Cancer Causes & Control

, Volume 9, Issue 6, pp 545–552 | Cite as

Case-control study of diet and prostate cancer in China

  • Marion M. Lee
  • Run-Tian Wang
  • Ann W. Hsing
  • Fung-Liu Gu
  • Tao Wang
  • Margaret Spitz


Introduction: A higher incidence of prostate cancer is observed in the Western world than in Asian countries. Although it is relatively rare in China, an increased incidence has been reported in recent years. Studies in high-risk populations have suggested that dietary fat may play a role in enhancing the risk of developing prostate cancer. However, limited epidemiologic study has never examined the role of diet in low risk populations.

Methods: A case-control study was conducted in 12 cities in China to evaluate the relationship between dietary factors and prostate cancer risk. We conducted personal interviews with 133 histopathologically confirmed prostate cancer cases diagnosed between 1989 to 1992 and 265 neighborhood controls of similar age.

Results: Cases were more likely than controls to consume food with high fat and from animal sources (p<0.01). The daily fat intake and the percentage of energy from fat were statistically significantly higher among cases than among controls (p<0.01). The adjusted odds ratio for total fat between lowest quartiles and highest quartiles was OR=3.6 (95percent C.I. 1.8-7.2); for saturated fat, OR=2.9 (95percent C.I. 1.5- 5.7); and for unsaturated fat, OR=3.3 (95percent C.I. 1.7- 6.3).

Discussion: The data suggest that dietary fat, both saturated and unsaturated, are associated with an increased risk for prostate cancer in a low risk population.

