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Dietary and serum α-tocopherol, β-carotene and retinol, and risk for colorectal cancer in male smokers

European Journal of Clinical Nutrition volume 56, pages 615–621 (2002)Cite this article

Abstract

Objective: To study the association between dietary and serum antioxidant vitamins and carotenoids and risk for colorectal cancer in male smokers.

Design: A prospective cohort study within a randomised, double-blind, placebo-controlled trial testing supplementation with α-tocopherol (50 mg/day), β-carotene (20 mg/day) or both in preventing cancer.

Subjects and methods: Participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study with complete dietary data and serum samples available from baseline. These included 26 951 middle-aged male smokers among whom 184 colorectal cancer cases were diagnosed during 8 y of follow-up. Relative risks were calculated with Cox proportional hazards models adjusting for trial supplementation, age, body mass index, serum cholesterol, cigarettes smoked per day and physical activity.

Results: There was no significant association between dietary vitamin C or E, α-or γ-tocopherol, retinol, α- or β-carotene, lycopene or lutein+zeaxanthin and risk for colorectal cancer. Serum α-tocopherol, β-carotene or retinol was also not associated with the risk, neither did the season when baseline blood was drawn modify the relationship between serum β-carotene and colorectal cancer risk.

Conclusions: Our data support the results from previous studies in which no association between dietary antioxidant vitamins and carotenoids and risk for colorectal cancer has been observed. Likewise, no association between baseline serum antioxidant concentrations and colorectal cancer risk was evident.

Sponsorship: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study was supported by a contract with the US National Cancer Institute (N01-CN-45165).

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References

  • Albanes D, Malila N, Taylor PR, Huttunen JK, Virtamo J, Edwards BK, Rautalahti M, Hartman AM, Barrett MJ, Pietinen P, Hartman TJ, Sipponen P, Lewin K, Teerenhovi L, Hietanen P, Virtanen M, Tangrea JA, Heinonen OP . 2000 Effects of supplemental alpha-tocopherol and beta-carotene on colorectal cancer: results from a controlled trial (Finland) Cancer Causes Control 11: 197–205

    Article  CAS  Google Scholar 

  • The ATBC Cancer Prevention Study Group. 1994 The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance Ann. Epidemiol. 4: 1–10

  • Benito E, Stiggelbout A, Bosch FX, Obrador A, Kaldor J, Mulet M, Munoz N . 1991 Nutritional factors in colorectal cancer risk: a case-control study in Majorca Int. J. Cancer 49: 161–167

    Article  CAS  Google Scholar 

  • Bostick RM, Potter JD, McKenzie DR, Sellers TA, Kushi LH, Steinmetz KA, Folsom AR . 1993 Reduced risk of colon cancer with high intake of vitamin E: the Iowa women's health study Cancer Res. 53: 4230–4237

    CAS  PubMed  Google Scholar 

  • Cannon G (ed). 1997 Food, Nutrition and the Prevention of Cancer: a Global Perspective Washington DC: the American Institute for Cancer Research pp 216–251

    Google Scholar 

  • Colbert LH, Hartman TJ, Malila N, Limburg PJ, Pietinen P, Virtamo J, Taylor PR, Albanes D . 2001 Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers Cancer Epidemiol. Biomarkers Prev. 10: 265–268

    CAS  PubMed  Google Scholar 

  • Comstock GW, Bush TL, Helzlsouer K . 1992 Serum retinol, beta-carotene, vitamin E, and selenium as related to subsequent cancer of specific sites Am. J. Epidemiol. 135: 115–121

    Article  CAS  Google Scholar 

  • Comstock GW, Alberg AJ, Helzlsouer KJ . 1993 Reported effects of long-term freezer storage on concentrations of retinol, beta-carotene, and alpha-tocopherol in serum or plasma summarized Clin. Chem. 39: 1075–1078

    CAS  PubMed  Google Scholar 

  • Connett JE, Kuller LH, Kjelsberg MO, Polk BF, Collins G, Rider A, Hulley SB . 1989 Relationship between carotenoids and cancer. The Multiple Risk Factor Intervention Trial (MRFIT) Study Cancer 64: 126–134

