Serum vitamins and the subsequent risk of bladder cancerNomura AM, Lee J, Stemmermann GN, Franke AA
PURPOSE: We determined whether serum vitamins are inversely related to bladder cancer risk. MATERIALS AND METHODS: A cohort of 9,345 Japanese-American men was examined from 1971 to 1977. At examination a blood specimen was obtained and the serum was frozen. After a surveillance period of more than 20 years 111 tissue confirmed incident cases of bladder cancer were identified. Stored serum and that of 111 age matched controls were tested by high pressure liquid chromatography for certain micronutrients, including lutein, zeaxanthin, anhydrolutein, alpha-cryptoxanthin, beta-cryptoxanthin, lycopene, dihydrolycopene, alpha-carotene, beta-carotene, total carotenoids, retinol, alpha-tocopherol, beta-tocopherol, gamma-tocopherol, delta-tocopherol and total tocopherols. RESULTS: Based on quartiles of serum micronutrient levels the ORs for bladder cancer were determined using the general estimating equations approach. There were statistically significant inverse linear trends in risk for alpha-carotene (p <0.01), beta-carotene (p = 0.03), lutein plus zeaxanthin (p = 0.03), beta-cryptoxanthin (p = 0.04) and total carotenoids (p = 0.02). However, after adjustment for pack-years of cigarette smoking none of the inverse trends remained significant. CONCLUSIONS: These results suggest that cigarette smoking, which is a strong risk factor for bladder cancer, may explain the apparent protective effect of individual and total carotenoids against this common cancer.
J Urol. 2003 Oct;170(4 Pt 1):1146-50. PMID: 14501712
A prospective study of diet, smoking, and lower urinary tract cancerChyou PH, Nomura AM, Stemmermann GN
The association of diet and smoking with bladder cancer was investigated in a cohort study conducted in Hawaii. The study included 7995 Japanese-American men who were born between 1900 and 1919, and were examined from 1965 to 1968. After 22 years of follow-up, 96 incident cases of bladder cancer were diagnosed. Current cigarette smokers had a 2.9-fold risk of bladder cancer, compared with nonsmokers. A direct dose-response relation was observed, based on pack-years of cigarette smoking. Consumption of fruit was inversely associated with the risk of bladder cancer (P = 0.038). The relative risk was 0.6 among subjects who had the most frequent (> or = 5 times/wk) intake of fruits compared to those with the least intake (< or = 1 time/wk). A weaker inverse association with milk intake was also observed (P = 0.07). Frequent consumption of fried vegetables, pickles, or coffee increased the risk of bladder cancer, but none of these foods showed a significant dose-response relationship. There was no association of other selected foods, alcohol, total calories, protein, fat, or carbohydrates with bladder cancer risk.
Annals of Epidemiology. 1993 May;3(3):211-6. PMID: 8275191
Breast cancer in women of Japanese and Caucasian ancestry in HawaiiStemmermann GN, Catts A, Fukunaga FH, Horie A, Nomura AM
A pathology review of breast cancers in Japanese and Caucasian women indicates more numerous in situ carcinomas in the Japanese. Carcinomas with uniform nuclei were also more numerous among Japanese. Japanese women showed more extensive lymphocytic infiltrates adjacent to their tumors than did Caucasian women, and also showed more conspicuous sinus histiocytosis in tumor-free lymph nodes. Fewer Japanese women had lymph node metastases and those with metastases were less likely to have three or more nodes involved. Of these differences only those relating to local invasion, nuclear grade, lymphocytic infiltration, and sinus histiocytosis were statistically significant, but the demonstrated differences are internally consistent with differences in breast cancer incidence and mortality in the two races. Since the two races share the same medical care system and similar environments, the basis of these differences is probably a genetic modulation of hormonal balance and/or immunologic response.
Cancer. 1985 Jul 1;56(1):206-09. PMID: 4005790
Cancer of the urinary bladder in the Pacific BasinNomura AM.
The incidence of urinary bladder cancer differs markedly among the different ethnic and national groups in the Pacific Basin. Because of these differences, the following colaborative studies can be done to identify and characterize factors associated with bladder cancer: 1) study population groups with different levels of bladder cancer risk who reside in the same geographic setting; 2) study ethnically similar groups who differ in risk and reside in different locations; and 3) study population groups who differ in risks and reside in different geographical regions. Factors possibly related to bladder cancer that have been identified and studied by others include occupational exposure to certain chemicals, cigarette smoking, coffee drinking, artificial sweeteners, certain viruses, radiation exposure, phenacetin, bracken fern, Schistosoma haematobium, tryptophan metabolites, nitrosamines, estrogens, hair dyes, vitamin A, and ascorbic acid. In collaborative studies, the pathologic interpretation of histologic material and the content of the questionnaire should be well standardized, and the laboratory tests should be done at one laboratory. Among the population groups in the Pacific Basin, the Japanese in Hawaii and in Japan provide a unique resource for further investigation with respect to bladder cancer.
Natl Cancer Inst Monogr. 1979 Nov;(53):143-48. PMID: 395442