Lung cancer: A prospective study of smoking, occupation, and nutrient intakeKato I, Nomura AM, Stemmermann GN, Chyou PH
A cohort study of lung cancer was conducted among 7,961 Japanese-American men who were interviewed and examined during 1965-1968. Information was collected about their smoking history, occupation, and nutrient intake. After 22 y, 227 incident cases of lung cancer were identified. Cigarette smoking significantly increased lung cancer risk. The relative risk (RR) was 3.1 for past smokers and 11.4 for current smokers, compared with never smokers. We separated lung cancer cases according to histological type, and it was found that current smokers had a RRs of 16.0 for squamous/small-cell carcinoma and 6.8 for adenocarcinoma of the lung. Unskilled manual workers had a significantly higher risk (RR = 1.5; 95% confidence interval, 1.1-2.2) for lung cancer than workers who were engaged in nonmanual occupations. There was no association between lung cancer and the 24-h intake of total calories, protein, fat, dietary cholesterol, carbohydrates, and alcohol, but this may have resulted from the limitations of a 24-h dietary questionnaire.
Arch Environ Health. 1993 Mar-Apr;48(2):69-72. PMID: 8476306
Prospective study of pulmonary function and lung cancerNomura AM, Stemmermann GN, Chyou PH, Marcus EB, Buist AS
The role of pulmonary function as an independent predictor of lung cancer risk was studied in a community-based cohort of 6,317 Japanese-American men who were aged 45 to 68 at the time of examination. After a follow-up period of about 22 yr, 172 incident cases of lung cancer were identified. The percentage of the predicted FEV1 was inversely related to lung cancer (p value for trend = 0.01) after adjustment for age and cigarette smoking history. The subjects in the lowest quartile of pulmonary function (% predicted FEV1 less than 84.5) had a relative risk of 2.1 (95% confidence interval = 1.3 to 3.5) for lung cancer compared with subjects in the highest quartile (% predicted FEV1 = 103.5+). For the 84 cases with a squamous or small cell histologic type of lung cancer, the subjects in the lowest quartile had a relative risk of 2.5 (95% Cl = 1.2 to 5.6) compared with subjects in the highest quartile of pulmonary function. For the 84 patients with lung cancer whose tumors were located within 4 cm of the pulmonary hilum, the subjects in the lowest quartile had a relative risk of 4.0 (95% Cl = 1.7 to 9.7). The results suggest that impaired pulmonary function in a community-based population is a predictor of lung cancer.
Am Rev Respir Dis. 1991;144:307-11 PMID: 1859052
Prospective study of alcohol consumption and cancerPollack E, Nomura AM, Heilbrun LK, Stemmermann GN, Green S
The relation between alcohol consumption and the subsequent occurrence of the five most frequent cancers in Japanese men in Hawaii (cancer of the stomach, colon, rectum, lung, and prostate) was analyzed in a prospective study of 8006 subjects. Information on alcohol consumption was obtained through interviews in the mid-1960s , and the cohort has been followed since then, the analysis, which was adjusted for the effects of age and cigarette smoking, revealed a positive association between consumption of alcohol and rectal cancer, accounted for primarily by an increased risk in men whose usual monthly consumption of beer was 500 ox (15 liters0 or more (relative risk, 3.05; P<0.01, as compared with those who did not drink beer). A significant positive relation between alcohol consumption and lung-cancer incidence was also found, accounted for primarily by an increased risk among subjects who consumed larger amounts of wine or whiskey, as compared with the risks among nonconsumers of these beverages (relative risk, 2.19, [P = 0.03] and 2.62 [P<0.01], respectively). No significant relation between alcohol consumption and the incidence of the other three cancers was found.
N Engl J Med. 1984 Mar;310(10):617-21. PMID: None
Dietary cholesterol and lung cancer risk among Japanese men in HawaiiHeilbrun LK, Nomura AM, Stemmermann GN
Dietary cholesterol intake was estimated for 7539 men clinically examined from 1965 to 1968, as part of a prospective cohort study. After 15 yr of surveillance, 113 incidence cases of lung cancer have been identified. We found no significant association between dietary cholesterol intake and lung cancer risk, either before or after adjustment for age and pack-years of cigarette smoking. Cases under age 60 at examination did consume more dietary cholesterol than controls of the same age group, but no significant age/dietary cholesterol interaction effect could be found. No significant association could be found with any of the subgroups of cases defined by: clinical stage of disease, histological type, or time interval from examination to diagnosis.
AM J Clin Nutr. 1984 Mar;39(3):375-79. PMID: 6695837
LETTER TO THE EDITOR - Body height and lung cancer riskNomura AM, Heilbrun LK, Stemmermann GN
Sir, - In our large prospective study, we have followed up to 8000 examined men of Japanese ancestry in Hawaii for almost fifteen years for the occurrence of incident cases of cancer. The results on the association of measure height with cancer are presented in the table. Although the tallest group of men had a higher rate of lung cancer than the shortest group, the linear trend was not significant. For the other cancers, there was no clear indication that height was directly related to cancer risk. Because the average height of the study subjects was only 163 cm, our assessment of cancer risk in taller individuals was limited. To our knowledge, none of the cancers listed in the table has been firmly associated with height.
Lancet. 1983 May;1162. PMID: None
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