    Article  CAS  Google Scholar 

  • Enger SM, Longnecker MP, Chen MJ, Harper JM, Lee ER, Frankl HD, Haile RW . 1996 Dietary intake of specific carotenoids and vitamins A, C, and E, and prevalence of colorectal adenomas Cancer Epidemiol. Biomarkers Prev. 5: 147–153

    CAS  PubMed  Google Scholar 

  • Ferraroni M, La Vecchia C, D'Avanzo B, Negri E, Franceschi S, Decarli A . 1994 Selected micronutrient intake and the risk of colorectal cancer Br. J. Cancer 70: 1150–1155

    Article  CAS  Google Scholar 

  • Freudenheim JL, Graham S, Marshall JR, Haughey BP, Wilkinson G . 1990 A case-control study of diet and rectal cancer in Western New York Am. J. Epidemiol. 131: 612–624

    Article  CAS  Google Scholar 

  • Ghadirian P, Lacroix A, Maisonneuve P, Perret C, Potvin C, Gravel D, Bernard D, Boyle P . 1997 Nutritional factors and colon carcinoma: a case–control study involving French Canadians in Montreal, Quebec, Canada Cancer 80: 858–864

    Article  CAS  Google Scholar 

  • Heilbrun LK, Nomura A, Hankin JH, Stemmermann GN . 1989 Diet and colorectal cancer with special reference to fiber intake Int. J. Cancer 44: 1–6

    Article  CAS  Google Scholar 

  • Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, Belanger C, LaMotte F, Gaziano JM, Ridker PM, Willett W, Peto R . 1996 Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease New Engl. J. Med. 334: 1145–1149

    Article  CAS  Google Scholar 

  • Kattermann R . 1984 Multicentre study of a new enzymatic method of cholesterol determination J. Clin. Chem. Clin. Biochem. 22: 245–251

    CAS  PubMed  Google Scholar 

  • La Vecchia C, Braga C, Negri E, Franceschi S, Russo A, Conti E, Falcini F, Giacosa A, Montella M, Decarli A . 1997 Intake of selected micronutrients and risk of colorectal cancer Int. J. Cancer 73: 525–530

    Article  CAS  Google Scholar 

  • Longnecker MP, Martin-Moreno JM, Knekt P, Nomura AM, Schober SE, Stahelin HB, Wald NJ, Gey KF, Willett WC . 1992 Serum alpha-tocopherol concentration in relation to subsequent cancer: pooled data from five cohorts J. Natl Cancer Inst. 84: 430–435

    Article  CAS  Google Scholar 

  • Meyer F, White E . 1993 Alcohol and nutrients in relation to colon cancer in middle-aged adults Am. J. Epidemiol. 138: 225–236

    Article  CAS  Google Scholar 

  • Milne DB, Botnen J . Retinol, alpha-tocopherol, lycopene, and alpha- and beta-carotene simultaneously determined in plasma by isocratic liquid chromatography Clin. Chem. 32: 874–876

  • Olsen J, Kronborg O, Lynggaard J, Ewertz M . 1994 Dietary risk factors for cancer and adenomas of the large intestine. A case–control study within a screening trial in Denmark Eur. J. Cancer 30A: 53–60

    Article  CAS  Google Scholar 

  • Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FLJ, Valanis B, Williams JHJ, Barnhart S, Cherniack MG, Brodkin CA, Hammar S . 1996 Risk factors for lung cancer and for intervention effects in CARET, the beta-carotene and retinol efficacy trial J. Natl Cancer Inst. 88: 1550–1559

    Article  CAS  Google Scholar 

  • Peters RK, Pike MC, Garabrant D, Mack TM . 1992 Diet and colon cancer in Los Angeles County, California Cancer Causes Control 3: 457–473

    Article  CAS  Google Scholar 

  • Pietinen P, Hartman AM, Haapa E, Räsänen L, Haapakoski J, Palmgren J, Albanes D, Virtamo J, Huttunen JK . 1988 Reproducibility and validity of dietary assessment instruments I. A self-administered food use questionnaire with a portion size picture booklet Am. J. Epidemiol. 128: 655–666

    Article  CAS  Google Scholar 

  • Rautalahti M, Albanes D, Haukka J, Roos E, Gref C-G, Virtamo J . 1993 Seasonal variation of serum concentrations of beta-carotene and alpha-tocopherol Am. J. Clin. Nutr. 57: 551–556

