CHICAGO—High consumption of red and processed meat over a long period of time is associated with an increased risk for a certain type of colon cancer, according to a study in the January 12 issue of JAMA.

Meat consumption has been associated with colorectal cancer in previous studies, but the strength of the association and types of meat involved have not been consistent, according to background information in the article. Few studies have evaluated long-term meat consumption or the relationship between meat consumption and the risk of rectal cancer. Clarifying the role of meat consumption and any subsequent development of colorectal cancer is important because meat is an integral component of diet in the United States and many other countries in which colorectal cancer is common. Per capita annual consumption of beef has increased in the United States since 1993, reversing a previous decrease since 1976.

Ann Chao, Ph.D., of the American Cancer Society, Atlanta, and colleagues examined the relationship between recent and long-term meat consumption and the risk of colon and rectal cancer. The study included 148,610 adults aged 50 to 74 years, residing in 21 states with population-based cancer registries, who provided information on meat consumption in 1982 and again in 1992/1993 when enrolled in the Cancer Prevention Study II (CPS II) Nutrition Cohort. Follow-up from time of enrollment in 1992/1993 through August 31, 2001, identified 1,667 incident colorectal cancers.

The researchers found that high intake of red and processed meat reported in 1992/1993 was associated with higher risk of colon cancer after adjusting for age and energy intake but not after further adjustment for body mass index, cigarette smoking, and other covariates. When long-term consumption was considered, persons in the highest tertile of consumption in both 1982 and 1992/1993 had a 50 percent higher risk of distal colon cancer (a section of the colon near the rectum) associated with processed meat, and those persons with the highest ratio of red meat-to-poultry and fish had a 53 percent increased risk of distal colon cancer, relative to those persons in the lowest tertile at both time points. Long-term consumption of poultry and fish was inversely associated with risk of both proximal and distal colon cancer. High consumption of red meat reported in 1992/1993 was associated with a 71 percent higher risk of rectal cancer, as was high consumption reported in both 1982 and 1992/1993 (43 percent increased risk).

ELEVATED GLUCOSE LEVELS AND DIABETES ARE ASSOCIATED WITH INCREASED RISK FOR CANCER

CHICAGO—New research involving more than one million people indicates that having high fasting serum glucose levels and diabetes are risk factors for several major cancers, according to a study in the January 12 issue of JAMA.

Diabetes mellitus is a serious and costly disease that is becoming increasingly common in many countries, including Korea, the site of this study, according to background information in the article. Recent data show that approximately 150 million people have diabetes mellitus worldwide, and this number may double by 2025, especially in developing countries, because of population growth, aging, unhealthy diets, obesity, and sedentary lifestyles.

Sun Ha Jee, Ph.D., M.H.S., of the Graduate School of Public Health, Yonsei University, Seoul, Korea, and colleagues examined the relationship between fasting serum glucose and diabetes and risk of all cancers and specific cancers in men and women in Korea. The 10 year Korean Cancer Prevention Study (KCPS) included 1,298,385 Koreans (829,770 men and 468,615 women) aged 30 to 95 years who received health insurance from the National Health Insurance Corp. and had a biennial medical evaluation in 1992-1995.

During the 10 years of follow-up, there were 20,566 cancer deaths in men and 5,907 cancer deaths in women. The researchers found that, while controlling for smoking and alcohol use, the group with the highest fasting serum glucose (140 mg/dL or greater [7.8 mmol/L or greater]) had a higher death rates from all cancers combined (29 percent higher for men; 23 percent higher for women) compared with the group with the lowest level (less than 90 mg/dL [less than 5.0 mmol/L]). By cancer site, the association was strongest for pancreatic cancer, comparing the highest and lowest stratums (91 percent increased risk in men; more than twice the risk for women). Significant associations were also found for cancers of the esophagus, liver, and colon/rectum in men and of the liver and cervix in women, and there were significant trends with glucose level for cancers of the esophagus, colon/rectum, liver, pancreas, and bile duct in men and of the liver and pancreas in women.

Of the 26,473 total cancer deaths in men and women, 848 were estimated as attributable to having a fasting serum glucose level of more than 90/mg/dL. For cancer incidence, the general patterns reflected those found for mortality. For persons with a diagnosis of diabetes or a fasting serum glucose level greater than 125 mg/dL (6.9 mmol/L), risks for cancer incidence and mortality were generally elevated compared with those without diabetes.

CHICAGO—Nearly 40 U.S. Army Rangers returning from Afghanistan in 2002 may have contracted malaria because of inadequate use of preventive measures, according to a study in the January 12 issue of JAMA.

War and conflict have had a long historical partnership with malarial outbreaks, according to background information in the article. Disruptions in health care infrastructure, maneuvering of numerous military personnel, and exposure of individuals with nominal or no immunity all bring about an increased risk for the disease. Throughout history, disease and nonbattle injuries have caused more casualties than combat action among military personnel, with malaria having a significant impact on many military operations.

U.S. Army soldiers operating in endemic regions are directed to consume antimalaria chemoprophylaxis and use personal protective measures, including minimizing exposed skin through proper wear of the uniform and use of bed nets, impregnating uniforms and bed nets with permethrin, and frequently applying topical insect repellent (33 percent diethyltoluamide [DEET]) to exposed skin.

