Skip to main content
SpringerLink
Log in

The epidemiology of cancer of the large bowel

  • National Large-Bowel Cancer Project — First Workshop on Large-Bowel Cancer (Part I)
  • Workshop in Colon Cancer—Plenary Session Paper
  • Published:
The American Journal of Digestive Diseases Aims and scope Submit manuscript

Abstract

The geographic distribution of cancer of the colon, particularly its low incidence in Japan, its increase among Japanese immigrants to the United States, and the high rate of this disease among North Americans and most Western Europeans, indicate that environmental factors are of etiological significance in the development of this disease. Available evidence suggests an association of colon cancer to dietary factors, largely related to dietary fat intake. Studies in metabolic epidemiology have shown a correiation between dietary fat intake and the composition of intestinal micro-flora, and between the fecal bile acids and cholesterol metabolites. A significant association has also been established between the level of fecal anaerobic bacteria, bacterial β-glucuronidase activity, bile acid and cholesterol metabolites, and the risk of colon cancer among different populations. We also found that in the rat model, lithocholic acid and deoxycholic acid, which are present in high concentration in the stool of man, acted as tumor promotors to an established large-bowel carcinogen. It remains to be shown whether this established association is causative in nature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. US Public Health Service: Vital statistics of the United States, 1968, Vol. II. Mortality. Part A, DHEW publication no. (HSM) 72-110. Bethesda, US Department of Health Education and Welfare, 1972

    Google Scholar 

  2. Japan Health and Welfare Statistics Division Minister's Secretariat: Vital statistics, 1968, Japan. Vol. 2. Tokyo, Ministry of Health and Welfare, 1968

    Google Scholar 

  3. US Public Health Service: Preliminary report. Third national cancer survey, 1969. Incidence. DHEW publication no. (NIH) 72-128. Bethesda, US Department of Health Education and Welfare, 1971

    Google Scholar 

  4. Phillips RL, Kuzma JW, Lemon FR, Walden RT: Mortality from colon-rectal cancer among California Seventh Day Adventists. Paper presented at Annual Meeting of the American Public Health Association, San Francisco, November 8, 1973

  5. Newill VA: Distribution of cancer mortality among ethnic subgroups of the white population of New York City, 1953–58. J Natl Cancer Inst 26:405–417, 1961

    Google Scholar 

  6. Seidman H: Cancer death rates by site and sex for religious and socioeconomic groups in New York City. Environ Res 3:234–250, 1970

    Google Scholar 

  7. Kato H, Tillotson J, Nichaman MZ, Rhoads GG, Hamilton HB: Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California. Am J Epidemiol 97:372–385, 1973

    Google Scholar 

  8. Haenszel W, Berg JW, Segi M, Kurihara M, Locke FB: Large bowel cancer in Hawaiian Japanese. J Natl Cancer Inst 51:1765–1779, 1973

    Google Scholar 

  9. Segi M, Kurihara M: Cancer mortality for selected sites in 24 countries, No. 6 (1966–1967). Tokyo, Japan Cancer Society, 1972

    Google Scholar 

  10. Segi M, Kurihara M: Mortality from selected causes in 30 countries (1950–1961). Tokyo, Japan Cancer Society, 1972

    Google Scholar 

  11. US Public Health Service: Arteriosclerocis. Report by National Heart and Lung Institute Task Force on Arteriosclerocis, Vol. II, DHEW publication no. (NIH) 72-219. Bethesda, US Department of Health, Education, and Welfare, 1971

    Google Scholar 

  12. World Health Organization: Mortality from malignant neoplasms 1955–1965, Parts I and II. Geneva, World Health Organization, 1970

    Google Scholar 

  13. Food and Agriculture Organization of the United Nations: Production yearbook, Vol. 23, 1969. Rome, Food and Agriculture Organization, 1970

