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My research interests during many years have centered on understanding the striking variations in cancer incidence and survival that are observed among the several different ethnic populations in Hawaii. This work began in the mid-1970's when I joined the newly formed epidemiology research program at the Cancer Research Center of Hawaii. We felt that important clues to cancer etiology might emerge from epidemiologic studies in this unique environment. formed.

In early studies of changing cancer risks among migrant populations, we showed that incidence rates in first generation migrants from Japan and the U.S. mainland were often remarkably higher (or lower) than the prevailing rates in their place of origin. Moreover, these changes were progressive from the first to the second generation (born in Hawaii). These findings added considerable weight to the premise that most cancers are environmentally determined. Accordingly, we concentrated much of our subsequent research on the role of lifestyle variables in the etiology of cancer, with a particular emphasis on nutritional factors. Several early ecologic and case-control studies in this unique population setting helped establish the importance of diet and nutrition in cancer etiology (e.g., Br J Cancer 1981;44:332-39; Int J Cancer 1983;32:727-32; Am J Epidemiol 1984;119:227-37; J Natl Cancer Inst 1987;78:595-600; Cancer Res 1987;47:2982-5; Am J Epidemiol 1988;127:999-1012).

Despite the encouraging results of many of these studies, we found that even known risk factors for certain cancers, such as cigarette smoking for lung cancer, could not fully account for the observed differences in incidence among the several ethnic groups in Hawaii. Furthermore, some of the changes in risk we observed among migrants were greater than one would have expected from lifestyle alterations alone. To further our research on diet, nutrition and cancer, and to better explore some of these anomalous findings, we established a large multiethnic cohort in 1993-1996 for long-term follow-up (Kolonel et al. Am J Epidemiol 2000;151: 346-357).

To enhance the value of this research, we included ethnic groups from California (African-Americans, and Latinos) as well as from Hawaii (Japanese-Americans, whites, and Native Hawaiians). The cohort includes more than 215,000 participants of both sexes, on whom extensive baseline questionnaire data have been collected, including a detailed quantitative dietary history. In addition, biological specimens are being collected from cohort participants, and will ultimately yield a unique biorepository of blood and urine samples on more than 80,000 subjects. Much of our current research is utilizing this cohort resource. The work is multidisciplinary, and includes a substantial molecular epidemiology component.

For example, we are examining the relationship of dietary variables, such as flavonoids, to breast and prostate cancer risk both within and among ethnic groups. We are also examining genetic markers (especially polymorphisms in genes involved in the metabolism of dietary constituents or hormones related to breast, prostate and colorectal cancers) both for differences in the distributions of alleles across ethnic groups and for their impact on cancer risk. The interaction of dietary exposures with genetic susceptibility in determining cancer risk is of particular interest. Building on past accomplishments, we feel that the potential for understanding the etiology of cancer through studies of ethnic and migrant populations has never been greater (Kolonel et al. Nature Rev Cancer 2004;4:519-527).