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23 (%) (Tobacco) 30 (Adult diet/obesity) 30 (Sedentary lifestyle) 5 (OccupaHonal factors) 5 (Family history of cancer) 5 (Viruses/other biologic agents) 5 (Perinatal factors/growth) 5 (ReproducHve factors) 3 (Alcohol) 3 (Socioeconomic status) 3 (Environmental polluhon) 2 (Ionizing/ultraviolet radiahon) 2 (PrescripHon drug/medical procedures) 1 (Salt/other food addihves/contaminants) 1 Harvard Center for Cancer Preven:on: Harvard Report on Cancer Preven:on, Volume 1: Causes of Human Cancer, Cancer Causes Control 1996 ;7:S3 S59.

24 N 3 / B2, B6, B12, C, D, E WHO technical report series 916. Diet, nutri:on and the preven:on of chronic diseases. WHO, Geneva, (2003)

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26 BRCA1 D. D. 2

27 BRCA1 (mulhple endocrine neoplasia) MEN types 1, 2a, 2b p53 Li Fraumeni (Li Fraumeni syndrome) ( ) APC (Familial adenomatous polyposis) Rb

28 : 60% 40% (80% ) 10-20% 90% 60

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30 95% 75 95% 95% (Environment and heritable factor in the causa:on of cohorts of twins from Sweden and Finland. N Eng J Med 343:78 85, 2000

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35 肝転移と骨転移 肝転移 肝臓の両葉に白い結節状の転移巣が 多発している 肝不全になる 骨シンチにて脊椎および仙腸関節部に集積がある CTにて脊椎の溶骨を認め MRIにて脊椎に低信号 部を認める 脊椎の圧迫骨折や骨盤の骨折が起こ りやすい

36 stage 0 ( ) stage 1 ( ) stage 2 ( ) stage 3 ( ) stage 4 ( )

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41 (%) (Tobacco) 30 (Adult diet/obesity) 30 (Sedentary lifestyle) 5 (OccupaHonal factors) 5 (Family history of cancer) 5 (Viruses/other biologic agents) 5 (Perinatal factors/growth) 5 (ReproducHve factors) 3 (Alcohol) 3 (Socioeconomic status) 3 (Environmental polluhon) 2 (Ionizing/ultraviolet radiahon) 2 (PrescripHon drug/medical procedures) 1 (Salt/other food addihves/contaminants) 1

42 N 3 / B2, B6, B12, C, D, E WHO technical report series 916. Diet, nutri:on and the preven:on of chronic diseases. WHO, Geneva, (2003)

43 g

44 1 2 BMI g [1 250ml 100ml 25ml ] 7 ( ) 1 80g g

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54 HP

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