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Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort.

Abstract

BACKGROUND

Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.

OBJECTIVE

This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer.

DESIGN

In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for α-carotene, β-carotene, lycopene, lutein, zeaxanthin, β-cryptoxanthin, retinol, α-tocopherol, γ-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided.

RESULTS

In quintile 5 compared with quintile 1, α-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and β-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for β-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).

CONCLUSION

Our results indicate that higher concentrations of plasma β-carotene and α-carotene are associated with lower breast cancer risk of ER- tumors.

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  • Authors+Show Affiliations

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    Julius Center for Health Sciences and Primary Care and m.f.bakker-8@umcutrecht.nl.

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    Julius Center for Health Sciences and Primary Care and Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom;

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    Julius Center for Health Sciences and Primary Care and Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;

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    Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom; National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;

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    National Institute for Public Health and the Environment, Bilthoven, Netherlands;

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    National Institute for Public Health and the Environment, Bilthoven, Netherlands;

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    Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain;

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    Danish Cancer Society Research Center, Copenhagen, Denmark;

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    Danish Cancer Society Research Center, Copenhagen, Denmark;

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    Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark;

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    International Agency for Research on Cancer, Lyon, France;

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    International Agency for Research on Cancer, Lyon, France;

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    International Agency for Research on Cancer, Lyon, France;

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    Inserm, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris-Sud, UMRS 1018, Villejuif, France; IGR, Villejuif, France;

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    Inserm, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris-Sud, UMRS 1018, Villejuif, France; IGR, Villejuif, France;

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    Inserm, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris-Sud, UMRS 1018, Villejuif, France; IGR, Villejuif, France;

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    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;

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    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;

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    German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany;

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    German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany;

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    WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece;

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    WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece;

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    Hellenic Health Foundation, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece;

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    Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom; Human Genetic Foundation (HuGeF), Turin, Italy;

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    Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;

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    Dipartimento Di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy;

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    Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy;

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    Cancer Registry and Histopathology Unit, "Civic M.P.Arezzo" Hospital, ASP Ragusa, Italy;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway;

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    Public Health Directorate, Asturias, Spain;

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    Navarre Public Health Institute, Pamplona, Spain; CIBER de Epidemiology and Public Health (CIPERESP), Spain;

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    Consortium for Biomedical Research in Epidemiology and public Health (CIBER de Epidemiología y Salud Pública), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain;

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    Consortium for Biomedical Research in Epidemiology and public Health (CIBER de Epidemiología y Salud Pública), Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastian, Spain;

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    Consortium for Biomedical Research in Epidemiology and public Health (CIBER de Epidemiología y Salud Pública), Madrid, Spain; Andalusian School of Public Health, Granada, Spain;

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    Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain;

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    Department of Clinical Sciences, Lund University, Malmö, Sweden;

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    Department of Clinical Sciences, Lund University, Malmö, Sweden;

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    International Agency for Research on Cancer, Lyon, France; Department of Biobank Research and.

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    Department of Surgery, Umeå University, Umeå, Sweden;

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    Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom;

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    Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom;

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    University of Cambridge, Cambridge, United Kingdom; and.

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    MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.

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    Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom;

    Julius Center for Health Sciences and Primary Care and.

    Source

    MeSH

    Adult
    Antioxidants
    Ascorbic Acid
    Breast Neoplasms
    Carotenoids
    Case-Control Studies
    Cohort Studies
    Diet
    Europe
    Female
    Follow-Up Studies
    Humans
    Middle Aged
    Neoplasm Proteins
    Postmenopause
    Premenopause
    Prospective Studies
    Receptors, Estrogen
    Risk
    Tocopherols
    Vitamin A
    beta Carotene

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    26791185

    Citation

    Bakker, Marije F., et al. "Plasma Carotenoids, Vitamin C, Tocopherols, and Retinol and the Risk of Breast Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort." The American Journal of Clinical Nutrition, vol. 103, no. 2, 2016, pp. 454-64.
    Bakker MF, Peeters PH, Klaasen VM, et al. Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 2016;103(2):454-64.
    Bakker, M. F., Peeters, P. H., Klaasen, V. M., Bueno-de-Mesquita, H. B., Jansen, E. H., Ros, M. M., ... van Gils, C. H. (2016). Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. The American Journal of Clinical Nutrition, 103(2), pp. 454-64. doi:10.3945/ajcn.114.101659.
    Bakker MF, et al. Plasma Carotenoids, Vitamin C, Tocopherols, and Retinol and the Risk of Breast Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort. Am J Clin Nutr. 2016;103(2):454-64. PubMed PMID: 26791185.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. AU - Bakker,Marije F, AU - Peeters,Petra Hm, AU - Klaasen,Veronique M, AU - Bueno-de-Mesquita,H Bas, AU - Jansen,Eugene Hjm, AU - Ros,Martine M, AU - Travier,Noémie, AU - Olsen,Anja, AU - Tjønneland,Anne, AU - Overvad,Kim, AU - Rinaldi,Sabina, AU - Romieu,Isabelle, AU - Brennan,Paul, AU - Boutron-Ruault,Marie-Christine, AU - Perquier,Florence, AU - Cadeau,Claire, AU - Boeing,Heiner, AU - Aleksandrova,Krasimira, AU - Kaaks,Rudolf, AU - Kühn,Tilman, AU - Trichopoulou,Antonia, AU - Lagiou,Pagona, AU - Trichopoulos,Dimitrios, AU - Vineis,Paolo, AU - Krogh,Vittorio, AU - Panico,Salvatore, AU - Masala,Giovanna, AU - Tumino,Rosario, AU - Weiderpass,Elisabete, AU - Skeie,Guri, AU - Lund,Eiliv, AU - Quirós,J Ramón, AU - Ardanaz,Eva, AU - Navarro,Carmen, AU - Amiano,Pilar, AU - Sánchez,María-José, AU - Buckland,Genevieve, AU - Ericson,Ulrika, AU - Sonestedt,Emily, AU - Johansson,Matthias, AU - Sund,Malin, AU - Travis,Ruth C, AU - Key,Timothy J, AU - Khaw,Kay-Tee, AU - Wareham,Nick, AU - Riboli,Elio, AU - van Gils,Carla H, Y1 - 2016/01/20/ PY - 2014/10/22/received PY - 2015/11/30/accepted PY - 2016/1/22/entrez PY - 2016/1/23/pubmed PY - 2016/6/14/medline KW - EPIC KW - antioxidants KW - breast cancer KW - carotenoids KW - plasma SP - 454 EP - 64 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 2 N2 - BACKGROUND: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity. OBJECTIVE: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer. DESIGN: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for α-carotene, β-carotene, lycopene, lutein, zeaxanthin, β-cryptoxanthin, retinol, α-tocopherol, γ-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided. RESULTS: In quintile 5 compared with quintile 1, α-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and β-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for β-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution). CONCLUSION: Our results indicate that higher concentrations of plasma β-carotene and α-carotene are associated with lower breast cancer risk of ER- tumors. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26791185/Plasma_carotenoids_vitamin_C_tocopherols_and_retinol_and_the_risk_of_breast_cancer_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition_cohort_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.114.101659 DB - PRIME DP - Unbound Medicine ER -