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Vitamins and plant ingredients

Repeated measurements of serum carotenoid, retinol and tocopherol levels in relation to colorectal cancer risk in the Women's Health Initiative

Abstract

Background/Objective:

Previous cohort studies examining the association of serum antioxidant levels and risk of colorectal cancer have used a single (baseline) measurement only. In the present study, we assessed the association of serum levels of eight antioxidant nutrients in relation to risk of colorectal cancer, using repeated measurements.

Subjects/Methods:

Data on a subsample of women in the Women's Health Initiative with repeated measurements of serum retinol, α-carotene, β-carotene, β-cryptoxanthin, lutein+zeaxanthin, lycopene, α-tocopherol and γ-tocopherol during follow-up were included in the analysis. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CIs).

Results:

Among 5477 women with baseline serum antioxidant values, 88 incident cases of colorectal cancer were identified over a median follow-up time of 12 years. Serum antioxidants measured at baseline generally showed no association with risk of colorectal cancer, although serum β-carotene at baseline showed a non-significant inverse association with colon cancer alone. Furthermore, using the repeated measurements of β-carotene, the average of all measurements was inversely associated with risk of both colorectal and colon cancer: HRs for highest vs lowest tertile 0.54, 95% CI 0.31–0.96, and 0.47, 95% CI 0.25–0.88, respectively. No associations were seen with other antioxidant nutrients in the repeated measure analyses.

Conclusions:

In this study, baseline levels of antioxidant nutrients were not associated with risk of colorectal or colon cancer; however, using repeated measures, a relatively high serum level of β-carotene (average of all measurements) was inversely associated with risk of colon and colorectal cancer in postmenopausal women.

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Acknowledgements

We would like to thank the following. Program office: Jacques Rossouw, Shari Ludlam, Dale Burwen, Joan McGowan, Leslie Ford, and Nancy Geller (National Heart, Lung, and Blood Institute, Bethesda, Maryland). Clinical Coordinating Center: Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg (Fred Hutchinson Cancer Research Center, Seattle, WA). Investigators and Academic Centers: JoAnn E Manson (Brigham and Women's Hospital, Harvard Medical School, Boston, MA); Barbara V Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University, Columbus, OH); Cynthia A Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); Marian Limacher (University of Florida, Gainesville/Jacksonville, FL); Robert Wallace (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker (Wake Forest University School of Medicine, Winston-Salem, NC). Women's Health Initiative Memory Study: Sally Shumaker (Wake Forest University School of Medicine, Winston-Salem, NC). For a list of all the investigators who have contributed to WHI science, please visit: http://www.whiscience.org/publications/WHI_investigators_longlist.pdf.

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Correspondence to G C Kabat.

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Kabat, G., Kim, M., Sarto, G. et al. Repeated measurements of serum carotenoid, retinol and tocopherol levels in relation to colorectal cancer risk in the Women's Health Initiative. Eur J Clin Nutr 66, 549–554 (2012). https://doi.org/10.1038/ejcn.2011.207

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