title: An ecological study of diet and lung cancer in the South Pacific.
abstract: Incidence rates of lung cancer have been markedly lower for Fiji than for other South Pacific countries, despite similar rates of smoking. We conducted population-based surveys in several island nations of the South Pacific (Cook Islands, Fiji, Tahiti and New Caledonia) and used data from Caucasian, Japanese, Hawaiian, Filipino and Chinese controls in a case-control study of lung cancer in Hawaii to investigate the role of diet in explaining differences in lung cancer incidence among 20 ethnic-sex groups. In a stepwise linear regression of lung cancer rates on smoking, diet and other variables, smoking, as expected, explained the majority (61%) of the variability in incidence. However, several dietary components also explained significant portions of the variance. Lutein intake explained 14% and vitamin E intake, cholesterol intake and height explained 5-7% each of the remaining variance in incidence. Associations with lutein and vitamin E were inverse, whereas those with cholesterol and height were direct. Dietary beta-carotene intake was not associated with lung cancer incidence. These ecological data provide evidence for a protective effect of lutein against lung cancer. A protective effect of dietary vitamin E and a risk-enhancing effect of dietary cholesterol are also suggested.
authors.affiliation: Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu 96813, USA.
authors.forename: L
authors.initials: L
authors.lastname: Le Marchand
authors.forename: J H
authors.initials: JH
authors.lastname: Hankin
authors.forename: F
authors.initials: F
authors.lastname: Bach
authors.forename: L N
authors.initials: LN
authors.lastname: Kolonel
authors.forename: L R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: M
authors.initials: M
authors.lastname: Stacewicz-Sapuntzakis
authors.forename: P E
authors.initials: PE
authors.lastname: Bowen
authors.forename: G R
authors.initials: GR
authors.lastname: Beecher
authors.forename: F
authors.initials: F
authors.lastname: Laudon
authors.forename: P
authors.initials: P
authors.lastname: Baque
mesh_terms: D000293:Adolescent; D000328:Adult; D003367:Cotinine / Q000097:blood; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D010139:Pacific Islands; D012044:Regression Analysis; D012907:Smoking; D014675:Vegetables
chemical_list: D003367:Cotinine