Racially restricted contribution of immunoglobulin Fcγ and Fcγ receptor genotypes to humoral immunity to human epidermal growth factor receptor 2 in breast cancer.

Tumour-associated antigen human epidermal growth factor receptor 2 (HER2) is over-expressed in 25-30% of breast cancer patients and is associated with poor prognosis. Naturally occurring anti-HER2 antibody responses have been described in patients with HER2 over-expressing tumours. There is significant interindividual variability in antibody responsiveness, but the host genetic factors responsible for this variability are poorly understood. The aim of the present investigation was to determine whether immunoglobulin genetic markers [GM (genetic determinants of γ chains)] and Fcγ receptor (FcγR) alleles contribute to the magnitude of natural antibody responsiveness to HER2 in patients with breast cancer. A total of 855 breast cancer patients from Japan and Brazil were genotyped for several GM and FcγR alleles. They were also characterized for immunoglobulin (Ig)G antibodies to HER2. In white subjects (n = 263), GM 23-carriers had higher levels of anti-HER2 antibodies than non-carriers of this allele (p = 0·004). At the GM 5/21 locus, the homozygotes for the GM 5 allele had higher levels of anti-HER2 antibodies than the other two genotypes (P = 0·0067). In black subjects (n = 42), FcγRIIa-histidine/histidine homozygotes and FcγRIIIa-phenylalanine/valine heterozygotes were associated with high antibody responses (P = 0·0071 and 0·0275, respectively). FcγR genotypes in white subjects and GM genotypes in black subjects were not associated with anti-HER2 antibody responses. No significant associations were found in other study groups. These racially restricted contributions of GM and FcγR genotypes to humoral immunity to HER2 have potential implications for immunotherapy of breast cancer.

Comparison of selenium status between Japanese living in Tokyo and Japanese brazilians in São Paulo, Brazil.

Selenium (Se) concentrations were determined in human serum, rice and wheat flour sampled in the city of São Paulo, Brazil, and compared with those sampled in Tokyo. Japan. Serum levels of Se were significantly lower in Japanese Brazilians than Japanese living in Tokyo. The samples of rice consumed by Japanese Brazilians in São Paulo contained 22.7 ng Se/g on average, which was about half the selenium level in rice consumed in Tokyo. Rice commonly consumed in São Paulo might be one of the factors to lower the serum level of Se.

Epstein-Barr virus-associated gastric carcinoma in Japanese Brazilians and non-Japanese Brazilians in São Paulo.

The proportion of Epstein-Barr virus-associated gastric carcinoma (EBV-GC) was examined in 149 Japanese-Brazilian and 151 non-Japanese-Brazilian gastric-carcinoma cases using in situ hybridization (ISH) assay to detect EBV-encoded small RNA (EBER), and the results were compared with our referent Japanese data. We found that 4.7% of cases in Japanese Brazilians were EBER-positive. This frequency was slightly lower than that of the referent Japanese, among whom 6.2% of 2038 gastric-carcinoma cases were EBER-positive. On the other hand, the non-Japanese-Brazilian series showed a significantly higher proportion of EBV-GC (11.2%) than the referent group did (P = 0.01). Although EBV-GC was predominant in males among non-Japanese Brazilians (M / F = 3.6, P = 0.047), as was the case in Japanese (M / F = 2.7), Japanese Brazilians did not show such a male predominance. The sex-ratio difference between the Japanese Brazilians and Japanese was statistically significant (P = 0.005). In conclusion, the present study in Japanese Brazilians and Japanese yielded no evidence suggesting any change in the frequency of EBV-GC caused by migration, except the absence of male predominance, which was observed both in Japanese and non-Japanese Brazilians.

Serological Immunoglobulin G antibody titers to Helicobacter pylori in Japanese Brazilian and Non-Japanese Brazilian gastric cancer patients and controls in São Paulo.

