In spite of the high incidence of high-grade squamous intraepithelial lesions (SIL) (CIN II and CIN III) of the cervix among minorities in the U.S., and the importance of SIL in the natural history of cervical cancer. few risk factors for this disease have been identified. The objective of this multiethnic, matched case-control study is to more fully examine the associations of dietary and serum nutrient levels, human papillomavirus, and tobacco smoking on the risk for high-grade SIL. Subjects will be identified in two clinics on Oahu during the 5-year period 1992 to 1995. Cases will include 600 women with histologically- confirmed, high-grade SIL from any of the following ethnic groups: Hawaiian, Japanese, Chinese, Filipino, and Caucasian. Eligible controls will be women with negative pap smears. One control will be matched to each case on age (plus-or-minus 5 years) ethnicity, and clinic. A personal interview will include the following content areas: demographic information, diet history, reproductive and sexual history, hormone use, medical history, lifetime history of tobacco use, environmental tobacco smoke exposure, personal hygiene, and physical activity. A fasting blood specimen will be obtained to determine plasma erythrocyte levels of retinol, retinol esters, alpha- and gamma- tocopherol, alpha- and beta-carotene, lycopene, canthaxanthin, beta- crytoxanthin, lutein, folate, ascorbic acid, cholesterol, and cotinine, the presence of papillomavirus subtypes will be determined in exfoliated cell samples. Data analysis will examine the independent associations and interactive effects of dietary and biochemical measures of nutritional status, papillomavirus, tobacco smoke exposure, and other variables on the risk for high-grade SIL, using multiple conditional logistic regression. The study sample will provide sufficient statistical power to detect relatively weak exposure-disease relationships. This multiethnic, interdisciplinary study should contribute to an understanding of the epidemiology of high-grade SIL, particularly the role of dietary factors in its etiology. Given the well-recognized continuum of disease from dysplasia to carcinoma in situ to invasive cancer, this study will allow for the identification of risk factors for early lesions of the cervix which are potentially reversible. The findings should be especially pertinent to future efforts to control cervical disease among Native Hawaiians and other minorities, since dietary and infectious factors are amenable to modification.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
1R01CA055700-01
Application #
3200214
Study Section
Special Emphasis Panel (SRC (40))
Project Start
1991-09-30
Project End
1996-07-31
Budget Start
1991-09-30
Budget End
1992-07-31
Support Year
1
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Hawaii
Department
Type
Organized Research Units
DUNS #
121911077
City
Honolulu
State
HI
Country
United States
Zip Code
96822
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Hernandez, Brenda Y; McDuffie, Katharine; Wilkens, Lynne R et al. (2003) Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12. Cancer Causes Control 14:859-70
Goodman, M T; McDuffie, K; Hernandez, B et al. (2001) Association of methylenetetrahydrofolate reductase polymorphism C677T and dietary folate with the risk of cervical dysplasia. Cancer Epidemiol Biomarkers Prev 10:1275-80
Goodman, M T (2001) Local studies address a previously hidden sexually transmitted disease: human papillomavirus and cervical neoplasia. Hawaii Med J 60:236-8
Goodman, M T; McDuffie, K; Hernandez, B et al. (2001) CYP1A1, GSTM1, and GSTT1 polymorphisms and the risk of cervical squamous intraepithelial lesions in a multiethnic population. Gynecol Oncol 81:263-9
Goodman, M T; McDuffie, K; Hernandez, B et al. (2000) Case-control study of plasma folate, homocysteine, vitamin B(12), and cysteine as markers of cervical dysplasia. Cancer 89:376-82
Goodman, M T; Kiviat, N; McDuffie, K et al. (1998) The association of plasma micronutrients with the risk of cervical dysplasia in Hawaii. Cancer Epidemiol Biomarkers Prev 7:537-44
Goodman, M T; Hernandez, B; Wilkens, L R et al. (1998) Effects of beta-carotene and alpha-tocopherol on bleomycin-induced chromosomal damage. Cancer Epidemiol Biomarkers Prev 7:113-7
Goodman, M T; Hankin, J H; Wilkens, L R et al. (1997) Diet, body size, physical activity, and the risk of endometrial cancer. Cancer Res 57:5077-85
Goodman, M T; Wilkens, L R; Hankin, J H et al. (1997) Association of soy and fiber consumption with the risk of endometrial cancer. Am J Epidemiol 146:294-306