was hypothesized that a high dietary intake of beta-carotene might reduce human cancer rates. Since then, several observational epidemiologic studies have addressed this topic. The results of both case-control and cohort studies show a remarkable consistency for the association of increased lung cancer risk with low amounts of dietary beta-carotene or low plasma beta-carotene concentrations. For stomach cancer, the evidence is also consistent, although the number of studies is more modest. For breast and prostate cancer, the studies indicate no consistent association of plasma or dietary beta-carotene and reduced cancer risk. For colorectal cancer, the effect will be moderate, if existent. For several other cancer sites, the numbers of cases in prospective studies are often small, implying that only strong associations can be detected. For some of these sites, results from retrospective studies are promising. The epidemiologic studies should be carefully interpreted because dietary habits may be misclassified and smoking may reduce plasma beta-carotene concentrations. Observational epidemiology cannot definitively resolve whether associations are indeed due to beta-carotene, or to other components of fruit and vegetables that are rich in beta-carotene. However, overall results are promising and several plausible cancer preventive mechanisms have been reported for beta-carotene. The ongoing human intervention studies will provide more answers regarding cancer prevention by beta-carotene but may need long follow-ups to be conclusive.

Antioxidants↗

PubMed1995

Lung cancer: is there an association with socioeconomic status in The Netherlands?

STUDY OBJECTIVE: To evaluate if there are differences in lung cancer incidence between socioeconomic groups in the Netherlands and if so, if smoking habits and other lifestyle characteristics could explain these differences. DESIGN: Prospective cohort study. Baseline measurement included information on socioeconomic status, smoking habits, and other covariates by means of a self-administered questionnaire. Follow up was established by computerised record linkage to cancer registries and a pathology register. SETTING: Population originating from 204 municipalities in The Netherlands. PARTICIPANTS: 58,279 men aged 55-69 years in September 1986. After 3.3 years of follow up 490 microscopically confirmed incident lung cancer cases were detected. MAIN RESULTS: An inverse association between lung cancer risk and highest level of education was found, which persisted after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol (rate ratio (RR) highest/lowest level of education = 0.52, 95% CI 0.33, 0.82, trend p < 0.001). Men with a lower white collar profession had a significantly lower relative rate of lung cancer compared with blue collar workers (RR = 0.66, 95% CI 0.47, 0.96), but after adjustment for smoking habits this difference was reduced (RR = 0.73, 95% CI 0.51, 1.08). CONCLUSIONS: There is an inverse association between highest level of education and lung cancer, which is still apparent after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol. The significantly lower lung cancer risk of lower white collar workers compared with the risk of blue collar workers could be partially explained by smoking habits.

Age Factors↗

PubMed1995

Differences in cancer incidence and mortality among socio-economic groups.

OBJECTIVES: In this article studies on the association between socioeconomic status (SES) and risk for cancer at different sites are reviewed. METHODS: The review is restricted to studies conducted in affluent societies, after 1970. Only studies using income, education and/or occupation as SES indicators are included. RESULTS: A more or less consistent positive association between SES and cancer risk was found for colon and breast cancer. More or less consistent inverse associations were found for lung, stomach, oropharyngeal and esophageal cancer. Inconsistent associations were reported for cancer of the rectum and pancreas. Possible explanations for SES differences in cancer risk are discussed with special emphasis on lifestyle variables related to cancer risk. CONCLUSIONS: It is concluded that it is still unclear whether the reported associations can be (partially) attributed to lifestyle related risk factors for cancer such as smoking, nutritional habits, drinking habits and reproductive factors.

Breast Neoplasms↗

PubMed1995

Reproducibility of a food frequency questionnaire and stability of dietary habits determined from five annually repeated measurements.

