Seventh-day Adventist Cohort Study: Cancer Epidemiology in Adventists-A Low Risk Group

Gary Fraser, M.B.Ch.B., Ph.D., M.P.H.
Loma Linda University School of Health Research
Department of Medicine, Loma Linda, Calif.
Funded since 2001
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The investigators are developing a cohort study of 80,000 white and 45,000 black adult Seventh-day Adventists who are being enrolled from across the United States. This cohort will enable questions about diet to be addressed that are not easily answered with other study populations.

Taking advantage of the unusual dietary habits of Adventists, the special focus of this research is to investigate associations between soy intake, calcium intake, and cancers of the breast, prostate, and colon. About half of black and white Adventists consume quantities of soy similar to the China or Singapore population. Adventists also have a wide variance in intake of calcium. The increasing use of soy and calcium supplements by the American population warrants further evidential support.

The very high incidence and mortality ascribed to prostate cancer in black men may be associated with their dietary habits. The investigators have completed a substantial amount of pilot work with black Adventists. In the past, however, they had not yet established a successful cohort of black members. Cohort members are being enrolled church-by-church using a pretested plan whereby institutional media and respected members at individual churches promote the study. Participants complete a comprehensive questionnaire that has been pretested.

Cancer surveillance during follow-up will be by matching with state tumor registries where possible, matching with the National Death Index, and by obtaining and coding hospitalization records as necessary. Calibration studies in both black and white Adventists will allow bias correction. The investigators believe that it is important to also gather blood, urine, and subcutaneous fat from the study participants, and have a largely pretested plan to accomplish this. This will be further tested for feasibility at a location away from Loma Linda.

The Adventist population has cooperated with epidemiologic investigators for many years and has some unusual strengths as a research population, including the virtual absence of confounding by tobacco and alcohol, the wide range of dietary habits, and the widespread use of soy products. They have made important contributions to the understanding of diet and chronic disease in the past. This cohort study will provide much greater statistical power, more accurate and documented exposure assessment, and includes a large cohort of black Adventists.