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Genes, Environment-Lifestyle, And Common Diseases

Genes, Environment-Lifestyle, And Common Diseases

Genes, Environment-Lifestyle, And Common Diseases
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Genes, Environment-Lifestyle, And Common Diseases


Incidence and Prevalence Concepts
How prevalent is a particular disease, such as diabetes, in a population? To answer this question, well-established measures are used.2 The incidence rate is the number of new cases of a disease reported during a specific period (typically one year) divided by the population size. The denominator is frequently expressed in terms of person-years. The incidence rate differs from the prevalence rate, which is the proportion of the population affected by a disease at a given time. Thus, the prevalence is determined by both the incidence rate and the length of survival in affected individuals. Because most people with AIDS live for at least several years after diagnosis, the prevalence rate of acquired immunodeficiency syndrome (AIDS) is higher than the yearly incidence rate.

The prevalence of many diseases varies from one population to the next. Cystic fibrosis is fairly common in Europeans, occurring approximately once every 2500 births. In Asians, however, it is extremely rare, occurring only once every 90,000 births. Similarly, sickle cell disease affects approximately 1 in 600 black Americans, but it is much less common in whites. Both of these diseases are single-gene disorders that vary across populations due to the prevalence of disease-causing mutations in different populations. (This is due to differences in these populations’ evolutionary histories.) Nongenetic (environmental) factors have little influence on the current prevalence of these diseases.

With adult diseases, the picture often becomes more complicated. For example, colon cancer was previously uncommon in Japan, but it is now the second most common cancer in the United States. Stomach cancer, on the other hand, is relatively common in Japan but uncommon in the United States. These statistics cannot distinguish between environmental and genetic influences in the two populations. However, because a large number of Japanese emigrated to Hawaii before moving to the United States mainland, we can see what happens to the rates of stomach and colon cancer among the migrants. It is critical that the Japanese émigrés retained their genetic identity by marrying primarily among themselves. The prevalence of colon cancer among first-generation Japanese in Hawaii increased severalfold—not as much as on the mainland of the United States, but more than in Japan. Colon cancer rates among second-generation Japanese on the US mainland increased to 5%, matching the national average. At the same time, stomach cancer has become uncommon in Japanese-Americans.

These findings strongly suggest that environmental factors play an important role in the etiology of colon and stomach cancers. A high-fat, low-fiber diet in the United States is thought to increase the risk of colon cancer, whereas techniques used to preserve and season the fish commonly consumed in Japan are thought to increase the risk of stomach cancer. It’s worth noting that the incidence of colon cancer in Japan has skyrocketed in recent decades as the Japanese population has adopted a more “Western” diet. These findings, however, do not rule out the possibility of genetic factors playing a role in common cancers. Genes are also involved in the development of colon and other cancers.

Genes, Environment-Lifestyle, And Common Diseases

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