Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study

Abstract

Some dietary factors could be involved as cofactors in cervical carcinogenesis, but evidence is inconclusive. There are no data about the effect of fruits and vegetables intake (F&V) on cervical cancer from cohort studies. We examined the association between the intake of F&V and selected nutrients and the incidence of carcinoma in situ (CIS) and invasive squamous cervical cancer (ISC) in a prospective study of 299,649 women, participating in the European Prospective Investigation into Cancer and Nutrition study. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CI). A calibration study was used to control measurement errors in the dietary questionnaire. After a mean of 9 years of follow‐up, 253 ISC and 817 CIS cases were diagnosed. In the calibrated model, we observed a statistically significant inverse association of ISC with a daily increase in intake of 100 g of total fruits (HR 0.83; 95% CI 0.72–0.98) and a statistically nonsignificant inverse association with a daily increase in intake of 100 g of total vegetables (HR 0.85: 95% CI 0.65–1.10). Statistically nonsignificant inverse associations were also observed for leafy vegetables, root vegetables, garlic and onions, citrus fruits, vitamin C, vitamin E and retinol for ISC. No association was found regarding beta‐carotene, vitamin D and folic acid for ISC. None of the dietary factors examined was associated with CIS. Our study suggests a possible protective role of fruit intake and other dietary factors on ISC that need to be confirmed on a larger number of ISC cases.

Garlic and Onions: Their Cancer Prevention Properties

“…However, after 11 years of follow-up and 683 cases, even this weak association was no longer evident for total gastric adenocarcinoma. Allium vegetables were also not associated with decreased risk of cardia, noncardia, intestinal, and diffuse subtypes of gastric cancer (27). The EPIC cohort, which included men and women aged 35–70 recruited from 1992–1998, had relatively high fruit and vegetable consumption even in the lowest quintile of intake, thus making it difficult to compare high to low or no intake.…”

“…Additional analyses of data from the EPIC cohort found that after 9 years of follow-up, garlic and onions combined had no effect on cervical carcinoma in situ or on invasive squamous cervical cancer (27). …”

Socio-Economic and Behavioral Risk-Factors of Cervical Lesions in Adjara Region (Republic of Georgia).

“…Some epidemiologic studies revealed that the some food or macro-and micronutrients may be used for the prevention of the progression from precancer-to cancer-state. "European Prospective Investigation into Cancer and Nutrients" (EPIC) has showed significant inverse correlation between cervical cancer and daily fruit intake (González CA, 2011). In particular, the intake of fruit and vegetables, vitamins A, C, and E, folates, carotinoids and minerals were associated with the decreased risk HPV infection, CIN and cervical cancer ( [18,20] during cervical cancer development.…”

Scientific Opinion on Dietary Reference Values for vitamin A

“…Several studies reported on the association between intake of "vitamin A" or retinol and risk of cancer at various sites, including risk of oral premalignant lesions (one prospective cohort study (Maserejian et al, 2007)), nasopharyngeal carcinoma (one case-control study (Hsu et al, 2012)), lung cancer (two prospective cohort studies (Yong et al, 1997;Takata et al, 2013)), benign proliferative epithelial disorders of the breast (one case-control study (Rohan et al, 1990); one nested case-control study (Rohan et al, 1998)), breast cancer (one meta-analysis (Fulan et al, 2011)), gastric cancer (two prospective cohort studies (Larsson et al, 2007;Miyazaki et al, 2012)), pancreatic cancer (two casecontrol studies (Zablotska et al, 2011;Jansen et al, 2013)), colorectal cancer (three case-control studies (Key et al, 2012;Wang et al, 2012;Leenders et al, 2014); one prospective cohort study (Ruder et al, 2011); one systematic review (Xu et al, 2013)), prostate cancer (one case-control study (Ghadirian et al, 1996); one prospective cohort study (Giovannucci et al, 1995)), cervical cancer (two systematic reviews (Garcia-Closas et al, 2005;Zhang et al, 2012); one prospective cohort study (Gonzalez et al, 2011)), ovarian cancer (one case-control study (Zhang et al, 2004); one prospective cohort study (Fairfield et al, 2001)), bladder cancer (one case-control study (Garcia-Closas et al, 2007)), melanoma or basal cell carcinoma (one case-control study (Naldi et al, 2004); three prospective cohort studies (Fung et al, 2002;Feskanich et al, 2003;Asgari et al, 2012)) and nonHodgkin's lymphoma (one case-control study (Mikhak et al, 2012); one prospective cohort study (Kabat et al, 2012)). Results were limited and/or inconsistent.…”