Abstract
The roles of diet and tobacco in the etiology of primary brain cancer are controversial. In this report, we compare dietary and cigarette smoking histories among 434 adults newly diagnosed with glioma in the San Francisco Bay Area (California, USA) between 1991 and 1994 with frequency age, gender, and ethnicity-matched population-based controls. Data were obtained on use of vitamin supplements and mean weekly consumption of each of 24 food groups. Adjusted for age, family income, and education, for both men and women, cases had higher mean weekly consumption of cured meats and other cured foods, lower consumption of high vitamin A and C fruits and vegetables, and higher average intakes of beer and other alcohol than controls. Men with brain cancer were twice as likely as control men to report high consumption of cured foods and low consumption of foods rich in vitamin C (odds ratio [OR]=2.0, 95 percent confidence interval [CI]=1.2-3.5). This association was less pronounced and not statistically significant in women (OR=1.5, CI=0.8-2.7). Similarly, men with brain cancer were twice as likely as controls to have high nitrite and low vitamin C consumption. Among men only, cases were 1.8 times more likely than controls to report smoking unfiltered cigarettes (CI=0.9-3.4). Moreover, among smokers, cases smoked unfiltered cigarettes almost twice as long as controls (P=0.04) and cases' average total pack-years also significantly exceeded controls. Although these findings support the hypothesis that N-nitroso compounds might be a factor in adult glioma, they are compatible with other dietary hypotheses. In particular, these results also favor the hypothesis that total body burden of oxidants may play a role in brain cancer causation.
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References
Wrensch M, Bondy ML, Wiencke J, et al. Environmental risk factors for primary malignant brain tumors: A review. J Neurooncol 1993; 17: 47-64.
Berleur MP, Cordier S. The role of chemical, physical, or viral exposures and health factors in neurocarcinogenesis: Implications for epidemiologic studies of brain tumors. Cancer Causes Control 1995; 6: 240-56.
Preston-Martin S, Mack W. Gliomas and meningiomas in men in Los Angeles County: Investigation of exposures to N-nitroso compounds. In: O'Neill IK, Chen J, Bartsch H, eds. Relevance to Human Cancer of N-Nitroso Compounds, Tobacco Smoke and Mycotoxins. Lyon, France: Interna-tional Agency for Research on Cancer, 1991; IARC Sci. Pub. No. 150: 197-203.
Boeing H, Schlehofer B, Blettner M, et al. Dietary carcino-gens and the risk for glioma and meningioma in Germany. Int J Cancer 1993; 53: 561-5.
Ahlbom A, Navier IL, Norell S, et al. Nonoccupational risk indicators for astrocytomas in adults. Am J Epidemiol 1986; 124: 334-7.
Giles GG, McNeil JJ, Donnan G, et al. Dietary factors and the risk of glioma in adults: Results of a case-control study in Melbourne, Australia. Int J Cancer 1994; 59: 357-62.
Burch JD, Craib KJ, Choi BCK, et al. An exploratory case-control study of brain tumors in adults. JNCI 1987; 87: 601-9.
Blowers L, Preston-Martin S, Mack W. Dietary and other lifestyle factors of women with brain gliomas in Los Angeles County (California, USA). Cancer Causes Control 1996; 8: 5-12.
Brownson RC, Reif JS, Chang JC, et al. An analysis of occupational risks for brain cancer. Am J Pub Health 1990; 80: 169-72.
Choi NW, Schuman LM, Gullen WH, et al. Epidemiology of primary central nervous system neoplasms. II. Case-control study. Am J Epidemiol 1970; 91: 467-85.
Preston-Martin S, Mack W, Henderson BE. Risk factors for gliomas and meningiomas in males in Los Angeles County. Cancer Res 1989; 49: 6137-43.
Hochberg F, Toniolo P, Cole P, et al. Nonoccupational risk indicators of glioblastoma in adults [published erratum appears in J Neurooncol 1990; 9: 90] J Neurooncol 1990; 8: 55-60.
