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Dietary antioxidant intake and the risk of cardia cancer and noncardia cancer of the intestinal and diffuse types: a population-based case-control study in Sweden.

Abstract

In spite of diverging incidence trends, subsite, and subtype-specific gastric cancer data on the association with dietary antioxidants are sparse. We aimed to test whether the apparent protective effect of antioxidants is mainly confined to noncardia (distal) cancer of the intestinal subtype, to which most of the incidence decline in gastric cancer has been ascribed. In a Swedish study base (total population 1.3 million), we interviewed 567 cases uniformly classified to subsite (cardia vs. noncardia) and subtype (intestinal vs. diffuse), and 1165 population-based controls, frequency matched for age and sex. Serologic data on H. pylori status was available for a subset of 542 individuals. Ascorbic acid (vitamin C) was inversely associated with all subsites and subtypes of gastric cancer in a significant dose-response manner (all p<0.05), with risk reductions between 40% and 60%. beta-carotene was also strongly and negatively associated with risk, particularly with the intestinal type. The associations with alpha-tocopherol (vitamin E) were less clear. The highest parallel intake of all three antioxidants (quartiles 4), compared to those with the lowest parallel intakes (quartiles 1), was associated with a 70% lower risk of developing noncardia cancer (OR 0.3, 95% CI 0.1-0.9). Our results suggest that antioxidants might be especially beneficial among subjects at increased risk for gastric cancer such as smokers and those infected by H. pylori. We conclude that a high intake of antioxidants, as a consequence of high consumption of fruit and vegetables, may lower the risk not only for gastric cancer of the intestinal type, but also for diffuse type adenocarcinoma and cardia cancer.

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  • Authors+Show Affiliations

    ,

    Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.

    , , , ,

    Source

    International journal of cancer 87:1 2000 Jul 01 pg 133-40

    MeSH

    Adenocarcinoma
    Adult
    Aged
    Antioxidants
    Ascorbic Acid
    Cardia
    Case-Control Studies
    Female
    Fruit
    Helicobacter pylori
    Humans
    Intestinal Neoplasms
    Male
    Middle Aged
    Odds Ratio
    Risk Factors
    Smoking
    Stomach Neoplasms
    Sweden
    Vegetables
    Vitamin E
    beta Carotene

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10861464

    Citation

    Ekström, A M., et al. "Dietary Antioxidant Intake and the Risk of Cardia Cancer and Noncardia Cancer of the Intestinal and Diffuse Types: a Population-based Case-control Study in Sweden." International Journal of Cancer, vol. 87, no. 1, 2000, pp. 133-40.
    Ekström AM, Serafini M, Nyrén O, et al. Dietary antioxidant intake and the risk of cardia cancer and noncardia cancer of the intestinal and diffuse types: a population-based case-control study in Sweden. Int J Cancer. 2000;87(1):133-40.
    Ekström, A. M., Serafini, M., Nyrén, O., Hansson, L. E., Ye, W., & Wolk, A. (2000). Dietary antioxidant intake and the risk of cardia cancer and noncardia cancer of the intestinal and diffuse types: a population-based case-control study in Sweden. International Journal of Cancer, 87(1), pp. 133-40.
    Ekström AM, et al. Dietary Antioxidant Intake and the Risk of Cardia Cancer and Noncardia Cancer of the Intestinal and Diffuse Types: a Population-based Case-control Study in Sweden. Int J Cancer. 2000 Jul 1;87(1):133-40. PubMed PMID: 10861464.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary antioxidant intake and the risk of cardia cancer and noncardia cancer of the intestinal and diffuse types: a population-based case-control study in Sweden. AU - Ekström,A M, AU - Serafini,M, AU - Nyrén,O, AU - Hansson,L E, AU - Ye,W, AU - Wolk,A, PY - 2000/6/22/pubmed PY - 2000/7/15/medline PY - 2000/6/22/entrez SP - 133 EP - 40 JF - International journal of cancer JO - Int. J. Cancer VL - 87 IS - 1 N2 - In spite of diverging incidence trends, subsite, and subtype-specific gastric cancer data on the association with dietary antioxidants are sparse. We aimed to test whether the apparent protective effect of antioxidants is mainly confined to noncardia (distal) cancer of the intestinal subtype, to which most of the incidence decline in gastric cancer has been ascribed. In a Swedish study base (total population 1.3 million), we interviewed 567 cases uniformly classified to subsite (cardia vs. noncardia) and subtype (intestinal vs. diffuse), and 1165 population-based controls, frequency matched for age and sex. Serologic data on H. pylori status was available for a subset of 542 individuals. Ascorbic acid (vitamin C) was inversely associated with all subsites and subtypes of gastric cancer in a significant dose-response manner (all p<0.05), with risk reductions between 40% and 60%. beta-carotene was also strongly and negatively associated with risk, particularly with the intestinal type. The associations with alpha-tocopherol (vitamin E) were less clear. The highest parallel intake of all three antioxidants (quartiles 4), compared to those with the lowest parallel intakes (quartiles 1), was associated with a 70% lower risk of developing noncardia cancer (OR 0.3, 95% CI 0.1-0.9). Our results suggest that antioxidants might be especially beneficial among subjects at increased risk for gastric cancer such as smokers and those infected by H. pylori. We conclude that a high intake of antioxidants, as a consequence of high consumption of fruit and vegetables, may lower the risk not only for gastric cancer of the intestinal type, but also for diffuse type adenocarcinoma and cardia cancer. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/10861464/Dietary_antioxidant_intake_and_the_risk_of_cardia_cancer_and_noncardia_cancer_of_the_intestinal_and_diffuse_types:_a_population_based_case_control_study_in_Sweden_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0020-7136&amp;date=2000&amp;volume=87&amp;issue=1&amp;spage=133 DB - PRIME DP - Unbound Medicine ER -