Etiologic Studies of Diet and Cancer

饮食和肥胖与肝癌的研究：肝癌是全球癌症相关死亡率的第三大原因。许多假说将饮食的不同方面与肝癌联系起来，例如酒精，肉类，脂肪，水果和蔬菜，咖啡，果汁。然而，在这份名单中，只有酒精是一个既定的风险因素。除了饮食成分外，人们越来越意识到能量平衡的重要性，包括肥胖，糖尿病和肝癌的体力活动。我们正在调查这些饮食和能量平衡的假设，利用大型前瞻性队列研究。在过去的一年中，我们在几项研究中测量了B型肝炎（HBV）和丙型肝炎（HCV）阳性。HBV和HCV是肝癌的强风险因素，因此现在我们可以在分析中考虑这些可能的风险因素。我们还测量了其他几种分析物，包括胰岛素，葡萄糖，维生素D和血清铁，旨在确定这些分析物与癌症的关联。我们还在研究与特定饮食成分的关系。SEER医疗保险。我们致力于在SEER-Medicare数据库中创建嵌套病例对照研究，以检查饮食和肥胖相关暴露与癌症风险的关联。SEER医疗保险数据库的规模非常大，使我们能够检查难以在其他地方进行的假设-例如糖尿病与结肠特定解剖子部位的关联。今年，我们开发了数据库，并检查了包括肥胖，糖尿病，吸烟和胃反流在内的初始暴露。

Studies of diet and obesity with liver cancer: Liver cancer is the third leading cause of cancer-related mortality worldwide. Numerous hypotheses link different aspects of the diet, e.g. alcohol, meat, fat, fruits and vegetables, coffee, fruit juice, with liver cancer. However of that list, only alcohol is an established risk factor. In addition to dietary components, there is a growing awareness of the importance of energy balance, including obesity, diabetes, and physical activity with liver cancer. We are investigating these dietary and energy balance hypotheses, taking advantage of large prospective cohort studies. In the past year, we have measured Hepatitis B (HBV) and Hepatitis C (HCV) positivity in several of our studies. HBV and HCV are strong risk factors for liver cancer and so now we can take account of these possible risk factors in our analyses. We have also measured several other analytes including insulin, glucose, vitamin D, and serum iron and aim to determine the association of these analytes with cancer. We are also in the process of examining associations with specific dietary components. SEER-Medicare. We have worked to create a nested-case control study in the SEER-Medicare database in which to examine the association of diet and obesity related exposures with cancer risk. The very large size of the SEER-Medicare database allows us to examine hypotheses which are difficult to conduct other places-- for example the association of diabetes with particular anatomic sub-sites of the colon. This year, we have developed the database and examined an initial set of exposures including obesity, diabetes, smoking, and gastric reflux.