Dietary Vitamin a and Risk of Cancer in the Western Electric Study

Shekelle, Richard B.; Liu, Shuguey; Raynor, William J.; Lepper, Mark H.; Maliza, Carol; Rossof, Arthur H.; Paul, Oglesby; Shryock, Anne Macmillan; Stamler, Jeremiah

doi:10.1016/s0140-6736(81)91435-5

Cited by 424 publications

(112 citation statements)

References 14 publications

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“…Recent reviews (Buring & Hennekens, 1989;Fontham, 1990) have examined in detail the epidemiologic evidence relating dietary intake of beta-carotene (Graham et al, 1978;Shekelle et al, 1981;Graham et al, 1982;Wu et al, 1985;1987;Ohno et al, 1988) and of vegetable and fruit intake (MacLennan & DeCosta, 1977;Hirayama, 1979;Mettlin et al, 1979;Ziegler, 1986;Fontham et al, 1988;LeMarchand et al, 1989) to risk of specific cancers and of cancer overall. Beta-carotene has been found to be a possible protective factor for several cancers, including especially cancers of the lung, gastrointestinal tract, prostate, and breast, in some but not all epidemiologic studies (Graham et Aoki et al, 1987;Stryker et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study

Shibata

Paganini‐Hill²,

Ross³

et al. 1992

Br J Cancer

322

197

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Summary A cohort of 11,580 residents of a retirement community initially free from cancer were followed from 1981 to 1989. A total of 1,335 incident cancer cases were diagnosed during the period. Relative risks of cancer were calculated for baseline consumption of vegetables, fruits, beta-carotene, dietary vitamin C, and vitamin supplements. After adjustment for age and smoking, no evidence of a protective effect was found for any of the dietary variables in men. However, an inverse association was observed between vitamin C supplement use and bladder cancer risk. In women, reduced cancer risks of all sites combined and of the colon were noted for combined intake of all vegetables and fruits, fruit intake alone, and dietary vitamin C. Supplemental use of vitamins A and C showed a protective effect on colon cancer risk in women. There was some suggestion that beta-carotene intake and supplemental use of vitamins A, C, and E were associated with reduced risk of lung cancer in women, but none of these results were statistically significant. These inverse associations observed in women seem to warrant further investigation, although there was inconsistency in results between the sexes. Diet appears to play an important role in human carcinogenesis (Ames, 1983; (Buring & Hennekens, 1989;Fontham, 1990; Willett, 1990a). The quality of the epidemiologic studies evaluating these hypotheses, especially in terms of statistical power and the rigor with which the dietary data were collected, has varied considerably.We report here the results of a prospective cohort study of an elderly population in which we examined the relationship between dietary intake of vegetables, fruits, beta-carotene, and vitamin C and the incidence of cancer. The effects of vitamin supplements on cancer risk was also assessed. Responses to each food item was assigned numerical values indicating approximate daily intake frequency (i.e., 0 for 'rarely or never', 0.01 for 'a few times per year', 0.03 for 'about monthly', 0.1 for 'a few times per month', 0.5 for 'a few times per week', and 1.0 for 'daily or almost daily'; if 'in season only' was marked, the figure was multiplied by 0.25) and these figures were summed over a group of food items to obtain scores for the following five food categories: (1) all vegetables and fruits (44 items), (2) all vegetables (21 items), (3) all fruits (23 items), (4) dark green vegeatables (other leafy greens, broccoli, and brussel sprouts), and (5) yellow vegetables (sweet potatoes, carrots, summer squash, red peppers, and chili peppers) (see Appendix). Therefore, the potential range of scores for each of these categories was from zero to the number of items in each food group (for a subject who ate all items in the group every day).Average daily intake of beta-carotene was estimated for each subject by summing the products of the respective betacarotene content in the common measure (serving size) of each food item (converted from Vitamin A values in the US Department of Agriculture tables of food composition (US Dep...

