Plasma Antioxidant Vitamins and Subsequent Cancer Mortality in the 12-Year Follow-up of the Prospective Basel Study

Abstract

Plasma antioxidant vitamins A, C, and E and carotene were measured in a group of 2,974 men participating in the third examination of the prospective Basel Study in 1971-1973. In 1985, the vital status and mortality of all participants were assessed. A total of 204 men had died from cancer, including 68 with bronchus cancer and 37 with gastrointestinal cancer (20 with stomach cancer and 17 with large bowel cancer excluding cancer of the rectum). Overall mortality from cancer was associated with low mean plasma levels of carotene adjusted for cholesterol (p less than 0.01) and of vitamin C (p less than 0.01). Bronchus and stomach cancers were associated with a low mean plasma carotene level (p less than 0.01). Subjects with subsequent stomach cancer also had lower mean vitamin C and lipid-adjusted vitamin A levels than did survivors (p less than 0.05). After calculation of the relative risk using the Cox model with exclusion of mortality during the first 2 years of follow-up, low plasma carotene (below quartile 1) was associated with a significantly increased risk for bronchus cancer (relative risk (RR) = 1.8, p less than 0.05), low plasma levels of carotene and vitamin A with all cancers (RR = 2.47, p less than 0.01), and low plasma retinol in older subjects (greater than age 60 years) with lung cancer (RR = 2.17, p less than 0.05). Low levels of vitamin C increased the risk of stomach cancer (RR = 2.38) and gastrointestinal cancer (RR = 2.46) in older subjects, but only significantly with the inclusion of the first 2 years. The authors conclude that low plasma levels of antioxidant vitamins are associated with an increased risk of subsequent cancer mortality. This effect was stronger in men above age 60 years at blood sampling, and the effect seems to be site-specific.

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

“…Certain plasma carotenoids can be considered as biomarkers of intake of fruits and vegetables (Al Delaimy et al, 2005a, b). Some earlier studies in Western populations (Willett et al, 1984;Stahelin et al, 1991) and more recent ones in high-risk Chinese populations Taylor et al, 2003;Yuan et al, 2004) show a higher GC risk in those with lower blood levels of some carotenoids or retinol. In contrast, some recent studies show a positive association between blood a-tocopherol levels and risk of GCs of the stomach cardia (Nouraie et al, 2005) and noncardial regions as well as the progression of dysplastic lesions to GCs (You et al, 2000).…”

Diet and the risk of gastric cancer: review of epidemiological evidence

“…This conclusion is based on 1 of 2 cohort studies and 12 of 13 case-control studies showing inverse associations between dietary vitamin C intake and the risk of gastric cancer. In addition, one prospective study showed that baseline plasma vitamin C levels among subjects who died from gastric cancer (n = 20) was 20% lower than those who remained cancer-free (n = 2421) during more than 12 years of follow-up [43].…”

Determinants of the nutritional status of vitamin E in a non-smoking Mediterranean population. Analysis of the effect of vitamin E intake, alcohol consumption and body mass index on the serum alpha-tocopherol concentration

“…Vitamin E is an essential micronutrient which may have protective effects against cardiovascular diseases and several cancers through different biological mechanisms (Grant & De Hoog, 1985;Willett, 1986;Diplock, 1991;Stahelin et al, 1991;Ashwell, 1993;Rimm et al, 1993;Stampfer et al, 1993;Bellizzi et al, 1994;Kushi et al, 1996). It has antioxidant properties, which may prevent cellular damage (Bieri, 1984;Ames, 1983).…”