Singapore Chinese Health Study
Lead Contact and/or Principal Investigator (PI):
- Woon-Puay Koh, Ph.D., M.B.B.S.
Duke-NUS Medical School
- Jian-Min Yuan, M.D., M.P.H., Ph.D.
University of Pittsburgh Cancer Institute
Years Funded: 1993
Funding Source: NCI Extramural Program (Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences; CA144034)
Year(s) of Enrollment: 1993-1998
The current research project continues support for a residential cohort of 63,257 middle-aged and older (45 to 74 years of age) Singapore Chinese men and women accrued between 1993 and 1998. At recruitment, each study participant was interviewed in person by a trained interviewer using a structured questionnaire that emphasized current diet assessed via a validated, 165-item food frequency questionnaire.
By April 2005, all surviving cohort participants had been recontacted for biospecimen donation. Samples were obtained from 32,543 subjects (28,330 bloods, 4,400 buccal cells, 31,895 urines), representing a consent rate of approximately 60 percent. The cohort has been followed for death, cancer occurrence, and other major health outcome occurrences through regular record linkage with the population-based Singapore Cancer Registry and the Singapore Registry of Births and Deaths, and through telephone follow-up interviews. The observed numbers of incident cancers and deaths within the cohort are comparable to corresponding expected numbers based on age- and sex-specific incidence rates for all Chinese in Singapore.
This prospective cohort study has contributed a wealth of knowledge on the role of dietary and other environmental factors in the etiology of cancer. More than 60 peer-reviewed articles have emanated from this study. Significant scientific contributions include finding:
- an inverse association between soy intake and markers of breast cancer risk, including mammographic parenchymal patterns (Cancer Epidemiol Biomarkers Prev. 2002 Jul;11(7):608-13) and serum estrogens (Cancer Epidemiol Biomarkers Prev. 2002 Sep;11(9):844-51);
- an adverse effect of soy intake on bladder cancer risk (Cancer Epidemiol Biomarkers Prev. 2002 Dec;11(12):1674-7);
- a protective effect of dietary isothiocyanates on colon cancer risk, especially among individuals deficient in glutathione S-transferases (Carcinogenesis. 2002 Dec;23(12):2055-61);
- an adverse effect of n-6 fatty acids in the presence of low fish (or n-3 marine fatty acids) intake on breast cancer risk (Br J Cancer. 2003 Nov 3;89(9):1686-92);
- an application of statistical modeling to simultaneously correct for dietary measurement errors and residual confounding by smoking to demonstrate an unequivocal beneficial effect of dietary beta-cryptoxanthin on lung cancer risk (Cancer Epidemiol Biomarkers Prev. 2003 Sep;12(9):890-8);
- an association between angiotensin-converting enzyme genotype and breast cancer risk (Cancer Res. 2003 Feb 1;63(3):573-8);
- an association between vitamin D receptor genotype and colon cancer risk (Carcinogenesis. 2003 Jun;24(6):1091-5);
- an interaction effect between COX-2 gene and dietary n-6 fatty acids on colon cancer risk (Br J Cancer. 2004 May 4;90(9):1760-4);
- an inverse association between green tea intake and breast cancer risk (Carcinogenesis. 2005 Aug;26(8):1389-94);
- a positive association between type II diabetes and risk of colorectal cancer (J Natl Cancer Inst. 2006 Jan 18;98(2):135-8);
- an association between peroxisome proliferator-activated receptor (PPAR) γ gene polymorphisms and colorectal cancer risk (Carcinogenesis. 2006 Sep;27(9):1797-802);
- the effect of the cyclin D1 (CCND1) A870G polymorphism on colorectal cancer risk is modified by glutathione S-transferase polymorphisms and isothiocyanate intake (Carcinogenesis. 2006 Dec;27(12):2475-82);
- DNA repair SNPs modify the effect of cigarette smoking and alcohol on colorectal cancer development (Cancer Epidemiol Biomarkers Prev. 2007 Nov;16(11):2363-72);
- irregular sleeping duration and low melatonin levels are associated with increased risk of breast cancer (Carcinogenesis. 2008 Jun;29(6):1244-8);
- an inverse association between soy intake and breast cancer risk (Br J Cancer. 2008 Jul 8;99(1):196-200);
- an inverse association between green tea intake and mammographic density (Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3358-65), and the interaction between green tea intake and MTHFR/TYMS genetic polymorphisms on breast cancer risk (Carcinogenesis. 2008 Oct;29(10):1967-72);
- an association between a vegetable-fruit-soy rich dietary pattern and reduced risk of colorectal cancer (Br J Cancer. 2008 Nov 4;99(9):1511-6);
- an adverse effect of marine n-3 fatty acids on colon cancer (Int J Cancer. 2009 Feb 1;124(3):678-86); and
- an inverse association between soy intake and risk of non-smoking related lung cancer ;among women (Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):821-7).