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In Reply: Dr Nath and colleagues suggest that the findings of our study are limited because we did not consider several other risk factors for cancer in assessing the association of serum glucose level and diabetes with cancer risk. The study data, coming from a questionnaire and blood chemistry laboratory tests, could not cover all known risk factors for cancer. However, such factors could confound the associations found in the study if they are also associated with serum glucose level and presence of diabetes. For example, dioxin in food would introduce bias only if the intake of dioxin were associated with blood glucose level and diabetes in our study population. We doubt that such confounding occurred, particularly because the population came from a relatively homogeneous group of professionals and their family members.

Similarly, time trends in diet, associated with the nutrition transition described by Kim et al,¹ would also have . . . [Full Text of this Article]

Sun Ha Jee, PhD, MHS
jsunha@yumc.yonsei.ac.kr
Department of Epidemiology and Health Promotion
Graduate School of Public Health

Heechoul Ohrr, MD, PhD
Department of Preventive Medicine and Public Health

Jae Woong Sull, PhD, MHS
Department of Public Health
Graduate School of Public Health

Ji Eun Yun, MPH
Department of Epidemiology and Health Promotion
Graduate School of Public Health

Ji Min, MPH
Department of Epidemiology and Health Promotion
Graduate School of Public Health
Yonsei University College of Medicine
Seoul, Korea

Jonathan M. Samet, MD, MS
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, Md

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