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Section: Discussionmentioning

confidence: 99%

Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study

Shibata

Paganini‐Hill²,

Ross³

et al. 1992

Br J Cancer

322

197

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“…Since then, there were many epidemiological studies [8][9][10][11][12][13][14] which have shown similar results such high dietary -carotene consumption from foods was a protective factor for certain types of cancer.…”

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confidence: 96%

Relationship Between Serum Carotenoid Levels and Cancer Death Rates in the Residents, Living in a Rural Area of Hokkaido, Japan

Ito

Suzuki

Yagyu

et al. 1997

Journal of Epidemiology

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“…Studies investigating serum ,Bcarotene or serum vitamin E and subsequent risk of cancer have not been published. Epidemiological studies of diet and cancer are consistent with ,Bcarotene intake being associated with a reduced risk of cancer (Peto et al, 1981: Shekelle et al, 1981 but the evidence is relatively non-specific as dietary factors other than #-carotene might well have been involved. There is some evidence based on experimental work on animals that both fl-carotene (Mathews-Roth, 1982) and vitamin E (Cook & McNamara, 1980) which plasma samples have been stored for future biochemical analysis.…”

mentioning

confidence: 97%

Plasma retinol, β-carotene and vitamin E levels in relation to the future risk of breast cancer

Wald¹,

Boreham²,

Hayward³

et al. 1984

Br J Cancer

189

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Summary In a prospective study of 5,004 women in Guernsey, plasma samples were collected and stored. Retinol, fl-carotene and vitamin E levels were later measured in the samples from 39 women who subsequently developed breast cancer and from 78 controls who did not develop cancer. Plasma retinol levels were not related to the risk of breast cancer, mean levels among cases and controls being 485 jigl-1 and 479,igl 1 respectively. Plasma vitamin E levels showed a clear association, low levels being associated with a significantly higher risk of cancer. The mean vitamin E levels among cases and controls were 4.7mgl-' and 6.0mgl-1 respectively (P<0.025), and the risk of breast cancer in women with vitamin E levels in the lowest quintile was about 5-times higher than the risk for women with levels in the highest quintile (P<0.01). f,-carotene levels showed a tendency to be lower in women who developed cancer than in controls (36ugl-1 among cases compared with 50 pgI-1 among controls) but the difference was not statistically significant.The view that certain vitamins, such as vitamin A (in the form of retinol or its precursor f-carotene) and vitamin E, may protect against the risk of cancer has recently attracted much scientific attention.Three prospective studies, all concerning men, have examined the relationship between serum retinol and subsequent risk of cancer. Two of these studies (Wald et al., 1980a,b;Kark et al., 1981) showed a statistically significant negative association between serum retinol and risk of cancer (particularly lung cancer) and the third (Stahelin et al., 1982) which plasma samples have been stored for future biochemical analysis. One such investigation is the ICRF prospective study in Guernsey which has been the subject of previous reports, mainly on the role of endocrine factors in the aetiology of breast cancer (Bulbrook et al., 1971;Kwa et al., 1981). The availability of data and plasma samples from this study encouraged us to explore the possibility that low plasma concentrations of retinol, P-carotene and vitamin E might be associated with subsequent risk of breast cancer. 1968 and 1975, 5,004 women in Guernsey aged between 28 and 75 years volunteered a blood sample from which plasma was stored at -200C. Women who developed breast cancer were notified to the study by the general practitioners concerned, and this report relates to the 39 cases reported until the end of 1982 from whom plasma was available for testing. Materials and methods BetweenStored plasma samples from these women were retrieved and for each two controls who had previously been used in a study of hormone levels in relation to breast cancer were identified and their plasma samples also retrieved. Selection of controls in this way meant that plasma samples for cases and controls had all been frozen and thawed a similar number of times. The matching criteria were age (± 5 years), menopausal status (if premenopausal, day of menstrual cycle within 4 days; if post-menopausal, number of years postmenopausal), and a number ...

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Dietary Vitamin a and Risk of Cancer in the Western Electric Study

Cited by 424 publications

References 14 publications

Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study

Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study

Relationship Between Serum Carotenoid Levels and Cancer Death Rates in the Residents, Living in a Rural Area of Hokkaido, Japan

Plasma retinol, β-carotene and vitamin E levels in relation to the future risk of breast cancer

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