Are retinol, vitamin C, vitamin E, folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study

Article metrics

Abstract

In the Netherlands Cohort Study among 120 852 subjects aged 55–69 years at baseline (1986), the association between vitamins and carotenoids intake, vitamin supplement use, and bladder cancer incidence was examined. Exposure status was measured with a food-frequency questionnaire. After 6.3 years of follow-up, data from 569 cases and 3123 subcohort members were available for case-cohort analyses. The age-, sex-, and smoking-adjusted relative risks (RRs) for retinol, vitamin E, folate, α-carotene, β-carotene, lutein and zeaxanthin, and lycopene were 1.04, 0.98, 1.03, 0.99, 1.16, 1.11, and 1.08, respectively, comparing highest to lowest quintile of intake. Only vitamin C (RR: 0.81, 95% CI: 0.61–1.07, P-trend = 0.08), and β-cryptoxanthin intake (RR: 0.74, 95% CI: 0.53–1.03, P-trend < 0.01) were inversely associated with bladder cancer risk. The association with vitamin C disappeared after adjustment for β-cryptoxanthin but not vice versa. The RRs for supplemental use of vitamin A, C or E compared to no use were around unity.

We conclude that dietary or supplemental intake of vitamin A, vitamin C, vitamin E, and intake of folate, and most carotenoids are not associated with bladder cancer. In this study, only β-cryptoxanthin intake appeared to be inversely associated. © 2001 Cancer Research Campaign http://www.bjcancer.com

Change history

  • 16 November 2011

    This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication

References

  1. Barlow WE (1994) Robust variance estimation for the case-cohort design. Biometrics 50: 1064–1072

  2. Birt DF (1986) Update on the effects of vitamins A, C, and E and selenium on carcinogenesis. Proc Soc Exp Biol Med 183: 311–320

  3. Blount BC, Mack MM, Wehr CM, MacGregor JT, Hiatt RA, Wang G, Wickramasinghe SN, Everson RB and Ames BN (1997) Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage. Proc Natl Acad Sci USA 94: 3290–3295

  4. Bruemmer B, White E, Vaughan TL and Cheney CL (1996) Nutrient intake in relation to bladder cancer among middle-aged men and women. Am J Epidemiol 144: 485–495

  5. Chyou PH, Nomura AM and Stemmermann GN (1993) A prospective study of diet, smoking, and lower urinary tract cancer. Ann Epidemiol 3: 211–216

  6. D'Avanzo B, La Vecchia C, Negri E, Decarli A and Benichou J (1995) Attributable risks for bladder cancer in northern Italy. Ann Epidemiol 5: 427–431

  7. Glynn SA and Albanes D (1994) Folate and cancer: a review of the literature. Nutr Cancer 22: 101–119

  8. Goldbohm RA, Brants HA, Hulshof KF and van den Brandt PA (1998) The contribution of various foods to intake of vitamin A and carotenoids in The Netherlands. Int J Vitam Nutr Res 68: 378–383

  9. Goldbohm RA, van den Brandt PA, Brants HA, van het Veer P, Al M, Sturmans F and Hermus RJSO (1994a) Validation of a dietary questionnaire used in large-scale prospective cohort study on diet and cancer. Eur J Clin Nutr 48: 253–265

  10. Goldbohm RA, van den Brandt PA and Dorant E (1994b) Estimation of the coverage of Dutch municipalities by cancer registries and PALGA based on hospital discharge data. Tijdschr Soc Gezond 72: 80–84

  11. Goldbohm RA, van ‘t Veer P, van den Brandt PA, van ‘t Hof MA, Brants HA, Sturmans F and Hermus RJ (1995) Reproducibility of a food frequency questionnaire and stability of dietary habits determined from five annually repeated measurements. Eur J Clin Nutr 49: 420–429

  12. Johansson SL and Cohen SM (1997) Epidemiology and etiology of bladder cancer. Semin Surg Oncol 13: 291–298

  13. Kamat AM and Lamm DL (1999) Chemoprevention of urological cancer. J Urol 161: 1748–1760

  14. Knekt P, Aromaa A, Maatela J, Aaran RK, Nikkari T, Hakama M, Hakulinen T, Peto R, Saxen E and Teppo L (1988) Serum vitamin E and risk of cancer among Finnish men during a 10-year follow-up. Am J Epidemiol 127: 28–41

  15. Konings EJ (1999) A validated liquid chromatographic method for determining folates in vegetables, milk powder, liver, and flour. J AOAC Int 82: 119–127

  16. Lin DY and Ying Z (1993) Cox regression with incomplete covariate measurements. JASA 88: 1341–1349

  17. Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Willett WC and Giovannucci E (2000) Prospective study of dietary supplements, macronutrients, micronutrients, and risk of bladder cancer in US men. [In Process Citation]. Am J Epidemiol 152: 1145–1153

