Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Abstract

Smoking has been positively and fruit and vegetable intake has been negatively associated with cervical cancer, the second most common cancer among women worldwide. However, a lower consumption of fruits and reduced serum carotenoids have been observed among smokers. It is not known whether the smoking effect on the risk of cervical neoplasia is modified by a low intake of fruits and vegetables. The present study examined the combined effects of tobacco smoking and diet using a validated FFQ and serum carotenoid and tocopherol levels on cervical intraepithelial neoplasia grade 3 (CIN3) risk in a hospital-based case -control study conducted in São Paulo, Brazil, between 2003 and 2005. The sample comprised 231 incident, histologically confirmed cases of CIN3 and 453 controls. A low intake (#39 g) of dark-green and deep-yellow vegetables and fruits without tobacco smoking had a lesser effect on CIN3 (OR 1·14; 95 % CI 0·49, 2·65) than among smokers with higher intake ($40 g; OR 1·83; 95 % CI 0·73, 4·62) after adjusting for confounders. The OR for the joint exposure of tobacco smoking and low intake of vegetables and fruits was greater (3·86; 95 % CI 1·74, 8·57; P for trend, 0·001) compared with non-smokers with higher intake after adjusting for confounding variables and human papillomavirus status. Similar results were observed for total fruit, serum total carotene (including b-, a-and g-carotene) and tocopherols. These findings suggest that the effect of nutritional factors on CIN3 is modified by smoking.

HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status

“…Cervical smear samples were obtained from the Newfoundland study site of the Canadian Cervical Cancer Screening trial, 2,13 the Community-Based Screening Study from the Democratic Republic of Congo, 14,15 and the Brazilian Investigation into Nutrition and Cervical Cancer Prevention. [16][17][18] These studies are referred to hereafter as studies A, B, and C, respectively. Details regarding these parent studies and the analysis sample for the current study are summarized in Table 1.…”

“…Details regarding these parent studies and the analysis sample for the current study are summarized in Table 1. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Written informed consent was obtained from all participants.…”

Salient beliefs about eating and buying dark green vegetables as told by Mid-western African–American women

“…are leafy, cruciferous, and the most nutritious subgroup (USDA, 2010). For example, they contain high amounts of vitamins A, B, and C, fiber, lutein and phytochemicals (Butt & Sultan, 2011; Johnston, Taylor, & Hampl, 2000; Tomita, Roteli-Martins, Villa, Franco, & Cardoso, 2011; Venzon & Izzy, 2012). Regular consumption of vegetables in the dark green group is strongly associated with reduced risk of chronic diseases, such as cardiovascular disease (Chaoyang et al, 2010; Van Duyn & Pivonka, 2000).…”

A Dietary Pattern Associated with LINE-1 Methylation Alters the Risk of Developing Cervical Intraepithelial Neoplasia

“…However, we still don’t exclude the possibility that specific groups of fruits and vegetables, specific substances in some fruits and vegetables or overall dietary patterns (DPs) have important cancer protective effects. Recent studies have shown that a higher consumption of dark green and deep yellow vegetables and fruits was associated with lower risk of having cervical intraepithelial neoplasia (CIN), precursor lesions for developing cervical cancer, especially among smokers (4). Frequent consumption of fruits high in anti-oxidant nutrients was also shown to be associated with lower risk of CIN (5).…”