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Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies.

Abstract

OBJECTIVE

To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer.

METHODS

Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model.

RESULTS

Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76-1.02, >4,000 vs. ≤ 1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤ 100 mg/day) for vitamin C, and 0.78 (0.66-0.92, > 200 vs. ≤ 6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81-0.96).

CONCLUSIONS

Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.

    , , , , , , , , , , , , , , , , , , , , , , , , , ,

    Source

    Cancer causes & control : CCC 21:11 2010 Nov pg 1745-57

    MeSH

    Ascorbic Acid
    Case-Control Studies
    Cohort Studies
    Colonic Neoplasms
    Dietary Supplements
    Dose-Response Relationship, Drug
    Europe
    Female
    Folic Acid
    Follow-Up Studies
    Humans
    Incidence
    Male
    Multivariate Analysis
    North America
    Proportional Hazards Models
    Prospective Studies
    Randomized Controlled Trials as Topic
    Reproducibility of Results
    Risk Assessment
    Vitamin A
    Vitamin E
    Vitamins

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20820901

    Citation

    Park, Yikyung, et al. "Intakes of Vitamins A, C, and E and Use of Multiple Vitamin Supplements and Risk of Colon Cancer: a Pooled Analysis of Prospective Cohort Studies." Cancer Causes & Control : CCC, vol. 21, no. 11, 2010, pp. 1745-57.
    Park Y, Spiegelman D, Hunter DJ, et al. Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies. Cancer Causes Control. 2010;21(11):1745-57.
    Park, Y., Spiegelman, D., Hunter, D. J., Albanes, D., Bergkvist, L., Buring, J. E., ... Smith-Warner, S. A. (2010). Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies. Cancer Causes & Control : CCC, 21(11), pp. 1745-57. doi:10.1007/s10552-010-9549-y.
    Park Y, et al. Intakes of Vitamins A, C, and E and Use of Multiple Vitamin Supplements and Risk of Colon Cancer: a Pooled Analysis of Prospective Cohort Studies. Cancer Causes Control. 2010;21(11):1745-57. PubMed PMID: 20820901.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies. AU - Park,Yikyung, AU - Spiegelman,Donna, AU - Hunter,David J, AU - Albanes,Demetrius, AU - Bergkvist,Leif, AU - Buring,Julie E, AU - Freudenheim,Jo L, AU - Giovannucci,Edward, AU - Goldbohm,R Alexandra, AU - Harnack,Lisa, AU - Kato,Ikuko, AU - Krogh,Vittorio, AU - Leitzmann,Michael F, AU - Limburg,Paul J, AU - Marshall,James R, AU - McCullough,Marjorie L, AU - Miller,Anthony B, AU - Rohan,Thomas E, AU - Schatzkin,Arthur, AU - Shore,Roy, AU - Sieri,Sabina, AU - Stampfer,Meir J, AU - Virtamo,Jarmo, AU - Weijenberg,Matty, AU - Willett,Walter C, AU - Wolk,Alicja, AU - Zhang,Shumin M, AU - Smith-Warner,Stephanie A, Y1 - 2010/09/05/ PY - 2009/09/03/received PY - 2010/03/18/accepted PY - 2010/9/8/entrez PY - 2010/9/8/pubmed PY - 2011/3/2/medline SP - 1745 EP - 57 JF - Cancer causes & control : CCC JO - Cancer Causes Control VL - 21 IS - 11 N2 - OBJECTIVE: To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. METHODS: Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model. RESULTS: Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76-1.02, >4,000 vs. ≤ 1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤ 100 mg/day) for vitamin C, and 0.78 (0.66-0.92, > 200 vs. ≤ 6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81-0.96). CONCLUSIONS: Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study. SN - 1573-7225 UR - https://www.unboundmedicine.com/medline/citation/20820901/Intakes_of_vitamins_A_C_and_E_and_use_of_multiple_vitamin_supplements_and_risk_of_colon_cancer:_a_pooled_analysis_of_prospective_cohort_studies_ L2 - https://doi.org/10.1007/s10552-010-9549-y DB - PRIME DP - Unbound Medicine ER -