Cervical cancer is a leading cancer among women in developing countries. Infection with oncogenic human papillomavirus (HPV) types has been recognized as a necessary cause of this disease. Serum carotenoids and tocopherols have also been associated with risk for cervical neoplasia, but results from previous studies were not consistent. We evaluated the association of serum total carotene and tocopherols, and dietary intakes with the risk of newly diagnosed, histologically confirmed cervical intraepithelial neoplasia (CIN) grades 1, 2, 3 and invasive cancer in a hospital-based case-control study in São Paulo, Brazil. The investigation included 453 controls and 4 groups of cases (CIN1, n 5 140; CIN2, n 5 126; CIN3, n 5 231; invasive cancer, n 5108) recruited from two major public clinics between 2003 and 2005. Increasing concentrations of serum lycopene were negatively associated with CIN1, CIN3 and cancer, with odds ratios (OR) (95% CI) for the highest compared to the lowest tertile of 0.53 (0.27-1.00, p for trend 5 0.05), 0.48 (0.22-1.04, p for trend 5 0.05) and 0.18 (0.06-0.52, p for trend 5 0.002), respectively, after adjusting for confounding variables and HPV status. Increasing concentrations of serum a-and c-tocopherols, and higher dietary intakes of dark green and deep yellow vegetables/fruit were associated with nearly 50% decreased risk of CIN3. These results support the evidence that a healthy and balanced diet leading to provide high serum levels of antioxidants may reduce cervical neoplasia risk in low-income women.Cervical cancer is the second most common cancer among women worldwide. Disease occurrence varies widely by geographic region, with the highest rates in Latin American countries and the Caribbean, sub-Sahara Africa and parts of Asia. 1 Infection with oncogenic human papillomavirus (HPV) types is considered a necessary cause in the development of cervical cancer, and cofactors are tobacco smoking, long-term oral contraceptive use and high parity. [2][3][4][5][6][7] The aforementioned associations notwithstanding, the results on the relationship of nutritional factors to cervical neoplasia have not been consistent across different studies. Only a few investigations have used large numbers of subjects but were conducted mostly in developed countries. An important limitation is the absence of valid information on HPV status and distribution of types, which varies by country. 8 Thus, it has been suggested that most of the observations to date must be accepted only tentatively. 9 The study of the relationship of nutritional factors with cervical neoplasia is complicated by its multifactorial etiology, with many of the identified risk factors being correlated with nutritional and socioeconomic status. 10 Dietary components may be involved in the etiology of this disease since socioeconomic differences in risk persist after adjustment for known factors which suggests that dietary inadequacy consequent to poverty may help explain the high incidence rates in developing countries. 11 Previous case-con...