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The relationship between cancer incidence and dietary constituents involves many factors that combine to produce a complicated pattern of interactions. Among these factors are the levels of critical enzymes in the body. One of these is glutathione-S-transferase which acts as a protective agent by combining pollutants and toxic substances with the sulfur-containing glutathione so that they are made innocuous. A study from the Harvard School of Public Health, Harvard Medical School and the Massachusetts General Hospital (ICDB/95609450), looked at these relationships in a hospital-based case-control study of 220 lung cancer cases and 274 controls. Deletion of the gene for glutathione-S-transferase (GSTM1) would be expected to increase the risk for lung cancer, and indeed there were increased odds ratios for GSTM1 loss, with an odds ratio 1.2, for all lung tumors combined, 1.8 for adenocarcinomas, and 1.2 small cell cancers. Vitamin C modified this effect for all tumors combined, but among specific histological types, this effect was only evident for small cell lung cancer, and not adenocarcinoma. Loss of GSTM1 increased the risk of small cell cancer about four- fold among subjects in the lowest tertile of vitamin C intake (odds ratio 3.8) but had no effect among those in the medium and high tertiles (odds ratios 1.5 and 0.5, respectively). There was also evidence of an effect of intake of vitamins E, D and B6.
