Background In many western countries an increase in incidence of adenocarcinoma of the oesophagus and/or gastric cardia have been reported. The aim of this study was to describe and compare trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in several areas of Europe, 1968–1995, using Eurocim (a database of cancer incidence and mortality data from 95 European cancer registries). Methods Time-trends in age-standardized incidence rates of adenocarcinomas of the oesophagus and gastric cardia are described in 11 population-based cancer registries from 10 countries in North, South, East, West and Central Europe, 1968–1995. The statistical significance of the time-trends in incidence was assessed using Poisson regression analysis. Results An increase in incidence of adenocarcinomas of the oesophagus and gastric cardia was observed in Northern Europe (Denmark), Southern Europe (Italy, Varese), Eastern Europe (Slovakia) and Western Europe (England and Wales, Scotland). In Central Europe (Switzerland, Basel) and in the cancer registries of Iceland (Northern Europe), France, Bas-Rhin and Calvados, Southern Ireland, and the Netherlands, Eindhoven (Western Europe) no rise in incidence was observed. The increase in incidence of adenocarcinomas of the oesophagus and gastric cardia was accompanied by a decrease in incidence of both adenocarcinomas and non-adenocarcinomas of the non-cardia part of the stomach in almost all of the 11 cancer registries studied. Increased histological verification of tumours of the oesophagus and stomach and improvement in precision of histological diagnosis may partly explain the increase in incidence of adenocarcinomas in some registries. Conclusions This study, using Eurocim data, supports the findings from other time-trend studies of population-based cancer registries in western countries.

Van den Brandt P A (Department of Epidemiology, University of Limburg, PO Box 616, 6200 MD Maastricht, The Netherlands), L J Schouten, R A Goldbohm, E Dorant and P M H Hunen. Development of a record linkage protocol for use by the Dutch cancer registry for epidemiological research. International Journal of Epidemiology 1990; 19: 553–558. A method has been developed to determine the optimal linkage key for record linkage between the cancer registry and a large-scale prospective cohort study in the Netherlands. The proposed linkage procedure is a two-stage process in which the initial computerized linkage using a particular linkage key is followed by visual inspection with additional information to separate the computer matches into true and false positives. In the determination of the optimal key, both informativeness and susceptibility to error of personal identifiers were taken into account. The performance of the various keys in the linkage was expressed in terms of sensitivity and predictive value of a reported computer match. The key, consisting of date of birth, first four characters of the family name and gender was the optimal choice, with a sensitivity of 98% and an initial predictive value of a computer match of 98%. When additional information on migration, place of birth and first initial was collected in the second stage, it was possible to eliminate the false positives from the reported computer matches without loss of true positives. Thus, the sensitivity remained constant whereas the secondary predictive value of accepted matches was maximized.

Background: Determining folate intake is difficult because existing folate data in food-composition tables are scarce and unreliable. Objective: The purposes of this study were first to analyze 125 of the most important foods that contribute to folate intake in the Netherlands and second to estimate the folate intake of a representative sample of the population. Design: We analyzed the folate content of foods by using a newly developed HPLC trienzyme method combined with an affinity chromatography cleanup step. These results were then used to estimate the folate intake of persons aged 1–92 y who participated in the second Dutch National Food Consumption Survey (DNFCS) in 1992 (n = 6218). Results: For 35 important folate-containing foods, the mean relative folate contents measured by HPLC were 66%, 80%, and 77% of values for comparable foods included in the British food-composition table; the Ministry of Agriculture, Fisheries and Food table; and the US Department of Agriculture database, respectively. P values for comparison of relative values with 100% were 0.001, 0.171, and 0.144, respectively. The mean dietary folate intake of the DNFCS participants was 182 ± 119 μg/d. Intake of supplement users (n = 86) was 344 μg/d, with 147 μg/d from supplements. On the basis of these findings, 42% of men and 54% of women do not meet current Dutch recommendations of 60 μg/d for children and 200 μg/d for adults. Conclusions: Total folate quantities in foods, analyzed by HPLC, are ≈25% lower than amounts listed in recent food-composition tables estimated by use of the microbiological method. On the basis of these new data, ≈50% of a representative Dutch population sample does not meet the current recommendations for folate intake.

Recently published results of epidemiologic case-control studies in China and Italy on gastric carcinoma in relation to diet suggest that consuming garlic may reduce the risk of gastric cancer. Chemical constituents of garlic have been tested for their inhibiting effect on carcinogenesis, using in vitro and in vivo models. In most experiments inhibition of tumour growth was established using fresh garlic extract, garlic compounds or synthetically prepared analogs. In this review the strengths and weaknesses of the experiments are discussed and the outcomes are evaluated to assess the possible significance of garlic or garlic compounds for the prevention of cancer in humans. It is concluded that evidence from laboratory experiments and epidemiologic studies is presently not conclusive as to the preventive activity of garlic. However, the available evidence warrants further research into the possible role of garlic in the prevention of cancer in humans.

In the Netherlands Cohort Study, the authors investigated whether anthropometry is associated with prostate cancer risk. At baseline in 1986, 58, 279 men aged 55–69 years completed a self-administered questionnaire on diet, anthropometry, and other risk factors for cancer. After 6.3 years of follow-up, 681 cases were available with complete data on height and weight at baseline, and for 523 cases, there were data for weight at age 20 years. In both age-adjusted and multivariate case-cohort analyses (adjusted for age, family history of prostate cancer, and socioeconomic status), height, body mass index (BMI; kg/m²), and lean body mass (kg) at baseline were not associated with prostate cancer risk. The rate ratios of prostate cancer for men with a BMI at age 20 of less than 19, 19–20.9, 21–22.9, 23–24.9, and 25 or greater were 1.00 (reference), 1.06, 1.09, 1.39, and 1.33, respectively (p for trend = 0.02). For gain in BMI from age 20 years to age of the cohort at baseline, an inverse trend in risk was found (p for trend = 0.01), which did not persist after additional adjustment for BMI at age 20 (p for trend = 0.07). In subgroup analyses, no clear associations between anthropometry and advanced prostate cancer were found. Our findings suggest that body composition in young adulthood may already exert an effect on later risk of prostate cancer. Am J Epidemiol 2000;151:541–9.