Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort

Marije F. Bakker, P. H. Peeters, V. M. Klaasen, H. B. Bueno-de-Mesquita, E. H. Jansen, M. M. Ros, N. Travier, A. Olsen, A. Tjonneland, K. Overvad, S. Rinaldi, I. Romieu, M. C. Boutron-Ruault, F. Perquier, C. Cadeau, H. Boeing, K. Aleksandrova, R. Kaaks, T. Kuhn, A. TrichopoulouP. Lagiou, D. Trichopoulos, P. Vineis, V. Krogh, S. Panico, G. Masala, R. Tumino, E. Weiderpass, G. Skeie, E. Lund, J. R. Quiros, E. Ardanaz, C. Navarro, P. Amiano, M. J. Sanchez, G. Buckland, U. Ericson, E. Sonestedt, M. Johansson, M. Sund, R. C. Travis, T. J. Key, K. T. Khaw, N. Wareham, E. Riboli, C. H. van Gils

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Background: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.Objective: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk ofbreast cancer.Design: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 femaleincident breast cancer cases were included, with an oversamplingof premenopausal (n = 582) and estrogen receptor–negative (ER2)cases (n = 462). Controls (n = 1502) were individually matchedto cases by using incidence density sampling. Prediagnostic samples were analyzed for a-carotene, b-carotene, lycopene, lutein,zeaxanthin, b-cryptoxanthin, retinol, a-tocopherol, g-tocopherol, andvitamin C. Breast cancer risk was computed according to hormonereceptor status and age at diagnosis (proxy for menopausal status)by using conditional logistic regression and was further stratified bysmoking status, alcohol consumption, and body mass index (BMI).All statistical tests were 2-sided.Results: In quintile 5 compared with quintile 1, a-carotene (OR:0.61; 95% CI: 0.39, 0.98) and b-carotene (OR: 0.41; 95% CI: 0.26,0.65) were inversely associated with risk of ER2 breast tumors. Theother analytes were not statistically associated with ER2 breast cancer. For estrogen receptor–positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity betweenER2 and ER+ tumors was statistically significant only for b-carotene(P-heterogeneity = 0.03). A higher risk of breast cancer was found forretinol in relation to ER2/progesterone receptor–negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant
interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).
Conclusion: Our results indicate that higher concentrations of plasma b-carotene and a-carotene are associated with lower breast cancer risk of ER2 tumors
Original languageUndefined/Unknown
Pages (from-to)454-464
Number of pages11
JournalAmerican Journal of Clinical Nutrition
Issue number2
Publication statusPublished - 20 Jan 2016

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