International Journal of Epidemiology 2003;32:67-70
© International Epidemiological Association 2003
Special Theme: Genetic Epidemiology |
Commentary: Colon cancer, folate and genetic status
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Rd, Bristol BS8 2PR, UK. E-mail: una.fallon@bristol.ac.uk
| The first 150 words of the full text of this article appear below. |
Colon cancer is the third most common cancer worldwide.1 Vastly different rates between countries,2 migrants quickly assuming the rates of the host country,3 and major changes in rates within populations over short periods of time, suggest that environmental and lifestyle factors are important in its aetiology. Ecological studies have shown that fat,4 meat,2 fibre, and fruit and vegetable consumption5 vary consistently with rates of colon cancer across countries. However, large prospective cohort studies6 and secondary prevention trials of recurrent adenomas79 have not demonstrated robust consistent associations, particularly with fibre and fruit and vegetable intake. Identifying specific constituents of food amenable to preventive interventions is difficult using traditional epidemiological methods. Case-control studies are subject to recall and selection bias. Cohort studies have problems with residual confounding, poorly understood interactions, and co-linearity of nutrients and vitamins, making it impossible to identify their separate effects. Primary prevention trials are possible,10 but likely to
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