OBJECTIVES: In studies on diet and cancer, diet assessment should address long-term intake. Therefore, the authors determined the 5-year reproducibility of a self-administered 150-item food frequency questionnaire (FFQ) used to assess dietary habits in the Netherlands Cohort Study on diet and cancer. Since the FFQ was repeated more than once, the pure test-retest reliability of the FFQ could be distinguished from the intra-individual change in nutrient intake over time. These results were furthermore used to investigate the measurement error structure of the FFQ. DESIGN: After baseline administration in 1986, the FFQ was annually repeated from 1987 to 1991 in independent random samples of the cohort (n = 400). Pearson correlation coefficients (r) between baseline and repeated measurements of nutrient intake, calculated for each time interval, were regressed on time interval to provide separate estimates of the test-retest correlation (intercept of regression line) and of the decline in correlation over time (slope). The proportion of correlated measurement error was derived from combining the test-retest results with those from a validation study, in which the FFQ was validated against three 3-day diet records. RESULTS AND CONCLUSIONS: Response was stable at 82%. The test-retest r ranged from 0.42 for selenium intake to 0.90 for alcohol intake. The slopes of the regression lines were relatively flat, but negative for most nutrients; on average, the decline in r amounted to 0.07 after 5 years, indicating that the potential of a single FFQ measurement to rank subjects according to nutrient intake dropped only slightly over time. This is important for studies on cancer since a long induction period may be involved. It was furthermore shown that the proportion of within-subject (error) variance of the FFQ method that could be attributed to correlated error ranged from 0 to 50%. This finding confirms that a reliability study may underestimate the measurement error of a method. SPONSORSHIP: Dutch Cancer Society (grants CIVO 86-1 and CIVO 90-3).

Aged↗

PubMed1994

A prospective cohort study on Allium vegetable consumption, garlic supplement use, and the risk of lung carcinoma in The Netherlands.

The association between the consumption of onions and leeks (vegetables belonging to the Allium genus), garlic supplements, and the risk of lung carcinoma was investigated in a large-scale prospective cohort study on diet and cancer in the Netherlands. The Netherlands Cohort Study was started in 1986 among 120,852 men and women, ages 55-69 years, by collecting information on usual diet and important life-style characteristics. After 3.3 years of follow-up, 550 incident lung carcinoma cases were observed. Information on Allium vegetable consumption was available for 484 lung carcinoma cases and 3123 members of a randomly sampled subcohort. In stratified analysis, a lower lung carcinoma risk was observed in the highest onion intake category [rate ratio (RR) = 0.65; 95% confidence interval, 0.45-0.95] compared to the lowest consumption category. After including other, dietary and nondietary, determinants of lung carcinoma in the multivariable models and using pack years for past and current smoking, instead of using smoking status categorized as never, ex-, and current smoking, the rate ratio in the highest intake category increased to 0.80 and was no longer significantly different from unity (95% confidence interval, 0.52-1.24). Leek consumption was not associated with risk for lung carcinoma (RR = 1.08; 95% confidence interval 0.80-1.45 in the highest intake category, compared to the lowest). No statistically significant trends in the rate ratios associated with increasing consumption of these vegetables were detected for lung carcinoma or the four histological subtypes. A higher lung carcinoma risk was observed for those subjects who used exclusively garlic supplements (RR = 1.78; 95% confidence interval, 1.08-2.92), compared to those not taking dietary supplements. A lower lung carcinoma risk was seen for those using garlic supplements together with any other supplement (RR = 0.93; 95% confidence interval 0.46-1.86) compared to those using any other supplement. In conclusion, we found no evidence of a relation between the consumption of onions or leeks and the risk of lung carcinoma or any of the histological subtypes. Garlic supplement use seems not associated with a lower risk of lung carcinoma.

Aged↗

PubMed1994

Toenail selenium levels and the risk of breast cancer.

The association between toenail selenium and breast cancer was studied in a prospective study on diet and cancer among 62,573 Dutch women aged 55-69 years that started in September 1986. The analysis was based on 355 breast cancer cases, detected during 3.3 years of follow-up (1986-1989), for whom selenium data were available. Selenium levels were significantly lower among cases diagnosed early during follow-up. After exclusion of cases that occurred in the first year of follow-up, multivariable-adjusted rate ratios of breast cancer in increasing quintiles of selenium were 1.00, 0.90, 0.76, 0.86, and 0.91 (trend p = 0.618). The authors found no evidence for an inverse association between selenium status and breast cancer.

Aged↗

PubMed1994

Fermented dairy products, calcium, and colorectal cancer in The Netherlands Cohort Study.

