Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 103, Issue 2, Pages 454-464Publisher
OXFORD UNIV PRESS
DOI: 10.3945/ajcn.114.101659
Keywords
breast cancer; EPIC; antioxidants; carotenoids; plasma
Categories
Funding
- Wereld Kanker Onderzoek Fonds (WCRF NL) [WCRF 2006/13]
- Europe Against Cancer Program of the European Commission
- Deutsche Krebshilfe, Deutsches Krebsforschungszentrum
- German Federal Ministry of Education and Research
- Danish Cancer Society
- Health Research Fund of the Spanish Ministry of Health [ISCIII RETICC RD06/0020]
- Spanish Regional Government of Andalucia
- Spanish Regional Government of Asturia
- Spanish Regional Government of Basque Country
- Spanish Regional Government of Murcia [6236]
- Spanish Regional Government of Navarra
- Catalan Institute of Oncology, Red de Centros RCESP, Spain [C03/09]
- Cancer Research UK
- Medical Research Council, United Kingdom
- Stroke Association, United Kingdom
- British Heart Foundation
- Department of Health, United Kingdom
- Food Standards Agency, United Kingdom
- Wellcome Trust, United Kingdom
- Helenic Health Foundation
- Italian Association for Research on Cancer
- Italian National Research Council, Fondazione-Istituto Banco, Napoli, Italy
- Dutch Ministry of Public Health, Welfare and Sports
- Dutch Prevention Funds
- LK Research Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane, Sweden
- European Research Council
- French League against Cancer
- National Institute for Health and Medical Research, France
- Mutuelle Generale de l'Education Nationale, France
- 3M Co, France
- Gustave Roussy Institute, France
- General Councils of France
- MRC [MC_UU_12015/1] Funding Source: UKRI
- Cancer Research UK [14136, 16491] Funding Source: researchfish
- Medical Research Council [G0401527, MC_U106179471, MC_PC_13048, G1000143, MC_UU_12015/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10135, NF-SI-0512-10114] Funding Source: researchfish
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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 alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, retinol, alpha-tocopherol, gamma-tocopherol, and 454 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, alpha-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and beta-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 beta-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 beta-carotene and alpha-carotene are associated with lower breast cancer risk of ER tumors.
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