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January 27, 1993

The Causes of Colon Cancer

Author Affiliations

Tulia, Tex

JAMA. 1993;269(4):474. doi:10.1001/jama.1993.03500040040024

To the Editor.  —I would offer the following comments on the article by Potter.1I am a retired general surgeon who worked as a medical missionary at the American Christian Hospital in Resht, Iran, from 1959 to 1964. During that 5-year period, despite a surgical schedule of 35 to 40 major cases a month, I encountered only three cases of colon cancer. Considering that the diet in that region of Iran consisted principally of polished rice, which is low in fiber, and assuming Burkitt's theory on the role of fiber in reducing the incidence colon cancer is correct, I would have expected colon cancer to be common in northern Iran.After returning to the United States in 1964,I wrote to the public health departments of several countries where rice is a dietary staple and requested information regarding the incidence of colon cancer, but received no response.I would suggest