Helicobacter pylori (H. pylori) infection is considered a cause of gastric cancer (GC), though evidence for this association is scarce in high-risk areas. Possible case control and/or ethnic differences were investigated as to the presence of H. pylori and its immunogloblin G antibody titer in the multi-ethnic city of São Paulo, where the incidence of GC is relatively high. We performed a cross-sectional comparison of antibody titers to H. pylori in Japanese Brazilian, and non-Japanese Brazilian GC patients and their controls. Japanese Brazilian patients were matched by age, sex and ethnicity with two controls, while non-Japanese Brazilian patients were matched as above with one control. Among Japanese Brazilians, 59 of 93 (63.4%) patients with GC and 127 of 186 (68.3%) controls were positive for H. pylori-specific antibody (odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.47 - 1.36), while among non-Japanese Brazilians, 171 of 228 patients with GC (75.7%) and 178 of 226 controls (78.8%) were positive (OR = 0.84, 95% CI = 0.54 - 1.30). The median serum antibody titer was lower in cases than in controls in both ethnic groups. A high titer (H. pylori titer > or = 50) was associated with less likelihood of GC for both ethnic groups (for Japanese Brazilians, OR = 0.39, 95% CI = 0.16 - 0.92; for non-Japanese Brazilians, OR = 0.56, 95% CI = 0.31 - 1.02). The high titer can be regarded as a sign of the necessity of eradication, and low titer is regarded as a sign of the necessity of close screening for GC in both ethnic groups, because extended atrophy may cause spontaneous disappearance of H. pylori from the stomach.

hOGG1 exon7 polymorphism and gastric cancer in case-control studies of Japanese Brazilians and non-Japanese Brazilians.

Polymorphism of hOGG1 may be capable of serving as a genetic marker for individual susceptibility to various cancers because of its role in the repair of oxyradical DNA damage. We examined the distribution of the hOGG1 Ser326Cys polymorphism and its presumed correlation with gastric cancer risk in two case-control studies of different ethnic groups in São Paulo, Brazil. Potentially eligible Japanese (JB) and non-Japanese Brazilian (NJB) case subjects were defined as patients with newly diagnosed malignant neoplasms of the stomach in 13 hospitals in São Paulo. Ninety-six JBs and 236 NJBs were adopted as subjects. Two controls were matched for each JB case, and one control for each NJB case. The subjects were interviewed using a questionnaire and their blood samples were collected. A significant difference in the distribution of this polymorphism between the two ethnic groups was observed (chi(2)=58.3, P<0.01). The mutant type (Ser/Cys or Cys/Cys) was predominant (approximately 65%) in the JBs, but was only present in approximately 40% of the NJBs. Logistic regression analysis showed no significant increased risk for either the Ser/Cys or Cys/Cys type in either group. The odds ratios of the Cys allele for gastric cancer were 1.01 (95% confidence interval (CI): 0.52-1.93) in the JBs and 0.85 (95% CI: 0.57-1.26) in the NJBs. In the NJBs, a significant increased risk of smoking was shown only in the Ser/Ser type, and no increased risk was shown in the genotypes with the Cys allele. However, no statistically significant interactions were observed with smoking or other possible confounding factors. No statistically significant difference in the distribution of the polymorphism was observed between the intestinal type and diffuse type of gastric cancer in either the JBs or the NJBs. The ethnic difference in hOGG1 Ser326Cys polymorphism was much greater than the case-control difference, and this polymorphism is unlikely to be associated with gastric cancer.

Cytochrome P450 2E1 polymorphism in gastric cancer in Brazil: case-control studies of Japanese Brazilians and non-Japanese Brazilians.

Cytochrome P450 2E1 (Cyp2E1) is involved in the metabolic oxidation of carcinogenic nitroso compounds, including N-nitrosoamines. There is an RsaI polymorphism in the transcriptional regulatory region of this gene, and in vitro evidence suggests that the variant type of this polymorphic site has higher transcriptional activity but less chlorzoxazone-metabolizing activity. Interindividual differences in the metabolic capacity of Cyp2E1 are assumed to be associated with cancer susceptibility, but the results of the previous studies on the relation between Cyp2E1 RsaI polymorphism and cancer susceptibility have been inconsistent. Two case-control studies of gastric cancer in Japanese Brazilians (96 cases, 192 controls) and Brazilians not of Japanese ancestry (non-Japanese Brazilians; 236 cases, 236 controls) in São Paulo were designed to clarify the role of the Cyp2E1 RsaI genotype in susceptibility to gastric cancer after considering multifactorial environmental influences. The subjects with variant RsaI genotypes amounted to 47% (28 of 59) and 48% (64 of 133), respectively, of the Japanese cases and controls, and 6% (11 of 187) and 10% (19 of 192), respectively, of the non-Japanese cases and controls. As expected, a difference in the distributions of the two groups was observed. The odds ratio of the RsaI variant genotype of Cyp2E1 was 0.46 (95% confidence interval, 0.21-1.04) in the non-Japanese Brazilian population and 0.98 (95% confidence interval, 0.50-1.90) in the Japanese Brazilian population after adjusting for sex, age, tobacco use, and meat consumption. Additional adjustment for potential confounding factors did not change the odds ratio substantially. No significant interactions were observed between the polymorphism and environmental factors. In regard to the histological type of gastric cancer, the variant genotype was significantly more prevalent than the common genotype in Japanese subjects with diffuse type gastric cancer. Our study suggests that the Cyp2E1 RsaI polymorphism is associated with a reduced risk of gastric cancer, although how the assumed increase in Cyp2E1 expression produced by this polymorphism is related to a reduced risk of cancer remains unclear. The observations in this study are consistent with the recent observations of esophageal cancer in endemic areas of China.

