Fiber-Deficiency and Colonic Tumors
Most of the evidence that I shall present relating large bowel tumors, both benign and malignant, to low-fiber diets will be epidemiological. As Dr. Hegsted said this morning, epidemiological relationships do not prove anything. However, they do provide an opportunity for formulating hypotheses that subsequently can be tested, and disproved, modified, or confirmed. I shall begin by placing tumors of the colon and rectum in the context of some other diseases with which they are constantly related epidemiologically. These include medical problems of such major importance in the Western world as diverticular disease, the most prevalent disorder of the large bowel; ischemic heart disease, the commonest cause of death; gallstones, the commonest indication for abdominal surgery; hiatus hernia, which is estimated to be present in approximately 20% of the adult population; and appendicitis, which is responsible for the commonest abdominal emergency operation. All of these diseases have their highest prevalence in Western Europe and North America and their lowest in rural Africa and other similar regions (Figure 1). In contrast, the prevalence of all these diseases is comparable in black and white Americans today (Figure 2).
KeywordsHiatus Hernia Acute Appendicitis Large Bowel Diverticular Disease Colonic Tumor
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