    Article  CAS  Google Scholar 

  • Schober SE, Comstock GW, Helsing KJ, Salkeld RM, Morris JS, Rider AA, Brookmeyer R . 1987 Serologic precursors of cancer. I. Prediagnostic serum nutrients and colon cancer risk Am. J. Epidemiol. 126: 1033–1041

    Article  CAS  Google Scholar 

  • Sellers TA, Bazyk AE, Bostick RM, Kushi LH, Olson JE, Anderson KE, Lazovich DeA, Folsom AR . 1998 Diet and risk of colon cancer in a large prospective study of older women: an analysis stratified on family history (Iowa, United States) Cancer Causes Control 9: 357–367

    Article  CAS  Google Scholar 

  • Slattery ML, Edwards SL, Anderson K, Caan B . 1998 Vitamin E and colon cancer: is there an association? Nutr. Cancer 30: 201–206

    Article  CAS  Google Scholar 

  • Slattery ML, Benson J, Curtin K, Ma K-N, Schaeffer D, Potter JD . 2000 Carotenoids and colon cancer Am. J. Clin. Nutr. 71: 575–582

    Article  CAS  Google Scholar 

  • Stone WL, Papas AM . 1997 Tocopherols and the etiology of colon cancer J. Natl Cancer Inst. 89: 1006–1014

    Article  CAS  Google Scholar 

  • Tucker KL, Chen H, Vogel S, Wilson PWF, Schaefer EJ, Lammi-Keefe CJ . 1999 Carotenoid intakes, assessed by dietary questionnaire, are associated with plasma carotenoid concentrations in an elderly population J. Nutr. 29: 438–445

    Article  Google Scholar 

  • van Poppel G . 1993 Carotenoids and cancer: an update with emphasis on human intervention studies Eur. J. Cancer 29: (A9) 1335–1344

    Article  Google Scholar 

  • Willett WC, Polk BF, Underwood BA, Stampfer MJ, Pressel S, Rosner B, Taylor J, Schneider K, Hames CG . 1984 Relation of serum vitamins A and E and carotenoids to the risk of cancer New Engl. J. Med. 310: 430–434

    Article  CAS  Google Scholar 

  • Willett W, Stampfer MJ . 1986 Total energy intake: implications for epidemiologic analyses Am. J. Epidemiol. 124: 17–27

    Article  CAS  Google Scholar 

  • Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE . 1990 Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women New Engl. J. Med. 323: 1664–1672

    Article  CAS  Google Scholar 

  • World Health Organization. 1998a IARC Handbooks of Cancer Prevention—Carotenoids Vol 2: Lyon: International Agency for Research on Cancer

  • World Health Organization. 1998b IARC Handbooks of Cancer Prevention—Vitamin A Vol 3: Lyon: International Agency for Research on Cancer

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Author notes

  1. N Malila: Guarantor: N Malila.

  2. N Malila, J Virtamo, M Virtanen, P Pietinen, D Albanes and L Teppo: Contributors: NM collected data on colorectal cancers, did primary analyses and wrote the first draft of the manuscript. JV acted as the supervisor of NM, coordinated and managed the trial, and edited the manuscript, MV provided methodological and statistical advice, PP provided methodological advice concerning dietary data and edited the manuscript, DA collaborated in the planning and writing of the manuscript, LT acted as the supervisor of NM, provided advice in epidemiology, and edited the manuscript.

Authors and Affiliations

  1. Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland

    N Malila, J Virtamo, M Virtanen & P Pietinen

  2. National Cancer Institute, Bethesda, Maryland, USA

    D Albanes

  3. Finnish Cancer Registry, Helsinki, Finland

    L Teppo

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  1. N Malila
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  2. J Virtamo
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  3. M Virtanen
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  4. P Pietinen
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  5. D Albanes
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  6. L Teppo
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Correspondence to N Malila.

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Malila, N., Virtamo, J., Virtanen, M. et al. Dietary and serum α-tocopherol, β-carotene and retinol, and risk for colorectal cancer in male smokers. Eur J Clin Nutr 56, 615–621 (2002). https://doi.org/10.1038/sj.ejcn.1601366

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601366

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