Shanghai Men's Health Study: Cohort Study of Cancer- Inhibitory Factors in Men

Xiao O. Shu, M.D., Ph.D.
Vanderbilt University Medical Center
Department of Medicine
Nashville, Tenn.
Funded since 2001

This research is to establish a cohort of adult men in Shanghai for a long-term epidemiological study of cancer and other chronic diseases, with a focus on identifying modifiable protective dietary factors for cancers. It will build upon the investigators' recent sucess in the Shanghai Women's Health Study (SWHS), which is a prospective cohort study of 75,000 women.

The aims are to:

• conduct in-person interviews and follow-up for cancer incidence and total mortality of 60,000 men who live in the seven SWHS communities and who are primarily between ages 40 to 70 years (30,000 of them are husbands of the SWHS participants); and
• collect and store baseline blood and urine samples from a subset of cohort members (30,000) and post-diagnostic blood samples from all men diagnosed with cancer during the follow-up period.

This cohort study will enable the investigators to test a spectrum of etiologic hypotheses for major cancers. The focus is on examination of the potential cancer-inhibitory effects of the following foods (their major phytochemical constituents):

• tea (polyphenols),
• soy foods (isoflavones),
• allium vegetables (organosulfur compounds),
• crucifers (isothiocyanates, dithiolthiones, indoles), and
• dark green-leafy vegetables (lutein and others).

In addition, the investigators will explore associations between cancer and specific oriental foods, such as bok choy, Chinese cabbage, white radish, ginger root, and ginseng. This research will be highly cost-efficient because most of the study participants have been recruited as part of the SWHS. The procedures for follow-up and dietary assessment have been developed, and feasibility of the study has been clearly demonstrated.

While hundreds of cancer epidemiological studies have been conducted, few have, as a primary goal, focused on identifying dietary protective factors. Men in Shanghai differ substantially from those in the United States in dietary and other exposure patterns, including high intake of tea, soy foods, and many other vegetables.

Given such exposure patterns, this study provides unique, unparalleled opportunities to examine many important etiologic hypotheses that cannot be addressed adequately among men in the United States and other Western countries. The stored blood and urine samples will be valuable for future studies of biologic variables and their interactions with environmental factors in the etiology of cancers, particularly for testing novel hypotheses when new knowledge and laboratory technology become available.