Cancer prevention trials in China and Finland

Intervention studies are now viewed as a useful and necessary approach to understanding the relation between nutrition and cancer. Over 20 such studies have been initiated in the past 7 years. Foreign countries may be an attractive site for such investigations, mainly because of desirable population characteristics such as unusually high rates of the cancer being studied, low dietary intake of potential chemopreventive nutrients, stability of the population, and high compliance, and also because of favorable logistical aspects including existing medical, social, or governmental structures that facilitate delivery of the intervention, ongoing cancer registries for endpoint determination, and reduced cost. The three basic elements of an intervention trial, identification and recruitment of a study population, delivery of the intervention and assessment of compliance, and ascertainment of endpoints, are the same in a foreign country as in the United States, but there are a number of special considerations, most notably communication difficulties due to language differences and distance between collaborators, which complicate foreign trials both before and during implementation. The basic elements and status of ongoing trials in China and Finland are presented.