Ryan P, Lee MW, North B, et al. Risk factors for tumors of the brain and meninges: Results from the Adelaide Adult Brain Tumor Study. Int J Cancer 1992; 51: 20-7.
Schlehofer B, Kunze S, Sachsenheimer W, et al. Occupa-tional risk factors for brain tumors: Results from a population-based case-control study in Germany. Cancer Causes Control 1990; 1: 209-15.
Mills PK, Preston-Martin S, Annegers JF, et al. Risk factors for tumors of the brain and cranial meninges in Seventh-Day Adventists. Neuroepidemiology 1989; 8: 266-75.
Musicco M, Filippini G, Bordo BM, et al. Gliomas and occupational exposure to carcinogens: Case-control study. Am J Epidemiol 1982; 116: 782-90.
Percy C, Van Holten V, Muir C, eds. International Clas-sification of Disease for Oncology, Second Edition. Geneva, Switzerland: World Health Organization, 1990.
Waksberg J. Sampling methods for random digit dialing. J Am Stat Assoc 1978; 73: 40-6.
Harlow BL, Davis S. Two one-step methods for household screening and interviewing using random digit dialing.Am J Epidemiol 1988; 127: 857-63.
Block G, Hartman AM, Dresser CM, et al. A data-based approach to diet questionnaire design and testing. Am J Epidemiol 1986; 124: 453-69.
SAS Institute Inc. SAS/STAT User's Guide, Version 6, Fourth Edition. Vol 1. Cary, NC (USA): SAS Institute Inc., 1990.
Breslow NE, Day NE. Statistical Methods in Cancer Re-search. Vol 1. The Analysis of Case-control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
Walker R. Nitrates, nitrites and N-nitrosocompounds: A review of the occurrence in food and diet and the toxico-logical implications. Food Addit Contam 1990; 7: 717-68.
Randles LL. Nitrate, nitrite, and nitrosamine values for database. (Unpublished data.) California Birth Defects Monitoring Program, January 1989.
Howe GR, Harrison L, Jain M. A short diet history for assessing dietary exposure to N-nitrosamines in epidemiologic studies. Am J Epidemiol 1986; 124: 595-602.
United States Department of Agriculture. Human Nutri-tion Information Service. Composition of Foods; Raw, Processed, Prepared. (Revised Handbooks #8-1 to #8-21, Diet, tobacco, and adult brain cancer Cancer Causes and Control. Vol 8. 1997 23.1988). Washington, DC: U.S. GPO, Nutrition Monitoring Division, 1976-88.
National Cancer Institute. Health Habits and History Questionnaire: Diet History and Other Risk Factors. Dietsys Version 3.4. Information Management Services, Inc., Block Dietary Data Systems, 1995.
Wrensch M, Lee MM, Miike R, et al. Family and personal medical history of cancer and nervous system conditions among adult brain cancer cases and controls. Am J Epidemiol, (in press).
Maekawa A, Mitsumori K. Spontaneous occurrence and chemical induction of neurogenic tumors in rats-influence of host factors and specificity of chemical structure. Crit Rev Toxicol 1990; 20: 287-310.
Preston-Martin S, Yu MC, Benton B, et al. N-nitroso com-pounds and childhood brain tumors: A case-control study. Cancer Res 1982; 42: 5240-5.
Ames BN, Shigenaga MK, Hagen T. Oxidants, antioxidants, and the degenerative diseases of aging. Proc Natl Acad Sci 1993; 90: 7915-22.
Block G, Patterson B, Subar A. Fruit, vegetables, and cancer prevention: A review of the epidemiologic evidence. Nutr Cancer 1992; 18: 1-29.
Ambrosone CB, Freudenheim JL, Marshall JR, et al. The association of polymorphic N-acetyltransferase (NAT2) with breast cancer risk. Ann NY Acad Sci 1995; 768: 250-2.
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Lee, M., Wrensch, M. & Miike, R. Dietary and tobacco risk factors for adult onset glioma in the San Francisco Bay Area (California, USA). Cancer Causes Control 8, 13–24 (1997). https://doi.org/10.1023/A:1018470802969
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DOI: https://doi.org/10.1023/A:1018470802969