Experimental studies suggest that an increased consumption of fermented dairy products and calcium might decrease the risk of colorectal cancer. The associations between fermented dairy products, dietary calcium, and colorectal cancer risk were investigated in a population with a wide variation in intake of dairy products. The Netherlands Cohort Study of diet and cancer started in 1986 when 120,852 Dutch men and women, ages 55-69, filled out a questionnaire concerning dietary patterns and lifestyle. The present analysis is based on 3.3 years of follow-up and includes 215 incident cases of colon cancer and 111 incident cases of rectal cancer, excluding cases diagnosed in the first year of follow-up. After adjustment for potential confounding variables, colorectal cancer risk was weakly inversely associated with the consumption of fermented milk [relative rate (RR) in the highest category of intake compared to nonusers, 0.89; 95% confidence interval (CI), 0.60, 1.33], unfermented milk (RR, 0.86; 95% CI, 0.57, 1.29), and cheese (RR, 0.88; 95% CI, 0.59, 1.33). However, category-specific relative rates and tests for trends were not statistically significant. For fermented milk, the inverse association was limited to colon cancer (RR, 0.70; 95% CI, 0.43, 1.15; trend, P = 0.33). In crude and multivariate models, total dietary calcium intake (highest versus lowest quintile, RR, 0.92; 95% CI, 0.64, 1.34) and calcium from fermented dairy products (RR, 1.14; 95% CI, 0.77, 1.68) were not significantly associated with colorectal cancer risk. Calcium from unfermented dairy products was inversely associated with rectal cancer risk (RR, 0.55; 95% CI, 0.30, 1.04; trend, P = 0.03). After 3.3 years of follow-up, these data are not consistent with a substantially decreased risk of colorectal cancer with increased intake of fermented dairy products and dietary calcium.

Aged↗

PubMed1994

A prospective cohort study on the relation between meat consumption and the risk of colon cancer.

The high incidence of colon cancer in affluent societies has often been attributed to a high fat diet and, more in particular, the consumption of meat. The association of the consumption of meat and the intake of fat with risk of colon cancer was investigated in a prospective cohort study on diet and cancer, which is being conducted in the Netherlands since 1986 among 120,852 men and women, aged 55-69. The analysis was based on 215 incident cases of colon cancer (105 men and 110 women) accumulated in 3.3 years of follow-up, excluding cases diagnosed in the first year of follow-up. Dietary habits were assessed at baseline with a 150-item semiquantitative food frequency questionnaire. No trends in relative rates of colon cancer were detected for intake of energy or for the energy-adjusted intake of fats, protein, fat from meat, and protein from meat. Consumption of total fresh meat, beef, pork, minced meat, chicken, and fish was not associated with risk of colon cancer either. Processed meats, however, were associated with an increased risk in men and women (relative rate, 1.17 per increment of 15 g/day; 95% confidence interval, 1.03-1.33). The increased risk appeared to be attributable to one of the five questionnaire items on processed meat, which comprised mainly sausages. This study does not support a role of fresh meat and dietary fat in the etiology of colon cancer in this population. As an exception, some processed meats may increase the risk, but the mechanism is not yet clear.

Age Factors↗

PubMed1994

Prospective study on alcohol consumption and the risk of cancer of the colon and rectum in the Netherlands.

The association between alcohol consumption and cancer of the colon and rectum was investigated in a prospective cohort study, conducted in the Netherlands from 1986 onwards among 120,852 men and women, aged 55 to 69 years. During 3.3 years of follow-up, 312 and 166 cases of colon and rectal cancer had accumulated, respectively. After exclusion of cases diagnosed in the first year of follow-up, the analysis was based on 217 incident cases of colon cancer (107 men and 110 women) and 113 cases of rectal cancer (75 men and 38 women). For colon cancer, no association with total intake of alcohol nor with the consumption of beer and wine, specifically, could be demonstrated; for liquor intake, a significant (P = 0.04) decreasing risk with increasing consumption was observed. For rectal cancer in men, positive trends were observed for total alcohol intake (P = 0.04), beer (P = 0.05), and liquor (P = 0.06). Results for rectal cancer in women were consistent with those in men, but data were too sparse to provide stable estimates. Simultaneous adjustment for beverage type and quantity appeared to strengthen the association of rectal cancer with drinking beer (relative rate (yes/no) = 2.0, 95 percent confidence interval = 1.1-3.9), although a dose-response effect was not observed. When alcohol intake from beer, wine, and liquor were included as continuous variables, the association was somewhat stronger for liquor than for beer, but none of the associations were statistically significant. It is concluded that consumption of alcoholic beverages (beer, in particular) is associated with an increased risk for rectal but not colon cancer.

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