Colorectal cancer in rural Nebraska.

A case-control interview study of colorectal cancer was conducted in two rural counties of eastern Nebraska to determine reasons for the elevated colon cancer mortality rates during 1950 to 1969. Comparison of the information provided by 86 colorectal cancer cases and 176 matched controls (or their next of kin) revealed an increased risk among persons of Czech background, with persons of Bohemian and Moravian extraction predominating in this area. The data suggest an interaction between Bohemian ancestry and certain dietary patterns in the pathogenesis of colon cancer in this region. Colon cancer risk was elevated among commercial beer drinkers regardless of their ethnic background, although Bohemians reported heavier consumption. An excess risk was also associated with intestinal polyps, reported more often by Moravians, and with familial occurrence of gastrointestinal and other cancers. Since 1969, the mortality and incidence rates for colon cancer in this area have declined, possibly as a consequence of acculturation of the American-born descendants of Czech immigrants.