THE ASSOCIATION OF JAPANESE DIET WITH RISK OF COMMON CANCER AMONG THE JAPANESE LIVING IN THE UNITED STATES AND JAPAN: THE MULTIETHNIC COHORT STUDY AND THE JAPAN PUBLIC HEALTH CENTER- BASED PROSPECTIVE STUDY

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2024

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【Introduction】Japanese migrants to the United States and their descendants have experienced an increased risk of cancer compared to Japan. This study aimed to describe the incidences and dietary risk factors for six common cancers among Japanese in two population-based cohort studies on-going since the 1990’s, the Multiethnic Cohort Study (MEC) and the Japan Public Health Center-based Prospective Study (JPHC). The common cancers among Japanese were defined as stomach cancer (SC), colorectal cancer (CRC), hepatocellular carcinoma (HCC), lung cancer (LC), breast cancer (BC, women only), prostate cancer (PC, men only). 【Methods】 We analyzed the data from the questionnaire collected at baseline for the MEC and at 5- year follow-up for the JPHC. These included demographics, life-style related risk factors such as smoking, drinking, and physical activity, and a self-reported quantitative food frequency questionnaire including more than 150 items in both studies. First, we assessed the incidences of common cancers of the Japanese Americans and the Japanese residing in Japan. Second, the association of rice with CRC risk was examined. Rice consumption(g/1000kcal/day) was categorized into quartiles and Hazard Ratios (HR) and 95% confidence intervals (95%CI) were computed to assess overall risk trends in cancer risk. Third, the study explored the relation of the Japanese Diet Index-8 (JDI) and common cancer risk. The JDI was developed and validated in Japan to assess the adherence to the traditional Japanese diet using eight food items. According to the JDI score group, the HR, 95%CI, and trend p value was computed. We hypothesized that the Japanese diet might reduce cancer risk of common cancers. 【Results】 In total, 57,017 Japanese Americans (26,982 men and 30,035 women) in the MEC and 10,4504 Japanese residing in Japan (49,751 men and 57,753 women) from the JPHC composed the study population. The MEC Japanese men and women were older and had fewer risk factors for cancer, such as smoking and alcohol consumption, but consumed a less traditional Japanese diet compared to the JPHC. In the MEC, rates of SC, CRC, HCC, LC both in men and women, were lower than those in the JPHC but MEC had a higher incidence of PC in men and BC in women than the JPHC. CRC incidence was similarly high in both studies. Rice consumption was not consistently associated with overall CRC cancer risk but was significantly associated with a reduced risk of distal colon cancer among the men without diabetes in both the MEC and JPHC. The trend was not observed in women of the MEC and JPHC. Lastly, the JDI score was associated with increased risk of SC and reduced risk of BC among women in the MEC but not in JPHC. Other common cancers were not significantly associated with the JDI. 【Discussion】 This study showed that Japanese Americans had higher risks of PC and BC than the JPHC and high incidence of CRC in men and women. The MEC had higher percentages of early- stage diagnosis of PC and BC, possibly indicating a screening effect. Consuming more rice might reduce distal colon cancer in men without diabetes because of resistant starch. Furthermore, a combination traditional Japanese diet, such as rice, miso soup, fish, and green tea, might increase the risk of SC and reduce the risk of BC only in the Japanese Americans women. Adoption of a westernized diet in Japan might increase the risk of distal colon cancer in men and BC in women. More nutrition specific investigations are needed to prevent common cancers among the Japanese Americans.

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Public health, Cancer, Incidence, Japanese, Japanese Diet, MEC

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86 pages

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