  18. Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Willett WC and Giovannucci EL (1999) Fruit and vegetable intake and incidence of bladder cancer in a male prospective cohort. J Nutr Cancer Inst 91: 605–613

  19. Mills PK, Beeson WL, Phillips RL and Fraser GE (1991) Bladder cancer in a low risk population: results from the Adventist Health Study. Am J Epidemiol 133: 230–239

  20. Negri E, La Vecchia C, Franceschi SBDA and Parazzini F (1991) Vegetable and fruit consumption and cancer risk. Int J Cancer 48: 350–354

  21. NEVO-table (1986) Dutch food composition table 1986–1987. Voolichtingsbureau voor de Voeding: The Hague, Netherlands

  22. Nomura AMY, Kolonel LN, Hankin JH and Yoshizawa CN (1991) Dietary factors in cancer of the urinary tract. Int J Cancer 48: 199–205

  23. Parkin DM, Pisani P and Ferlay J (1999) Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 80: 827–841

  24. Patterson RE, White E, Kristal AR, Neuhouser ML and Potter JD (1997) Vitamin supplements and cancer risk: the epidemiologic evidence. Cancer Causes Control 8: 786–802

  25. Prentice RL (1986) A case-cohort design for epidemiologic cohort studies and disease prevention trials. Biometrika 73: 1–11

  26. Riboli E, Gonzalez CA, Lopez Abente G, Errezola M, Izarzugaza I, Escolar A, Nebot M, Hemon B and Agudo A (1991) Diet and bladder cancer in Spain: a multi-centre case-control study. Int J Cancer 49: 214–219

  27. Risch HA, Burch JD, Miller AB, Hill GB, Steele R and Howe GR (1988) Dietary factors and the incidence of cancer of the urinary bladder. Am J Epidemiol 127: 1179–1191

  28. Ross RK, Jones PA and Yu MC (1996) Bladder cancer epidemiology and pathogenesis. Semin Oncol 23: 536–545

  29. Shibata A, Paganini Hill A, Ross RK and Henderson BE (1992) Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study. Br J Cancer 66: 673–679

  30. Silverman DT, Hartge P, Morrison AS and Devesa SS (1992) Epidemiology of bladder cancer. Hematol Oncol Clin North Am 6: 1–30

  31. StataCorp (1999) Stata Statistical Software: Release 6.0. Stata Corporation: College Station, TX

  32. Steinmaus CM, Nunez S and Smith AH (2000) Diet and bladder cancer: a meta-analysis of six dietary variables. Am J Epidemiol 151: 693–702

  33. Steinmetz KA and Potter JD (1991) Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 2: 427–442

  34. van den Brandt PA, Goldbohm RA, van het Veer PAV, Hermus RJJ and Sturmans F (1990a) A large-scale prospective cohort study on diet and cancer in the Netherlands. J Clin Epidemiol 43: 285–295

  35. van den Brandt PA, Schouten LJ, Goldbohm RA, Dorant E and Hunen PHM (1990b) Development of a record linkage protocol for use in the Dutch cancer registry for epidemiological research. Int J Epidemiol 19: 553–558

  36. van der Meijden APM (1998) Bladder cancer. BMJ 317: 1366–1369

  37. Volovics A and van den Brandt PA (1997) Methods for the analyses of case-cohort studies. Biometrical Journal 2: 195–214

  38. World Cancer Research Fund & American Institute for Cancer Research (1997) Bladder In: Food, Nutrition and the Prevention of Cancer: a global perspective pp 338–361. Banta Book Group: Menasha

  39. Zeegers MP, Tan FE, Verhagen AP, Weijenberg MP and van den Brandt PA (1999) Elevated risk of cancer of the urinary tract for alcohol drinkers: a meta-analysis. Cancer Causes Control 10: 445–451

  40. Zeegers MP, Tan FE, Dorant E and van den Brandt PA (2000a) The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies. Cancer 89: 630–639

  41. Zeegers MPA, Tan FES, Goldbohm RA and van den Brandt PA (2000b) Are coffee and tea consumption associated with urinary tract cancer risk: a systematic review and meta-analysis. Int J Epidemiol,

Download references

Author information

Rights and permissions

From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/

Reprints and Permissions

About this article

Cite this article

Zeegers, M., Goldbohm, R. & Brandt, P. Are retinol, vitamin C, vitamin E, folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study. Br J Cancer 85, 977–983 (2001) doi:10.1054/bjoc.2001.1968

Download citation

Keywords

  • urologic neoplasms
  • bladder neoplasms
  • vitamin-A
  • vitamin-C
  • vitamin-E
  • folate
  • carotenoids

Further reading