Seventh-day Adventist Cohort Study: Cancer Epidemiology in Adventists-A Low Risk Group
Lead Contacts and/or Principal Investigators (PIs):
- Synnove Knutsen, M.D., Ph.D.
- Gary Fraser, M.B.Ch.B., Ph.D., M.P.H.
Loma Linda University School of Health Research
Funded Since: 2001
Funding Source: Linda University and World Cancer Research Fund
Year(s) of Enrollment: 2002-2007
Study Website: http://www.llu.edu/public-health/health/index.page
The investigators have formed a cohort study of 71,000 white and 25,000 black adult Seventh-day Adventists who were enrolled from across the United States. This cohort will enable questions about diet and cancer to be addressed that are not easily answered with other study populations.
Taking advantage of the unusual dietary habits of Adventists, the special focus of this research is to investigate associations between soy intake, long chain fatty acids, calcium intake, and cancers of the breast, prostate, and colon. About half of black and white Adventists consume quantities of soy similar to the China or Singapore population. Adventists also vary widely in their intake of calcium. The increasing use of soy and calcium supplements by the American population warrants further evidential support.
The very high incidence and mortality ascribed to prostate cancer in black men may be associated with their dietary habits. The investigators have completed a substantial amount of pilot work with black Adventists. In the past, however, they had not yet successfully established a cohort of black members. Cohort members were enrolled church-by-church using a pretested plan whereby institutional media and respected members at individual churches promoted the study. Participants completed a comprehensive questionnaire that was pretested.
Cancer surveillance during follow-up is by matching with state tumor registries where possible, matching with the National Death Index, and by obtaining and coding hospitalization records as necessary. Calibration studies in both black and white Adventists will allow bias correction. The investigators believe that it is important to also gather blood, urine, and subcutaneous fat from the study participants, and have a completed representative calibration study (n=1,011) to accomplish this.
The Adventist population has cooperated with epidemiologic investigators for many years and has some unusual strengths as a research population, including the virtual absence of confounding by tobacco and alcohol, the wide range of dietary habits, and the widespread use of soy products. They have made important contributions to the understanding of diet and chronic disease in the past. This cohort study will provide much greater statistical power, more accurate and documented exposure assessment, and includes a larger cohort of black Adventists than past studies.