Seventh-day Adventists (SDAs) are a health-oriented religious group with a conservative lifestyle who do not smoke or drink by church proscription. Among SDAs, mortality for most cancer sites, which are unrelated to smoking, is 50-70% of the general population. The SDA Church strongly discourages the use of coffee, highly refined foods, and hot spices. They also recommend a lacto-ovo-vegetarian diet, which is low in saturated fat and high in fiber, vitamin A, and vitamin C, as well as many other health habits. However, there is great variation in the degree of adherence to these habits among SDAs which makes them an ideal population to investigate the role of diet and other lifestyle characteristics in cancer risk. Furthermore, the great variation in duration of exposure and age at first exposure to the SDA lifestyle provides a unique opportunity to determine the relative effect of lifestyle patterns early vs. late in life. This ongoing prospective study seeks to (1) identify the specific elements of lifestyle that relate to risk of cancer within the SDA population, (2) to identify interactions among lifestyle factors which relate to cancer, and (3) to compare the risk of cancer between SDAs and the general population. Collection of baseline data on demographic characteristics from 61,706 California SDAs, as well as detailed lifestyle characteristics from 40,859 of these subjects, is complete. This application requests funds for 3.5 years which will bring this study to completion. We expect to identify 1130 new cancer cases by record linkage with population based tumor registries and reviewing the hospital records of all hospitalizations which are reported during an annual contact with each subject. Comparison of site specific cancer incidence and mortality among subgroups of the SDA population with differing dietary and/or lifestyle characteristics is likely to identify new (or confirm previously suspected) lifestyle characteristics as risk factors or protective factors for cancer.
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