Case-control China diet prostate 


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  1. 1.
    Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J, eds. Cancer Incidence in Five Continents, Vol VI. Lyon, France: International Agency for Research on Cancer, 1992.Google Scholar
  2. 2.
    Parker SL, Tong T, Bolden S, Wingo P. Cancer statistics, 1997. CA Cancer J Clin 1997; 47: 5–27.Google Scholar
  3. 3.
    Jin F, Devesa SS, Zhong W, Blot WJ, Fraumeni JF, Gao YT. Cancer incidence trends in urban Shanghai 1972-1989. Int J Cancer 1993; 53: 764–70.Google Scholar
  4. 4.
    Nomura AMY, Kolonel LN. Prostate cancer: a current perspective. Epidemiol Rev 1991; 13: 200–27.Google Scholar
  5. 5.
    Prentice RL, Sheppard L. Dietary fat and cancer: Consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1990; 1: 81–97.Google Scholar
  6. 6.
    Breslow N, Chan C, Dhom G, et al. Latent carcinoma of the prostate at autopsy in seven years. Int J Cancer 1977; 20: 680–8.Google Scholar
  7. 7.
    Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 1975; 15: 617–31.Google Scholar
  8. 8.
    Graham S, Haughey B, Marshall J, et al. Diet in the epidemiology of carcinoma of the prostate gland. J Natl Cancer Inst 1983; 70: 687–92.Google Scholar
  9. 9.
    Ross RK, Shimizu H, Paganini-Hill A, Honda G, Henderson BE. Case-control studies of prostate cancer in blacks and whites in Southern California. J Natl Cancer Inst 1987; 78: 869–74.Google Scholar
  10. 10.
    West DW, Slaterry MLI, Robinson LM, et al. Adult dietary intake and prostate cancer risk in Utah. A case-control study in Hawaii. A case-control study with special emphasis on agressive tumors. Cancer Causes Control 1991; 2: 85–94.Google Scholar
  11. 11.
    Whittemore A, Kolonel L, Wu AH, et al. Prostate Cancer in relation to diet, physical activity and body size in blacks, whites and Asians in the U.S. and Canada. J Natl Cancer Inst 1995; 87(9): 652–61.Google Scholar
  12. 12.
    Whittemore AS, Wu-Williams AH, Lee M, et al. Diet, physical activity, and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst 1990; 82: 915–26.Google Scholar
  13. 13.
    Wong RT. A study of gastric cancer in Beijing. Chinese J Epidemiol 1992; 6: 23–8.Google Scholar
  14. 14.
    Chen J, Campbell JC, Li J, Peto R. Diet, Lifestyle and Mortality in China: A Study of the Characteristics of 65 Chinese Counties. Oxford (UK): Oxford University Press, 1990Google Scholar
  15. 15.
    Department of Nutrition, Institute of Occupational Health, Environment and Nutrition: Table of Food Composition. Peking (China): The Chinese Academy of Medical Science, 1980.Google Scholar
  16. 16.
    Breslow NE, Day NE. Statistical Methods in Cancer Research. The Analysis of Case-Control Studies. Vol I. IARC Sci Publ No 32. Lyon (France): IARC, 1980.Google Scholar
  17. 17.
    Graham S, Haughey B, Marshall J, et al. Diet in the epidemiology of carcinoma of the prostate gland. J Natl Cancer Inst 1983; 70: 687–92.Google Scholar
  18. 18.
    Kolonel LN. Nutrition and prostate cancer. Cancer Causes Control 1996; 7: 83–94.Google Scholar
  19. 19.
    Giovannucci E, Rimm EB, Colditz GA, et al. A prospective study of dietary fat and risk of prostate cancer. J Natl Cancer Inst 1993; 85: 1571–9.Google Scholar
  20. 20.
    Talamini R, LaVecchia C, Decarli A, Negri E, Franceschi S. Nutrition, social factors and prostatic cancer in Northern Italian population. Br J Cancer 1986; 53: 817–21.Google Scholar
  21. 21.
    Snowdon DA, Phillips RL, Choi W. Diet, obesity, and risk of fatal prostate cancer. Am J Epidemiol 1984; 120: 224–50.Google Scholar
  22. 22.
    Mills PK, Beeson WL, Phillips RL, Fraser GE. Cohort study of diet, lifestyle, and prostate cancer in Adventist men. Cancer 1989; 64: 598–604.Google Scholar
  23. 23.
    LeMarchard L, Kolonel LN, Wilkens LR, Myers BC, Hirohata T. Animal fat consumption and prostate cancer: A prospective study in Hawaii. Epidemiology 1994; 5: 276–82.Google Scholar
  24. 24.
    Hsing AW, McLaughlin JK, Schuman LM, et al. Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study. Cancer Res 1990; 50: 6836–40.Google Scholar
  25. 25.
    Hirayama T. Epidemiology of prostate cancer with special reference to the role of diet. Natl Cancer Inst Monogr 1979; 53: 149–55.Google Scholar
  26. 26.
    Severson RK, Nomura AMY, Grove JS, et al. A prospective study of demographics, diet and prostate cancer among men of Japanese ancestry in Hawaii. Cancer Res 1989; 49: 1857–60.Google Scholar
  27. 27.
    Rose DP, Connolly JM. Dietary fat, fatty acids and prostate cancer. Lipids 1992; 27: 798–30.Google Scholar
  28. 28.
    Mettlin C, Selenskas S, Natarajan N, Huben R. Beta-carotene and animal fats and their relationship to prostate cancer risk: A case-control study. Cancer 1989; 64: 605–12.Google Scholar
  29. 29.
    Middleton B, Byers T, Marshall J, Graham S. Dietary vitamin A and cancer: A multisite case control study. Nutr Cancer 1986; 8: 107–16.Google Scholar
  30. 30.
    Peterson G, Barnes S. Genistein and biochanin A inhibit the growth of human prostate cancer cells but not epidermal growth factor receptor tyrosine autophosphorylation. Prostate 1993; 22: 335–45.Google Scholar
  31. 31.
    Evans BAJ, Griffiths K, Morton MS. Inhibition of 5a-reductase in genital skin fibroblasts and prostate tissue by dietary ligans and isoflavonoids. J Endocrinol 1995; 147: 295–302.Google Scholar
  32. 32.
    Jacobsen BK, Knutsen SF, Fraser GE. Does high soy milk intake reduce prostate cancer incidence? The Adventist Health Study. Cancer Causes Control 1998; 9: 553–7.Google Scholar
  33. 33.
    Swartz GG, Hulka BS. Is vitamin D deficiency a risk factor for prostate cancer? (Hypothesis) Anticancer Res 1990; 10: 1307–11.Google Scholar
  34. 34.
    Giovannucci E. Dietary influences of 1,25(OH)2 vitamin D in relation to prostate cancer: A hypothesis. Cancer Causes Control 1998; 9: 567–82.Google Scholar
  35. 35.
    Chan JM, Giovannucci E, Andersson S, Yuen J, Adami H-O, Wolk A. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998; 9: 559–66.Google Scholar
  36. 36.
    Nomura AMY, Stemmermann GN, Lee J, et al. Serum vitamin D metabolite levels and the subsequent development of prostate cancer. Cancer Causes Control 1998; 9: 425–32.Google Scholar
  37. 37.
    Yu He, Harris RE, Gao YT, Gao R, Wynder E. Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States. Int J Epidemiol 1991; 20: 76–81.Google Scholar
  38. 38.
    Popkin BM, Keyou G, Zai F, Guo X, Ma H, Zohoori N. The nutrition transition China: a cross-sectional analysis. Eur J Clin Nutr 1993; 47: 333–46.Google Scholar
  39. 39.
    Popkin BM, Paeratakul S, Ge K, Zai F. Obesity in China. Am J Public Health 1995; 85: 690–4.Google Scholar
  40. 40.
    Thompson MM, Garland C, Barrett-Connor E, Khaw K, Friedlander NJ, Wingard DL. Heart disease risk factors, diabetes and prostatic cancer in an adult community. Am J Epidemiol 1989; 129: 511–7.Google Scholar
  41. 41.
    Yatani R, Chigusa I, Akazaki K, Stemmerman G, Welsh R, Correa P. Geographic pathology of latent prostatic carcinoma. Int J Cancer 1984; 29: 611–6.Google Scholar
  42. 42.
    Pollard M, Luckert PH. Promotional effects of testosterone and dietary fat on prostate carcinogenesis in genetically susceptible rats. Prostate 1985; 6: 1–5.Google Scholar
  43. 43.
    Clinton SK, Palmer SS, Spriggs CE, Visek WJ. Growth of Dunning transplantable prostate adenocarcinomas in rats fed diets with various fat contents. J Nutr 1988; 118: 908–14.Google Scholar

Copyright information

© Kluwer Academic Publishers 1998

Authors and Affiliations

  • Marion M. Lee
    • 1
  • Run-Tian Wang
    • 2
  • Ann W. Hsing
    • 3
  • Fung-Liu Gu
    • 2
  • Tao Wang
    • 2
  • Margaret Spitz
    • 4
  1. 1.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan Francisco
  2. 2.Department of Epidemiology and Department of Urology, BeijingMedical UniversityBeijingChina
  3. 3.Department of Cancer Epidemiology and GeneticsNational Cancer InstituteUSA
  4. 4.M.D. Anderson Cancer CenterUniversity of Texas at HoustonUSA

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