ABSTRACT
Regional age-adjusted mortality rates of the Federal Republic of Germany from 1976 to 1980 were correlated with regional nutritional data from a national survey on income and consumption. This survey was conducted in 1973 and covered a sample of 50,000 households. The mortality rates due to carcinomas of the stomach, colon, rectum, liver, gallbladder, pancreas, breast, and prostate and the consumption data of 15 nutrients and other compounds are shown for the 11 Federal States. For alcohol, vitamin C and calcium variations range about 20%, whereas deviations in the consumption of protein, fat, and most carbohydrates appear of minor importance. Some of the 45 correlation coefficients significant at the 5% level (out of 210) may have etiologic importance. The associations that coincide in both sexes are alcohol and disaccharide consumption with stomach cancer and protein intake with pancreatic cancer. Because previous habits and consumption may have a stronger etiologic influence than do present ones in the induction of chronic diseases, the utilization of existing information from the 1930s (e.g., Atlas of Ethnic Studies) and the assessment of habits in previous decades by means of case-control studies are emphasized.
Subject(s)
Neoplasms/mortality , Nutritional Physiological Phenomena , Alcohol Drinking , Breast Neoplasms/mortality , Epidemiologic Methods , Feeding Behavior , Female , Gallbladder Neoplasms/mortality , Gastrointestinal Neoplasms/mortality , Germany, West , Humans , Liver Neoplasms/mortality , Male , Pancreatic Neoplasms/mortality , Prostatic Neoplasms/mortality , Sex FactorsABSTRACT
Stomach cancer represents an important cause of death in the Federal Republic of Germany, the regional analysis of mortality rates showing that the rates in Bavaria lay significantly above the national average during the years 1952 till 1978. Within this Federal State the mortality again is not uniform but regions in the Northeast with high rates are distinguishable from low mortality in the Southwest. Furthermore, the analysis by age and birth cohorts shows a decrease of mortality from stomach cancer with later years of birth. The considerable differences in consecutive birth cohorts, given the regional patterns, may indicate a varying exposure to etiological factors, most likely to be sought in the early life of the later cancer victims. In an attempt to clarify the reasons for these regional particularities a case-control study is designed to investigate, among other factors, the etiological relevance of nutritional habits. The possible influence of competing causes of death is discussed.
Subject(s)
Stomach Neoplasms/mortality , Adult , Age Factors , Aged , Female , Germany, West , Humans , Male , Middle Aged , Sex Factors , Time FactorsABSTRACT
The time trends from 1952-1978 show a decreasing mortality from stomach cancer and increasing rates of cancers of the colon, rectum and pancreas in the Federal Republic of Germany. An analysis of regional trends shows that the stomach cancer rates are highest in the Federal State of Bavaria during the last 30 years. The analysis by age and birth cohorts shows a decrease of mortality rates with increasing year of birth. The effect is most pronounced in persons born after 1910 and in the age groups above 60 years. Since the regional pattern shows higher than average rates in Northeastern Bavaria and the lowest rates in the adjacent region of the Federal State of Hessen, a case control study was launched to investigate the possible reasons. This study will include hitherto considered risk factors, which are discussed, and additional information on dietary and traditional habits.