Ethnic differences in serum pepsinogen levels among Japanese and non-Japanese Brazilian gastric cancer patients and controls.

A low level of serum pepsinogen I (Pg I) is a risk factor for gastric cancer (GC); low levels of Pg I and the pepsinogen ratio (Pg I:Pg II) are correlated with chronic atrophic gastritis. We report serum Pg levels and compare the degree of association with GC among Japanese and non-Japanese Brazilians. Sera were cross-sectionally ascertained from 93 Japanese Brazilian patients category matched by age and sex with 110 controls, and 228 non-Japanese Brazilian patients individually matched by age and sex with one control. Among non-Japanese Brazilians, GC was associated with a Pg I level <30 ng/ml (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7-3.8) and a Pg I:Pg II ratio < 3.0 (OR, 3.4; 95% CI, 2.2-5.3). However, among Japanese Brazilians, the association was present with a level of Pg I < 30 ng/ml (OR, 3.5; 95% CI, 1.9-6.3), and was weak with a Pg I:Pg II ratio < 3.0 (OR, 1.3; 95% CI, 0.73-2.4). Serum Pg I may be preferred to the Pg I:Pg II ratio to study the association between Pg and GC among Japanese Brazilians.

Serum n-3 fatty acids, fish consumption and cancer mortality in six Japanese populations in Japan and Brazil.

Japanese people consume significant amounts of long chain n-3 polyunsaturated fatty acids (PUFAs) derived from fish, but the association of PUFAs with cancer mortality has not been fully investigated. To study geographic differences in n-3 PUFAs intake, we compared serum fatty acid and dietary fish intake among various Japanese populations having different rates of cancer mortality. The subjects were 50 men from each of five regions in Japan and 47 Japanese men from Sao Paulo, Brazil. All were randomly selected and aged 40 to 49 years. Serum fatty acids were measured by gas chromatography and the frequency of fish intake was obtained by a food frequency questionnaire. Significant geographic differences in serum fatty acid levels (% of total fatty acids) and fish intake (days/4 weeks) were observed. The percentages of serum total PUFA were similar in the six regions, though there was an almost three-fold difference in n-3 PUFAs content between Brazil (3.9%) and Akita (10.9%). The frequency of total fish intake corresponded to serum n-3 PUFAs composition. The relationship between cancer mortality and serum n-3 PUFAs levels was not clear, though an inverse association between prostate cancer and serum n-3 PUFAs levels appeared to exist. The results suggest that although serum n-3 PUFAs varied significantly, the observed geographic difference did not account for the different cancer risks at the population level.

Helicobacter pylori infection and atrophic gastritis in middle-aged Japanese residents of São Paulo and Lima.

BACKGROUND: Helicobacter pylori infection and atrophic gastritis (AG) are markedly more prevalent in Japan than in other industrialized countries, however, the reasons for such a high prevalence are not fully understood. To add to information on H. pylori infection and its association with AG, the authors studied Japanese living in less developed countries. METHODS: Cross-sectional surveys were conducted of randomly selected Japanese residents aged 40-59 years in São Paulo, Brazil and Lima, Peru. Serum IgG antibody to H. pylori and pepsinogen I (PGI) and II (PGII) were measured as markers of AG. RESULTS: The prevalence of H. pylori infection was similar in both populations, 77% (95% CI: 70-83) in São Paulo and 75% (95% CI: 65-82) in Lima, and was within the range of five populations in Japan from our previous study. However, the prevalence of AG, defined by PGI < 70 ng/ml and PGI/PGII < 3.0 was more prevalent among Japanese in São Paulo (39% [95% CI: 32-47]), than Japanese in Lima (18% [95% CI: 12-27]). This difference was not explained by sex, age, generation or H. pylori infection. CONCLUSIONS: Helicobacter pylori infection among Japanese in less developed countries was similar to Japanese in Japan, although prevalence of AG varied. Factors other than H. pylori infection are important in the development of AG among Japanese.

