CANCER INCIDENCE IN THE NATIONAL-HEALTH-AND-NUTRITION-SURVEY-I FOLLOW-UP DATA - DIABETES, CHOLESTEROL, PULSE, AND PHYSICAL-ACTIVITY

We examined cancer incidence among 14,407 men and women who were enrol led in the National Health and Nutrition Survey I in the early 1970s a nd then followed through 1987. We studied 657 male and 593 female canc er cases, using Cox regression. Analyses were conducted for all cancer s, lung, colorectal, breast, and prostate cancer. Analyses focused on diabetes, cholesterol, pulse, and physical activity, four risk factors with limited or inconsistent prior evidence. All four risk factors we re modestly associated with all cancers for men but not for women. For diabetic men, the rate ratio for all cancers was 1.38 [95% confidence interval (CI) = 1.00-1.91]; the elevated risk was particularly eviden t for colorectal and prostate cancer. Slight inverse trends of cancer risk with cholesterol were apparent for men but not for women and were diminished compared to prior analyses of these data with less follow- up. Males with the lowest quartile of cholesterol versus the highest h ad a rate ratio of 1.21 (CI = 0.98-1.51) for all cancers. A modest pos itive trend between pulse and all cancers was seen for males [rate rat io of 1.27 (CI = 1.04-1.57)] for the highest versus the lowest quartil e). The rate ratio for men with the least amount of nonrecreational ph ysical activity was 1.29 (CI = 0.99-1.69). There is some evidence in t hese data that findings for cholesterol and nonrecreational physical a ctivity could be artifacts of the early effects of disease because the y diminished when eases were restricted to those with longer follow-up .