Letter from the Editors

Issue 23, Summer/Fall 2014

While cancer prevention has been of growing interest for close to 100 years, marked by the recent centennial anniversary of the American Cancer Society, successful prevention presumes a knowledge of cancer causation. Most of those in the field appreciate that cancers arise out of an interaction between genetic and environmental factors. And, for practical purposes, an understanding of the role that environmental factors such as tobacco or obesity play can lead to risk reducing interventions.

Thus, it is an optimistic message when we discover that a given cancer has significant contributions from lifestyle or behavioral factors, because it implies to us that we can potentially modify an individual’s lifestyle or behavior for a healthier lifestyle – tobacco cessation, better diet, weight loss, etc.

When a cancer epidemiologist studies a cancer, the first clue he examines is how the cancer varies from country to country. Oftentimes, one sees, for example, wide variations in incidence from the US to countries like Japan and China for breast, colon and gastric cancer. But this does not tell us if these variations stem from lifestyle/cultural differences or if there may be some genetic factor at play between Japan versus the U.S.

So how can we determine whether cancer differences arise primarily from environmental/lifestyle or genetic factors? One of the most dramatic ways is by migrant studies. In this issue of Cancer Prevention, we describe a career of outstanding and elegant studies by Dr. Laurence Kolonel of the University of Hawaii of Japanese immigrants to Hawaii and the United States and what effect this had on their cancer rates. Cancers, such as breast or colon cancer, that were historically uncommon in Japan became common among the children of the Japanese immigrants, mirroring the rates among their new U.S. neighbors, while cancers that were historically high in Japan, such as gastric cancer, dropped among their progeny. Such rapid changes in one or two generations could not occur on a genetic basis, but must represent lifestyle changes.

Thus the work of Dr. Kolonel has been a spur to investigations of U.S.-Japan differences in diet, body size, tea drinking, soy consumption, and other factors to try to determine the underlying causes. One large building block at a time – some day soon we will hopefully know the reasons for the large changes in Dr. Kolonel’s studies.

The Editors:

Andrew J. Dannenberg, MD
Henry R. Erle, MD -Roberts Family Professor of Medicine
Weill Cornell Medical College
Co-Director, Cancer Prevention Program
NewYork-Presbyterian Cancer Centers

Alfred I. Neugut, MD, PhD
Myron M. Studner Professor of Cancer Research
Professor of Medicine and Epidemiology
Associate Director for Population Sciences
Herbert Irving Comprehensive Cancer Center
Columbia University College of Physicians and Surgeons and Mailman School of Public Health
Co-Director, Cancer Prevention Program
NewYork-Presbyterian Cancer Centers