Dietary patterns in Japanese migrants to southeastern Brazil and their descendants.

This paper describes the dietary patterns of people of Japanese ancestry living in São Paulo, Brazil. Two cross-sectional surveys using a food frequency questionnaire (in 1989 and 1995) and self-administered three-day food record (only in 1995) were carried out in randomly chosen first-generation (Japan-born) and second-generation (Brazil-born) Japanese living in the city of São Paulo (n = 166), aged 40-69 years at the time of the first survey (1989). Daily intake of rice, bread, milk, fruits and coffee, and infrequent consumption of pork, green tea, black tea, tsukemono (pickled vegetables), seaweed and mushrooms were reported. The mean (+/- standard deviation) daily proportions of energy from fat among Japan-born participants were 27.2 +/- 6.7% for men and 26.2 +/- 6.7% for women. The respective figures for Brazil-born Japanese were 30.1 +/- 7.4% and 29.5 +/- 6.4%. These values were quite close to recent estimates for the general Brazilian population in metropolitan areas (about 30%), but seem to be higher than available data from Japan (25.3%). Dietary changes in this migrant population are discussed with focus on nutrients currently implicated in the etiology of major chronic diseases.

CYP1A1 and CYP2E1 polymorphism and lung cancer, case-control study in Rio de Janeiro, Brazil.

Msp I polymorphism and exon 7 Ile-Val polymorphism of CYP1A1, and Rsa I polymorphism of CYP2E1 were studied in lung cancer patients and controls in Rio de Janeiro, Brazil. Of the three polymorphisms studied, only the exon 7 polymorphism of CYP1A1 (Val-containing genotypes) had a distribution which was statistically significant in the patients and controls. The contribution of Val containing genotypes of CYP1A1 exon 7 was greater in the subpopulation of squamous cell carcinoma patients with a lower life-time smoking consumption (OR, 2.92 vs 1.97). This association is consistent with the previous findings by Kawajiri et al. and the first observation of the positive association of this locus with lung cancer in a Western population (Kawajiri K, Nakachi K, Imai K, Yoshii A, Shimada N, Watanabe J. FEBS Let 1990; 263, 131-133). Furthermore, together with the lack of association of Msp I polymorphism in the non-coding region of CYP1A1, the locus truly responsible for lung cancer risk among pleural polymorphisms of CYP1A1 appeared to be exon 7 Ile-Val polymorphism. In the future, investigations of multiple markers in different ethnic populations may reveal cancer risk markers common to all mankind.

Risk factors for lung cancer in Rio de Janeiro, Brazil: a case-control study.

The association between the risk of lung cancer and tobacco smoking, dietary factors and occupational exposures was examined in a hospital-based case-control study. The study involved 123 consecutive cases and 123 controls, matched by age (+/- 3), sex, and race. In this first study of lung cancer risk in Brazil, we found that tobacco smoking is the strongest risk factor with an odds ratio (OR) for current and former smokers of 22 (CI, 6.5-76) and 7.7 (CI, 2.2-27), respectively. An OR of 2.8 (CI, 1.0-7.7) was found for users of black tobacco in the form of hand-rolled cigarettes) in combination with conventional cigarettes, after adjustment for life-time consumption of any kind of tobacco; users of conventional cigarettes only were considered as a reference group. Cessation of smoking had an important influence in reducing the lung cancer risk, whereas early initiation of smoking increased the risk. Among dietary factors, frequent consumption of meat (P < 0.01) and pasta (P = 0.02) were positively associated with lung cancer risk after adjusting for smoking and income. No association was found with green/yellow vegetables or fruits. We were unable to detect any significant association related to occupational exposures. This study confirmed the association of lung cancer with smoking as the most important predictor of risk. It also indicates the increase in risk associated with the use of black tobacco in combination with conventional cigarettes.

Cytochrome P-450 lA1 genotype in lung cancer patients and controls in Rio de Janeiro, Brazil.