Russ S. Kotwal, M.D., M.P.H., of the Naval Operational Medicine Institute, Pensacola, Fla., and colleagues conducted a study to determine the extent of malaria in U.S. Army personnel deployed to a combat zone. The unit studied was the 725-man Ranger Task Force that deployed to eastern Afghanistan between June and September 2002.

The researchers found that a total of 38 patients were infected with malaria, yielding an attack rate of 52.4 cases per 1,000 soldiers. Diagnosis was confirmed a median of 233 days (range, 1-339 days) after return from the malaria endemic region, with additional laboratory findings noting anemia and thrombocytopenia (a blood disease).

From an anonymous postdeployment survey of 72 percent (521/725) of the task force, the self-reported compliance rate was 52 percent for weekly chemoprophylaxis, 41 percent for terminal (postdeployment) chemoprophylaxis, 31 percent for both weekly and terminal chemoprophylaxis, 82 percent for treating uniforms with permethrin, and 29 percent for application of insect repellent.

LONG-TERM, HIGH CONSUMPTION OF RED AND PROCESSED MEAT LINKED TO 50% INCREASE IN COLORECTAL CANCER RISK - FISH AND CHICKEN LINKED TO DECREASED RISK

VIDEO:
B-ROLL
Raw hamburgers, cooked steaks, sandwich, cook preparing burgers

AUDIO:
HAMBURGERS, STEAKS, PROCESSED DELI MEATS. AMERICANS LOVE THESE FOODS, AND EAT LOTS OF THEM.

AUDIO:
"I eat red meat, ya."

VIDEO:
SOT/FULL
@: 08
Super: Karen Nutt
Eats red meat
Runs :04

AUDIO:
"I do cook a lot of red meat, just because it's easy and it's quick."

VIDEO:
B-ROLL
Woman eating steak
Woman eating gyro

AUDIO:
BUT EATING TOO MUCH RED OR PROCESSED MEAT, SAY ONCE A DAY OR MORE, OVER MANY YEARS, CAN INCREASE YOUR RISK OF CANCER IN THE COLON OR RECTUM.

VIDEO:
NAT SOT UP FULL FOR :08
Dr. Thun pointing at graphic on computer - close-up on graphic.

AUDIO:
"Most of the association with red meat was in the distal part of the colon, and much of the association with processed meat was in the rectum."

VIDEO:
B-ROLL
Dr. Thun and colleagues going over data
Elderly people eating lunch
GFX/JAMA COVER

AUDIO:
DR. MICHAEL THUN (Tune) AND COLLEAGUES AT THE AMERICAN CANCER SOCIETY SURVEYED ABOUT 150-THOUSAND PEOPLE, AGES 50 TO 74, ABOUT THEIR EATING HABITS AND HEALTH STATUS. STUDY PARTICIPANTS FILLED OUT QUESTIONAIRRES IN 1982 AND 1992, AND RESEARCHERS FOLLOWED UP ON THEIR HEALTH STATUS UNTIL 2001. THE FINDINGS APPEAR IN JAMA, THE JOURNAL OF THE AMERICAN ASSOCIATION.

VIDEO:
SOT/FULL 1:4:26-:37
@:50
Super: Michael Thun, M.D., M.S.
American Cancer Society
Runs :11

AUDIO:
"For people who reported high consumption of red meat and processed meat on both questionnaires, that is long-term high consumption, we found about a 50 percent higher risk of colon cancer."

VIDEO:
B-ROLL
Raw beef, Pork dish, lamb on grill
Sliced cold cuts/cooked bacon
Man eating Gyro
Cooked chicken on plate with pasta
Pan of seafood case (raw seafood)

AUDIO:
THE RESEARCHERS DEFINED RED MEAT AS BEEF, PORK AND LAMB, AND PROCESSED MEAT INCLUDED COLD CUTS AND BACON. HIGH CONSUMPTION MEANT EATING SUCH FOOD ABOUT NINE TIMES A WEEK. THE STUDY ALSO LOOKED AT CHICKEN AND FISH CONSUMPTION, AND FOUND SOME GOOD NEWS ABOUT COLON CANCER RISK.

VIDEO:
SOT/FULL
Michael Thun, M.D., M.S.
American Cancer Society
Runs :15

AUDIO:
"The consumption of fish and chicken was related to lower risk and this was not just a function of displacing red meat in the diet, but it actually was significantly related to lower risk on its own."

VIDEO:
B-ROLL
Chef cooking fish on grill

AUDIO:
SO EATING MORE CHICKEN AND FISH MAY BE A GOOD THING, ALONG WITH CUTTING BACK RED MEAT TO ONCE OR TWICE A WEEK.

VIDEO:
SOT/FULL
Michael Thun, M.D., M.S.
American Cancer Society
Runs :11

AUDIO:
"Having a steak to celebrate is not really going to affect your risk of colon cancer, but if meat is a central component of your diet over a long period of time, that could well affect your risk."

VIDEO:
B-ROLL
Close up - Raw steak in grocery store

AUDIO:
THIS IS MAVIS PRALL REPORTING.