nutrition_physical_activity_cancer_-2-11-10_(kucuk)

nutrition_physical_activity_cancer_-2-11-10_(kucuk) - EMORY...

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EMORY UNIVERSITY PREDICTIVE HEALTH EDUCATION February 11, 2010 Diet, Physical Activity and Cancer Omer Kucuk, MD Professor of Hematology, Medical Oncology and Urology Emory Winship Cancer Institute [email protected]
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Percent of all cancer deaths Factor or class of factors Best estimate Range of acceptable estimates Tobacco Alcohol 30 3 25-40 2-4 Diet Food Additives 35 <1 10-70 -5 -2 Occupation 7 4 1-13 2-8 Pollution Industrial products 2 <1 <1-5 <1-2 Medicine & medicinal procedures Geophysical factors 1 3 0.5-3 2-4 Infection Unknown 10 ? ? 1- ? ? Proportion of Cancer Deaths Attributed to Various Different Factors (Doll & Peto, 1981)
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0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Vegetables Fruits Carotenoids Vitamin C Mouth & pharynx Larynx Oesophagus Lung Stomach Pancreas Liver Colon, rectum Breast Ovary Endometrium Cervix Prostate Thyroid Kidney Bladder 3 3 3 3 3 3 3 3 3 2 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3=Decreases risk convincing 2=Decreases risk probable 1=Decreases risk possible Cancers World Cancer Research Fund, 1997
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Mortality from Cancer According to Body Mass Index among US Women in the Cancer Prevention Study II, 1982-1998 (Calle et al. 2003) Types of Cancer Body Mass Index P-trend 18.5-24.9 25.0-29.9 30.0-34.9 35.0-39.9 ≥40.0 All cancers 1.0 1.08 (1.05-1.11) 1.23 (1.18-1.29) 1.32 (1.20-1.44) 1.62 (1.40-1.87) <0.001 Colorectal 1.0 1.10 (1.01-1.19) 1.33 (1.17-1.51) 1.36 (1.06-1.74) 1.46 (0.94-2.24) <0.001 Liver 1.0 1.02 (0.80-1.31) 1.40 (0.97-2.00) 1.68 (0.93-3.05) ---- 0.04 Gallbladder 1.0 1.12 (0.86-1.47) 2.13 (1.56-2.90) ---- ---- <0.001 Pancreatic 1.0 1.11 (1.00-1.24) 1.28 (1.07-1.52) 1.41 (1.01-1.99) 2.76 (1.74-4.36) <0.001 Lung 1.0 0.88 (0.83-0.94) 0.82 (0.72-0.92) 0.66 (0.50-0.86) 0.81 (0.52-1.28) <0.001 Breast 1.0 1.34 (1.23-1.46) 1.63 (1.44-1.85) 1.70 (1.33-2.17) 2.12 (1.41-3.19) <0.001 Corpus & uterine 1.0 1.50 (1.26-1.78) 2.53 (2.02-3.18) 2.77 (1.83-4.18) 6.25 (3.75-10.42) <0.001 Cervical 1.0 1.38 (0.97-1.96) 1.23 (0.71-2.12) 3.20 (1.77-5.78) ---- 0.001
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Cancer and Physical Activity Site # of studies Risk Reduction Level of evidence Colon 43 of 51 40-50% Convincing Breast 32 of 44 30-40% Convincing Prostate 17 of 30 10-30% Probable Uterus 9 of 13 30-40% Possible Lung 8 of 11 30-40% Possible nsufficient data for testis, ovary, kidney, pancreas, thyroid, melanoma
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Multivariate RRs of Overall Mortality According to Joint (Nurses Health Study 1980-2000) Physical Activity (Hour/Week) ≥3.5 1-3.5 <1 BMI <25 RR 1.00 1.18 1.55 BMI 25-30 RR 1.28 1.33 1.64 BMI 30+ RR 1.91 2.05 2.42 (Hu FB, et al. 2004)
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Diet and Fatal Prostate Cancer in SDA Men, 1960-1980 (n = 99 cases) (Snowdon et al, 1984) Milk <1 glass/day 1.0 1-2 glasses/day 1.8 (1.0-3.0) 3+ glasses/day 2.4 (1.3-4.3)
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(Giovannucci et al. 2006) 2 1 0 <500 500- 749 750- 999 1000- 1499 1500- 1999 2000+ Relative Risk Calcium Intake mg/day Fatal (p=0.01) Non-advanced (p=0.55)
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nutrition_physical_activity_cancer_-2-11-10_(kucuk) - EMORY...

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