Mspl restriction fragment length polymorphism in cytochrome P-450 IA1 (CypIA1) gene, which has been associated with lung cancer susceptibility in Japanese, was studied in persons from Rio de Janeiro, in the framework of a hospital-based, age, race (black or nonblack), and gender-matched case-control study (n = 222; 110 cases and 112 controls). Contrary to the hypothesis, there was no difference in the frequency of the C genotype (Mspl site-present homozygous), even after racial breakdown. There were no significant differences between cases and controls when categorized according to tobacco consumption. The lifetime quantity of tobacco smoked was not different among lung cancer patients with three different genotypes (A, Mspl site-absent, homozygous; B, heterozygote; and C). The background frequency of the Mspl polymorphism C genotype is a little less than 10%, similar to that of the Japanese healthy population. The CyplA1 Mspl polymorphism itself does not seem to be related to susceptibility to bronchial carcinogenesis in this area.

[Human ecological and epidemiological studies of Japanese immigrants and their descendants in South America].

Over a million people of Japanese origin reside in South America. However, only a limited number of studies on their health status and lifestyle factors affecting it have been carried out. The author and his co-workers have been conducting a series of field surveys on the health situation and lifestyle factors in Japanese immigrants and their descendants in various areas of South America. The subjects of the first-phase study were residents in four agricultural settlements (colonies) in the suburbs of Brazil, Paraguay and Bolivia. The levels of minerals and heavy metals in the hair were measured, and significant variations were found in several elements. These different levels were found to be regulated by the environmental level of their living place and by the dietary pattern. In the second-phase study, several health-related indicators such as blood pressure, anthropometric features, viral infection markers in sera, and dietary pattern were investigated in two group of immigrants, one from Okinawa and the other from the mainland of Japan, both living in Bolivia. Differences in health situation and lifestyle were identified between them. Traditional habits seen in their original places of residence in Japan still existed in their life in Bolivia, while the introduction of Bolivian lifestyle was prevalent among them. Although the number of Japanese residents in Brazil is largest in the world outside of Japan, little has been known about their health situation. The subjects of the third-phase study were Japanese Brazilians. A descriptive epidemiologic study was carried out, and the mortality and incidence of cancer were determined. Some changes in disease pattern were noted when compared with Japanese in Japan, but these changes were not as marked as in the case of Japanese in the U.S.. A cross-section study on the lifestyle factors of Japanese residents in São Paulo showed some differences in health-related indicators and dietary habits in comparison with Japanese living in five areas of Japan. Such differences were also found among Japanese in São Paulo according to the place of origin in Japan. These series of studies in Japanese immigrants in South America showed the importance of lifestyle factors, especially dietary habits, for the health situation.

Proportional cancer incidence according to selected sites--comparison between residents in the city of S. Paulo, Brazil: Japanese and Brazilian/Portuguese descent.

The percentual distributions of selected sites of cancer cases according to origin, sex and age are compared. Data were obtained from the Registry of Cancer of S. Paulo (School of Public Health of the University of S. Paulo, Brazil). The reference period for inhabitants of Japanese descent was 1969/78 and for those of Brazilian descent, the period was 1969/75. Standardized Proportionate Incidence Ratios (SPIR) with approximate 95% Confidence Intervals (CI) were evaluated using age specific Incidence Ratios of S. Paulo, 1973, as standards. The results agree with findings of previous works on mortality, but show different patterns according to origin. The well known fact that some sub-groups of a population may be different from the overall group is once again brought to the fore. Attention should be drawn to the differences detected for stomach, skin and prostate, in males, and for stomach, skin, cervix and uterus in females.

Cancer incidence rates among Japanese immigrants in the city of São Paulo, Brazil, 1969-78.

Cancer incidence rates among first-generation Japanese immigrants in the city of São Paulo, Brazil, were estimated from the data of the São Paulo Cancer Registry during the years 1969 to 1978. From all registered cases, 2,179 cancer cases of Japan-born residents (1,288 males, 891 females) were selected and age-specific and summary age-adjusted incidence rates (AAIR) were calculated for the selected sites of cancer. The AAIR for all sites except non-melanoma skin cancer was 195.2 per 100,000 population (95 percent confidence interval: 176.4-214.1) in males and 147.3 (134.6-160.0) in females. Stomach cancer had the highest incidence rate of all cancers in both sexes (males, 69.3; females, 32.0). This was followed by cancer of the lung (22.5), esophagus (10.2), colon (8.3), and prostate (7.1) in males; and by breast (24.0), cervix (18.0), colon (8.4), and lung (7.2) in females. When these rates were compared with those among Japanese in Japan, cancer of the stomach and rectum revealed significantly lower rates, while non-melanoma skin cancer, and prostate and breast cancer showed higher rates. No significant increase of colorectal cancer was recognized among Japanese immigrants in São Paulo, contrary to the remarkably high rates of colorectal cancer being observed among Japanese immigrants in the US.

