Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 96, Issue 4, Pages 902-910Publisher
AMER SOC NUTRITION-ASN
DOI: 10.3945/ajcn.111.032920
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Funding
- European Commission Public Health and Consumer Protection Directorate
- Ligue contre le Cancer
- Institut Gustave Roussy
- Mutuelle Generale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (France)
- German Cancer Aid, the German Cancer Research Center
- Federal Ministry of Education and Research (Germany)
- Danish Cancer Society (Denmark)
- Health Research Fund of the Spanish Ministry of Health
- Cancer Research UK
- Medical Research Council (United Kingdom)
- Hellenic Health Foundation
- Stavros Niarchos Foundation
- Hellenic Ministry of Health and Social Solidarity
- Italian Association for Research on Cancer
- National Research Council (Italy)
- Dutch Ministry of Public Health, Welfare and Sports
- Netherlands Cancer Registry
- LK Research Funds
- Dutch Prevention Funds
- Dutch Zorg Onderzoek Nederland
- World Cancer Research Fund
- Dutch Cancer Society
- Statistics Netherlands (Netherlands)
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane (Sweden)
- Helga study-Nordforsk Center of Excellence Programme in Food and Nutrition (Norway)
- Medical Research Council [G1000143, MC_U106179471, G0401527] Funding Source: researchfish
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Background: Published associations between dietary carotenoids and vitamin C and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. Objective: We investigated the association between plasma carotenoids and vitamin C and risk of urothelial cell carcinoma (UCC) in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Design: A total of 856 patients with newly diagnosed UCC were matched with 856 cohort members by sex, age at baseline, study center, date and time of blood collection, and fasting status. Plasma carotenoids (alpha- and beta-carotene, beta-cryptoxanthin, lycopene, lutein, and zeaxanthin) were measured by using reverse-phase HPLC, and plasma vitamin C was measured by using a colorimetric assay. Incidence rate ratios (IRRs) were estimated by using conditional logistic regression with adjustment for smoking status, duration, and intensity. Results: UCC risk decreased with higher concentrations of the sum of plasma carotenoids (IRR for the highest compared with the lowest quartile: 0.64; 95% CI: 0.44, 0.93; P-trend = 0.04). Plasma beta-carotene was inversely associated with aggressive UCC (IRR: 0.51; 95% CI: 0.30, 0.88; P-trend = 0.02). Plasma lutein was inversely associated with risk of nonaggressive UCC (IRR: 0.56; 95% CI: 0.32, 0.98; P-trend = 0.05). No association was observed between plasma vitamin C and risk of UCC. Conclusions: Although residual confounding by smoking or other factors cannot be excluded, higher concentrations of plasma carotenoids may reduce risk of UCC, in particular aggressive UCC. Plasma lutein may reduce risk of nonaggressive UCC. Am J Clin Nutr 2012;96:902-10.
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