BREAST CANCER IN WOMEN OF POLISH ANCESTRY

波兰妇女的乳腺癌发病率（BC）是美国妇女的三分之一（1990年每10万人的年龄调整率;华沙市37;华沙农村18; 1985-9;美国白人94）。 然而，最近对波兰移民到西方的研究表明，BC省移民的死亡率与东道国的死亡率相似（标准化死亡率为91（美国），100（澳大利亚）和97（英格兰和威尔士）。 没有任何其他移民人口显示出如此迅速的转变。 表达BC这种变化的风险所需的时间很短，这意味着可改变的环境因素是风险的重要决定因素。 为了评估这些因素的作用，必须评估原籍地和目的地的特点、习惯的变化、这些变化发生的时间以及影响BC风险的个人特点。 我们建议进行两个平行的，以人群为基础的病例对照研究，20-74岁的事件BC病例在两个人群：1）波兰出生的移民，（378例和378对照）居住在库克县和底特律大都会区和2）波兰本地人，（500例和500对照）居住在华沙市。 我们假设，通常和过去的饮食成分与BC风险相关。 我们假设，在调整了既定的风险因素后，BC风险将增加：（1）减少特定类型食物的摄入量（例如十字花科蔬菜、泡菜、根茎类蔬菜、全麦面包和其他谷物），从而：2）减少植物化学物质的摄入（例如葡萄糖、类胡萝卜素、类黄酮及抗氧化剂）及膳食纤维;及3）增加肉类、肉制品及膳食脂肪的摄入量; 4）上述1-3中膳食成分之间的相互作用。 在生命的三个阶段（20世纪80年代后期，月经前期，绝经前）评估饮食摄入量将提供洞察力，是否有饮食因素改变BC风险的关键年龄。 这项研究汇集了BC研究的不同领域（营养，流行病学，由于迁移的风险变化），在战略选择的人群中，BC死亡率有3倍的差异，以发展对营养风险因素及其在BC病因学中的影响的重要理解。 该研究小组在进行流行病学研究方面具有丰富的经验，并有接触这些人群的独特途径。 拟议的研究将审查新出现的和既定的BC风险因素及其相互作用的作用。 因此，这项研究的结果应该有助于澄清膳食脂肪的模糊发现，并将有助于理解特定蔬菜和植物化学物质在降低BC风险中的作用，对BC预防具有明确的意义。

Polish women experience breast cancer incidence (BC) one third that of U.S. women (age-adjusted rates per 100,000 in 1990; Warsaw City 37; Warsaw Rural 18; and in 1985-9; U.S. whites 94). Yet, recent studies of Polish immigrants to the West showed BC mortality rates for immigrants similar to the rates of the host county (standardized mortality ratios 91 (US), 100 (Australia), and 97 (England and Wales). No other population of migrants has shown so rapid a transition. The short time needed to express this changing risk for BC implicates modifiable environmental factors as significant determinants of risk. To evaluate the role of these factors, characteristics of place of origin and destination, change in habits, and when these changes occurred, as well as the individual's characteristics that influence BC risk, must be assessed. We propose to conduct two parallel, population-based case control studies of 20-74 years old incident BC cases in two populations: 1) Polish-born Immigrants, (378 cases and 378 controls) residing in Cook County and Detroit Metropolitan Area and 2) Polish-native, (500 cases and 500 controls) residing in Warsaw City. We hypothesize that components of both usual and past diet are associated with BC risk. We hypothesize that after adjusting for established risk factors BC risk will be increased by: (1) reduction in intake of specific types of foods (e.g. cruciferous vegetables, sauerkraut, root vegetables, whole grain breads and other cereals), and thus: 2) reduction in intake of phytochemicals (e.g. glucobrassicins, carotenoids, flavonoids, and antioxidants), and dietary fiber; and 3) increase in intake of meat, meat products and dietary fat; and 4) interaction among the dietary constituents in 1-3 above. Assessment of dietary intakes at three points in life (late 1980'S, premenarcheal, premenopausal) will provide insight whether there are key ages when dietary factors alter BC risk. This study brings together disparate areas of BC research (nutrition, epidemiology, changes in risks due to migration) in strategically selected populations with 3 fold difference in BC mortality in order to develop critical understanding of the nutritional risk factors and their implications in BC etiology. The research team has extensive experience in the conduct of epidemiological studies and unique access to these populations. The proposed study will examine the role of emerging and established risk factors for BC and their interactions. Thus, results from this study should help clarify the ambiguous findings for dietary fat, and will contribute to understanding the role specific vegetables and phytochemicals play in lowering BC risk, with clear implications for BC prevention.