Hepatitis B virus markers in Japanese immigrants and their descendants in Bolivia and native Bolivians.

A survey of hepatitis B virus (HBV) markers of Japanese immigrants, their descendants and native Bolivians was performed in two agricultural settlements in Bolivia. The prevalence of HBV markers in sera, either hepatitis B surface antigen (HBsAg) or its antibody (HBsAb), was higher in the Japanese (46.4%) than in the native Bolivian (12.9%) adult generations of both colonies. There was no significant difference between Japanese (4.3%) and Bolivian (0.9%) school children in one colony, but a high percentage (32.6%) was recognized among Japanese children in the other colony. The numbers of adw subtypes were unexpectedly high among these HBsAg positive Japanese children, compared to those in Japan. Antibody to hepatitis delta virus (HDV) was detected in one case. These data suggested that although horizontal transmission of adw HBV had occurred within the Japanese population, HBV and HDV were not endemic to this geographic area.

[Current status of air pollution in Sao Paulo, Brazil: effects and problems associated with the introduction of ethanol-fueled motor vehicles].

Recently suggestions have been advanced that alternative fuels including ethanol, methanol or methane instead of so called "fossil fuels" may help improve the current conditions of air pollution. According to results of general survey in Sao Paulo, since their introduction in 1978, ethanol-fueled cars have increased their share to almost 50% of all light vehicles in 1983. The current status of air pollution in Sao Paulo metropolitan area (SPMA) is described in relation to the use of such alternative fuel. The average concentrations in air of SO2 and lead have been decreasing drastically during the period of 1982-88, whereas non-methane hydrocarbon, NO2 and O3 levels have been increasing to attain the worst levels in the world as indicated in Fig. 2. The use of ethanol-fuel, which contains less sulphate and lead, is thought to have contributed more or less to the above reductions of SO2 and lead in the air. However, the pollutants that have increased may derive mainly from diesel and gasoline exhausts of heavy vehicles. The general state of air pollutions appears not to have been improved, suggesting the difficulty in resolving air pollution issues. On the other hand, a current problem specific to ethanol-fuel is the aldehydes or other carcinogenic components in exhaust. Peak formaldehyde concentration, for example, have been reported to have reached 159 ppb in SPMA, which may be one of the highest levels shown in ambient air.(ABSTRACT TRUNCATED AT 250 WORDS)

Cancer mortality among Japanese residents of the city of São Paulo, Brazil.

Death certificates of Japanese residents of the city of São Paulo, Brazil from 1979 to 1981 were analyzed for cancer deaths by means of the standardized mortality ratio (SMR) and the standardized proportional mortality ratio (SPMR). Compared with residents of Japan, a significantly higher SMR value was obtained from Japan-born residents of São Paulo for prostate cancer, whereas lower values were obtained for cancer of the liver and gall-bladder in both sexes, of the esophagus and rectum in males, and of the lung in females. SMR values were higher for cancer of the stomach in both sexes but lower for those of the esophagus and prostate in males and of the gall-bladder and breast in females, when compared with the general population of São Paulo. Among Japan- and Brazil-born residents, stomach cancer in women revealed a significant stepwise decrease by generation when SPMR was used as an indicator. The high proportion of stomach cancer in males, however, was as high among the Brazil-born generation as in Japan. The SPMR of liver cancer decreased to the low level of the general population of São Paulo, even among the first generation. These changes in cancer patterns are discussed in relation to those among Japanese residents in the United States.

Mortality and cause of death among first-generation Japanese in São Paulo, Brazil.

The death certificates of first-generation Japanese in the city of São Paulo, Brazil, were analysed for underlying causes of death, and standardized mortality ratio (SMR) values were calculated using the age-specific mortality rates for Japan and São Paulo. Mortality rates for all causes were lower than those of the general population in São Paulo for all age groups and both sexes, and were almost equal to those in Japan. Compared with the mortality in Japan, significantly higher SMR values were obtained for diabetes mellitus, ischaemic heart disease, respiratory diseases (females), motor vehicle accidents, and homicide (males), whereas SMR values were low for all causes (males), other heart diseases, cerebrovascular disease, chronic liver diseases (males), suicide, and malignant neoplasms (males). On the other hand, compared with the mortality for São Paulo, SMR values were significantly low for most causes of death. The potential cultural and social factors contributing to these changes in mortality pattern are discussed.