Division of Nutritional Sciences
Cornell University
Savage Hall
Ithaca, NY 14850
email: bjp1@cornell.edu
Overview | Results | Implications | Publications | Slide Show


"The 'Grand Prix'...the most comprehensive large study ever undetaken of the relationship between diet and the risk of developing disease...tantalizing findings." - The New York Times

"...the most comprehensive survey of food, environment, social practices and diseases ever made in China-and one of the largest epidemiological studies ever done anywhere." - Science

  - Scientific Justification
  - Why China?
  - Study Design
          1983 Survey
          1989 Survey

   - Funding

The China Project was conceived in 1980-81 during the sabbatic visit of Dr. Chen Junshi, Deputy Director of Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, to the laboratory of Professor T. Colin Campbell, Division of Nutritional Sciences, Cornell University, Ithaca, NY. A short while later, they were joined by Professor Richard Peto, University of Oxford, England, and by Dr. Li Junyao, China Cancer Institute, Chinese Academy of Medical Sciences and their colleagues in China, the United States, England, Canada, and France.

Scientific Justification

In the late 1970s and early 1980s, there were two principal observations suggesting a relationship between diet and cancer. First, rich Western diets (high in fat and meat, low in dietary fiber) were strongly associated (correlated) with incidence of colon and breast cancer. Second, migrants moving to areas of different cancer risks acquired the risk of the country to which they moved, regardless of their ethnic or genetic backgrounds.

Much of this was summarized by a US National Academy of Sciences 1982 report on Diet, Nutrition and Cancer.

Why China?

In 1981, the Chinese Academy of Medical Science published an Atlas of Cancer Mortality on the 1973-75 mortality rates for about a dozen different cancers for 2400 counties in China. These maps showed that cancer was highly localized in specific geographic regions. Cancers rates ranged several dozen, even a few hundred fold from highest to lowest rate areas, far more than the 1.5-2.0 fold ranges of the US.

Residents of these regions tended to live in the same regions all their lives and to consume the same diets unique to each region each and every year.

Their diets (low in fat and high in dietary fiber and plant material) also were in stark contrast to the rich diets of the Western countries.

Study Design

Sixty five counties in rural China were selected for study and the dietary, lifestyle and disease characteristics of populations of each county were compared.

1983-84 Survey - view map

Within each of the 65 counties, 2 villages were selected and 50 families in each were randomly chosen for study. One adult from each household (half men and half women), 6500 for the entire survey, participated. Blood, urine and food samples were obtained for later analysis, while questionnaire and 3-day diet information was recorded.

A total of 367 items of information on these 6500 families eventually were judged to be reliable. These 1983-84 diet and lifestyle data included the 1973-75 mortality rates for about 4 dozen different kinds of cancers and other diseases.

1989-90 Survey - view map

The same counties and individuals surveyed in 1983-84 were re-surveyed in 1989-90, with the addition of 20 new counties in mainland China and Taiwan, and 20 additional families per county, thus yielding 10,200 total adults and their families. A large amount of socioeconomic information also was collected.

These data were combined with new mortality data for 1986-88, using the most recent disease classification scheme (International Classification of Disease, Edition 9). The data from the second study is now available on-line at the Clinical Trial Service Unit & Epidemiological Studies Unit of Oxford website.


The US National Cancer Institute (of NIH), along with the American Institute for Cancer Research (Washington, DC), provided the initial funds. The Imperial Cancer Research Fund in England also provided significant support for the Oxford University activity. Since 1993, the American Institute for Cancer Research has provided the primary funds.

However, the majority of the support for this study came from the Chinese people and their government. This support was 'in kind', resulting in the provision of approximately 800+ years of professional and technical labor.

Cornell University | Division of Nutritional Sciences