(Gut 1998;42:442-447)

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A case-control study probing the role of diet on the incidence of colorectal cancer was undertaken in Athens, Greece, in a population characterized by ethnic homogeneity but substantial heterogeneity with respect to dietary habits. The case series consisted of 100 consecutive patients with histologically confirmed colorectal cancer admitted to two large hospitals of Athens during a 16-month period; the control series consisted of orthopaedic patients, admitted to the same hospitals during the same time period, individually matched to the index cases by age and sex. Dietary histories concerning the frequency of consumption (per month or per week) of about 80 food items were obtained by the same interviewer. Cases reported significantly less frequent consumption of vegetables (particularly beets, spinach, lettuce and cabbage) and, independently, significantly more frequent consumption of meat (notably lamb and beef). Between the two extremes (high-vegetable, low-meat diet versus high-meat, low-vegetable diet) a risk ratio of about 8 appears to exist, sufficient (in size and direction) to explain a substantial part of the international variation in the incidence of colorectal cancer. Significant associations were not found with beer or other alcoholic beverages, and significant interactions were not noted with respect to age, sex and anatomic localization (colon vs. rectum).

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A case-control study focusing on the role of diet in the etiology of gastric cancer was undertaken in Piraeus, the sister city of Athens, in a population characterized by ethnic homogeneity but substantial heterogeneity with respect to dietary habits. The case series consisted of 110 consecutive patients with histologically confirmed adenocarcinoma of the stomach, admitted to two teaching hospitals during a 3-year period; the control series consisted of orthopedic patients admitted to a nearby hospital for accidents, fractures and other orthopedic disorders, during the same time period. Dietary histories concerning the frequency of consumption (per month or per week) of about 80 food items were obtained by the same interviewer. Cases reported significantly less frequent consumption of lemons, oranges, brown bread, and raw, salad-type vegetables (particularly lettuce, onions and cucumbers) and, independently, significantly more frequent consumption of pasta, beans and nuts. A relative risk of about 40 was found between extreme quintiles when the above 9 food items were combined in a linear risk score. Use of an index constructed from the study material will clearly overestimate the level of risk between the extreme quintiles, but nevertheless the risk differences appear noteworthy, and consistent with the international variation in the incidence of gastric cancer. No significant associations were found with alcoholic beverages, coffee or tea.

Recent data suggest that the IGF system plays an important role in the pathogenesis of several forms of human cancer, and there is evidence that IGFs acting in an autocrine and paracrine manner may also affect colorectal cancer risk. We have conducted a case‐control study on the island of Crete, Greece, to examine the potential relation between circulating IGF‐I and ‐II and their major binding protein (IGF‐BP3), on the one hand, and colorectal cancer, on the other. IGF‐I, IGF‐II and IGF‐BP3 were determined in the serum from 41 patients with colorectal cancer and 50 healthy controls; data were analyzed using unconditional multiple logistic regression, adjusting for age, gender, education, height and BMI, as well as mutually. Both IGF‐I and IGF‐II were positively, while IGF‐BP3 was inversely, associated with risk for colorectal cancer, though none of these relations reached statistical significance. However, individuals with IGF‐I and –II values in the upper 2 tertiles of the respective distributions had a significantly elevated odds ratio for colorectal cancer (OR = 5.2, 95% confidence interval 1.0–26.8) compared with those in the lower tertile in both distributions. Our results provide evidence that high levels of circulating IGF‐I and ‐II might be associated with colorectal cancer. Int. J. Cancer 83:15–17, 1999. © 1999 Wiley‐Liss, Inc.

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SummaryThe transit times of food residues through the gastrointestinal tract have been studied by administering food mixed with a small amount of barium sulphate. Observations were made on 88 normal subjects, 75 patients with the irritable colon syndrome, and 43 patients with diverticulosis. The transit times were found to be substantially shorter in the patients with diverticula than in normal subjects and to follow closely the transit shown by patients with the irritable colon syndrome. This finding is put forward as evidence supporting the hypothesis that incoordinated colonic activity is the basic abnormality in diverticulosis.We wish to express our gratitude to all the patients and normal subjects who volunteered to take part in this study, the Beer, E. (1904). Amer. 7. med. Sci., 128, 135. Burnett, F. L. (1923). Amer. 7. Roentgenol., 10, 599. Cole, L. G. (1914). Ainer. Y. med. Sci., 148, 92. Edwards, H. C. (1939 It has been generally accepted that diverticulosis of the colon is a common condition in Western countries, especially in the older age groups (Barborka, 1958; Reichman and Watkins, 1962). However, up to the present time the frequcncy of diverticulosis has been calculated from radiological studies carried out on patients or from post-mortem examinations in hospital, and consequently the results apply only to selected sections of the population. Spriggs and Marxer (1925) examined 1,000 consecutive barium enemas and found diverticula in 10%. Rankin and Brown (1930) Until some years ago diverticula were more common in men than in women (Spriggs and Marxer, 1925;Ochsner and Bargen, 1935); recently, however, it appears that a change in sex ratio is taking place and a female preponderance is now commonly observed (Ford, 1953;Brown and Toomey, 1960). Table I shows the sex ratio in diverticulosis and diverticulitis reported by various authors. In a recent study on the prognosis of diverticulosis and diverticulitis (Manousos and Truelove, 1967) it was found that whereas below the age of 60 diverticula were equally common in men and women, above that age the condition was much more common in women. It was also shown that the number of patients admitted to hospital with diverticulosis, diverticulitis, and the complications of diverticular disease is increasing, and this probably indicates a true increase in the prevalence of the disease as a whole.In view of the lack of accurate information on the frequency of diverticulosis in the population at large the present study was made. f Consultant Radiologist, United Oxford Hospitals, Oxford. Methods and SubjectsThe radiological appearances of the colon of 109 subjects without gastrointestinal symptoms were studied. The majority of the subjects were healthv volunteers who were either members of the staff of the Radcliffe Infirmary or visitors to inpatients. A minority of the subjects were patients in a geriatric unit (Cowley Road Hospital, Oxford) who were volunteers and who were completely free from gastrointestinal symptoms.