This proposal requests support for the US component of a collaborative case-control study of large bowel cancer among Chinese-Americans in Los Angeles and the San Francisco Bay Area, and among Chinese in high and low risk areas of Zhejiang Province, People's Republic of China. Investigators in the two countries will use a common protocol and questionnaire instrument to administer personal interviews to approximately 800 Chinese patients (350-400 Chinese-Americans) with histologically confirmed adenocarcinoma of the colon or rectum, and 2400 cancer-free Chinese controls (1050-1200 Chinese-Americans). Controls will be matched to cases on age, sex, and neighborhood of residence. The information requested from subjects will permit testing of hypotheses relating colorectal cancer risk to 1) dietary factors, including intake of fat (saturated and unsaturated), animal protein, fiber, and vitamins A, C and E; 2) physical activity levels and body mass index; 3) reproductive factors among women; 4) history of bowel disease; and 5) family history of cancer. The information requested of Chinese-American subjects will also permit testing of hypotheses relating cancer risk to such migrant factors as US-vs-Chinese nativity, duration of US residence, and Chinese province of ancestry. The above factors will be tested for associations with cancers of the colon and rectum separately, and with cancers of the large intestine as a whole. The project will examine sex and geographical differences in 1) relative risks for etiologic factors; 2) location of tumors within the large bowel; 3) histologic subtype of adenocarcinoma; and 4) frequency of accompanying polyps. The proposed study has the following strengths: 1) it offers a unique opportunity to elucidate the etiology and pathogenesis of a major group of cancers using populations homogeneous in genetic background but heterogeneous in life style characteristics and in colorectal cancer rates; 2) it draws study subjects from areas in China having both high and low colorectal cancer rates and from areas in the US having the highest population density of Chinese-Americans in the nation; and 3) it fosters improved scientific, scholarly, and diplomatic exchange between the US and the People's Republic of China. The Chinese component of the study has already been funded.
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