Serum carotenoids and vitamins and risk of cervical dysplasia from a case–control study in Japan

Abstract

SummaryThe relationships between risk of cervical dysplasia and dietary and serum carotenoids and vitamins were investigated in a case-control study. Cases were 156 women who attended Papanicolaou test screening in nine institutes affiliated with Japan Study Group of Human Papillomavirus (HPV) and Cervical Cancer and had cervical dysplasia newly histologically confirmed. Age-matched controls were selected from women with normal cervical cytology attending the same clinic. Blood sample and cervical exfoliated cells were obtained for measuring serum retinol, α-carotene, β-carotene, zeaxanthin/lutein, cryptoxanthin, lycopene and α-tocopherol and for HPV detection. Higher serum level of α-carotene was significantly associated with decreased risk of cervical dysplasia after controlling for HPV infection and smoking status (odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.04-0.62 for the highest as compared with the lowest tertile). Decreased risk for the highest tertile of serum lycopene (OR = 0.28) was marginally significant. Decreased risks observed for the highest tertiles of β-carotene (OR = 0.65) and zeaxanthin/lutein (OR = 0.53), were not statistically significant. © 1999 Cancer Research Campaign Keywords: cervical dysplasia; carotenoids; human papillomavirus; diet 1234British Journal of Cancer (1999) 81(7), 1234-1237© 1999 Cancer Research Campaign Article no. bjoc.1999 Received 12 November 1998 Revised 8 April 1999 Accepted 13 April 1999Correspondence to: C Nagata Serum carotenoids and cervical dysplasia 1235British Journal of Cancer (1999) 81(7), 1234-1237 © 1999 Cancer Research Campaign match) after the identification of case was approached. About 90% of the first eligible controls agreed to participate in the study.A self-administered questionnaire including demographic factors, smoking and drinking habits, diet, reproductive history and sexual behaviour was distributed to each case and control when she visited the institute to know the result of Papanicolaou test. Diet was assessed by asking about the intake amounts of 22 foods that are retinol-and carotene-rich during the past 7 days. Daily intake of retinol and carotene were estimated using the Standard Tables of Food Composition in Japan (4th revised edition published by the Science and Technology Agency of Japan). The detailed information about the dietary questionnaire including validity was described elsewhere (Shimizu et al, 1996). A total of 167 cases and matched controls responded to the questionnaire.Blood sampling as well as collection of cervical smear samples were performed on the same day. Serum was isolated and frozen at -80°C. The fraction of carotenoids, retinol and tocopherol of the serum samples were extracted into n-hexane, and the concentrations of α-carotene, β-carotene, cryptoxanthin, lutein/zeaxanthin, lycopene, and α-tocopherol were determined by high-performance liquid chromatography (HPLC) using a slight modification of Nells and Leenheer's method (Nells and De Leenheer, 1983). The serum of cases and matched controls was a...

Relationship of serum antioxidant micronutrients and sociodemographic factors to cervical neoplasia: a case-control study

“…With respect to retinol, several observational studies have shown a protective effect of serum retinol against cervical neoplasia (25,26). Clinical trials that have evaluated the effects of topically applied retinoic acid showed an increase in the regression rates of CIN 2 but not CIN 3, lending support to its efficacy in patients with early lesions.…”

“…In a randomized clinical trial investigating the association of b-carotene with early preinvasive lesions, oral administration of b-carotene had no effect on atypical squamous cells of undetermined significance (ASCUS)-CIN1 regression rates during 2 years of follow-up (24). Results from a case-control study by Nagata et al showed an inverse association between serum lycopene concentrations and cervical dysplasia (25). The results of our study support the hypothesis that increased blood concentrations of several carotenoids, especially b-carotene and lycopene, may decrease the risk of cervical cancer.…”

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

“…However, prospective studies showed that higher circulating concentration of red blood cell folate is associated with lower risk of becoming positive for HPV and lower persistent HPV infection 40 and lower risk of CIN 2-3. 41 Retinol intake was not associated with ISC in one follow-up study, 42 while results from case-control studies are inconsistent. 18,22,26,32 A RCT showed an increase in the regression rates of CIN2 43,44 but not of CIN3.…”

Functional polymorphism in manganese superoxide dismutase and antioxidant status: Their interactions on the risk of cervical intraepithelial neoplasia and cervical cancer

“…Few epidemiologic studies have explored the possible significance of micronutrients on the clearance of HPV or on the risk of CIN or cancer [18][19][20][21][22][23]. In a recent review study, it was reported that α-carotene, β-carotene, lycopene, zeaxanthin plus lutein, and cryptoxanthin had protective effects on cervical neoplasia [21].…”