    Google Scholar 

  14. Wynder EL, Shigematsu T: Environmental factors of cancer of the colon and rectum. Cancer 20:1520–1561, 1967

    Google Scholar 

  15. Wynder EL, Kajitani T, Ishikawa S, Dodo H, Takano A: Environmental factors of cancer of the colon and rectum. II. Japanese eipdemiological data. Cancer 23:1210–1220, 1969

    Google Scholar 

  16. Rose G, Blackburn H, Keys A, Taylor HL, Kanel WB, Paul O, Reid DD, Stamler J: Colon cancer and blood cholesterol. Lancet 1:181–183, 1974

    Google Scholar 

  17. Burkitt DP: Epidemiology of cancer of the colon and rectum. Cancer 28:3–13, 1971

    Google Scholar 

  18. Selikoff IJ, Churg J, Hammond EC: Asbestos exposure and neoplasia. JAMA 188:22–26, 1964

    Google Scholar 

  19. Correa P, Llanos G: Morbidity and mortality from cancer in Cali, Columbia. J Natl Cancer Inst 36:717–745, 1966

    Google Scholar 

  20. Lacassagne A, Buu-Hoi NP, Zajdela F: Carcinogenic activity of apocholic acid. Nature 190:1007–1008, 1961

    Google Scholar 

  21. Lacassagne A, Buu-Hoi NP, Zajdela F: Carcinogenic activity in situ of further steroid compounds. Nature 209:1026–1027, 1966

    Google Scholar 

  22. Cook JW, Kennaway EL, Kennaway NM: Production of tumors in mice by deoxycholic acid. Nature 145:627, 1940

    Google Scholar 

  23. Haddow A: Chemical carcinogens and their modes of action. Br Med Bull 14:79–92, 1958

    Google Scholar 

  24. Hill MJ, Crowther JS, Drasar BS, Hawksworth G, Aries V, Williams REO: Bacteria and aetiology of cancer of the large bowel. Lancet 1:95–100, 1971

    Google Scholar 

  25. Reddy BS, Wynder EL: Large bowel carcinogenesis: fecal constituents of populations with diverse incidence rates of colon cancer. J Natl Cancer Inst 50:1437–1442, 1973

    Google Scholar 

  26. Reddy BS, Weisburger JH, Wynder EL: Fecal bacterial β-glucuronidase: control by diet. Science 183:416–417, 1974

    Google Scholar 

  27. Reddy BS, Dhar AK, Weisburger JH, Wynder EL: Effect of high-risk and low-risk diets for colon carcinogenesis on fecal bile acids and neutral steroids in man. Fed Proc 33:663, 1974

    Google Scholar 

  28. Finegold SM, Sutter VL, Boyle JD, Shimada K: The normal flora of ileostomy and transverse colostomy effluents. J Infect Dis 122:376–381, 1970

    Google Scholar 

  29. Hill MJ: Bacteria and the etiology of colon cancer. Cancer, in press, 1974

  30. Reddy BS, Wynder EL: Unpublished data, 1974

  31. Narisawa T, Magadia N, Weisburger JH, Wynder EL: Unpublished data, 1974

  32. Reddy BS, Weisburger JH, Wynder EL: Effect of dietary fat level and dimethylhydrazine on fecal acid and neutral sterol excretion and colon carcinogenesis in rats. J Natl Cancer Inst 52:507–511, 1974

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisions of Epidemiology and Nutrition, the Naylor Dana Institute for Disease Prevention, American Health Foundation, 1370 Avenue of the Americas, 10019, New York, New York

    Ernest L. Wynder MD & Bandaru S. Reddy DVM, PhD

Authors
  1. Ernest L. Wynder MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bandaru S. Reddy DVM, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported in part by NIH contract No. 1-CP-12310 and grant CA-16382 from the National Cancer Institute and by the American Health Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wynder, E.L., Reddy, B.S. The epidemiology of cancer of the large bowel. Digest Dis Sci 19, 937–946 (1974). https://doi.org/10.1007/BF01076220

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01076220

Keywords

Search

Navigation