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；华沙城市37人；华沙农村18人；1985- 1989年；美国白人94人）。然而，最近对西方波兰移民的研究表明，不列颠哥伦比亚省移民的死亡率与东道国相似（标准化死亡率为91（美国），100（澳大利亚）和97（英格兰和威尔士））。没有其他国家的移民人口表现出如此迅速的转变。表达这种变化的BC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征、习惯的变化、这些变化发生的时间，以及影响BC风险的个人特征。我们建议在两个人群中对20-74岁的BC病例进行两个平行的、基于人群的病例对照研究：1)居住在库克县和底特律大都会区的波兰出生的移民（378例和378例对照）和2)居住在华沙的波兰本地人（500例和500例对照）。我们假设通常和过去的饮食成分都与BC风险有关。我们假设，在调整了已确定的危险因素后，BC风险将通过以下方式增加：（1)减少特定类型食物的摄入（如十字花科蔬菜、酸菜、根茎类蔬菜、全谷物面包和其他谷物），因此：2）减少植物化学物质（如葡萄花青素、类胡萝卜素、类黄酮和抗氧化剂）和膳食纤维的摄入；3)增加肉类、肉制品和膳食脂肪的摄入量；4)以上1 ~ 3种饲粮成分间的相互作用。在生命的三个阶段（20世纪80年代末、月经初潮前、绝经前）评估饮食摄入量将有助于了解饮食因素是否存在改变乳腺癌风险的关键年龄。本研究汇集了BC研究的不同领域（营养、流行病学、移民风险变化），在战略选择的BC死亡率差异为3倍的人群中，以发展对营养风险因素及其在BC病因学中的意义的批判性理解。该研究小组在开展流行病学研究方面具有丰富的经验，并具有接触这些人群的独特途径。拟议的研究将检查新出现的和已确定的BC危险因素的作用及其相互作用。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，并有助于理解特定蔬菜和植物化学物质在降低BC风险方面的作用，对BC的预防有明确的意义。

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.