Stomach Cancer Among Japanese in Hawaii2

Study of 220 Japanese stomach cancer patients and 440 hospital controls in Hawaii revealed that migrants (Issei) from prefectures with the highest stomach cancer risks in Japan continued to display an excess risk in Hawaii, but this effect did not persist among their Nisei offspring. Lower risks were suggested for Nisei, but not Issei adhering to Western-style diets. These nativity distinctions are consistent with other studies suggesting that early exposures are critical. Associations of stomach cancer with consumption of specific foods were noted. Elevated risks were described for Issei and Nisei users of pickled vegetables and dried/salted fish, the most frequent consumers having the highest risks. Since similar associations did not appear for raw fish and unprocessed vegetables, suspicion is directed to methods of preparation. Low risks were suggested for several Western vegetables, many of which are eaten raw. The associations for uncooked vegetables appeared independent of those found for pickled vegetables; both persisted after control for other facets of vegetable consumption. Associations for tobacco, liquor, coffee, and milk were observed only in the Issei population. Points of consistency between the Hawaii findings and those assembled in Japan are cited. Experimental evidence bearing on the epidemiologic data for processed fish and vegetables is mentioned.—J Natl Cancer Inst 49: 969–988, 1972.