Serum Retinol Level and Risk of Subsequent Cervical Cancer in Cases with Cervical Dysplasia

Abstract

We followed up on 134 women who had been diagnosed with cervical dysplasia to examine the relationship of dietary and serum vitamin A to subsequent cervical cancer. The subjects were women attending the Papanicolaou test screening for residents in Miyagi, Japan and histologically diagnosed as having cervical dysplasia between October 1987 and September 1988. Personal interviews were carried out, and blood samples were taken on the date of diagnosis of cervical dysplasia. The subjects were followed-up with cervical smear and colposcopy at about 3-month intervals from the date of interview until the end of February 1995. During the follow-up, 8 women (5.9%) developed cancer in situ or invasive cervical cancer and 106 (79.1%) reverted to normal. The rate of progression of the cancer in situ or invasive cervical cancer was 4.5 times higher in women with lower serum retinol levels than those with higher serum retinol levels (p = 0.08). The results suggest an association of low serum retinol level with development of cervical cancer.

Relation between deranged antioxidant system and cervical neoplasia

“…cervix from initial HPV infection (4) . In a previous casecontrol study of women with CIN, it has been reported that plasma vitamin levels, especially the carotenoids, ascorbate, and retinol levels, were significantly decreased in cervical cancer patients compared to those in normal controls (5)(6)(7)11,12) .…”

“…Therefore, it is presumable that other factors, such as various sources of oxidative stress, smoking, and defects in the anti‐oxidative system, may play an important role in the process of neoplastic transformation of the uterine cervix from initial HPV infection ( 4 ) . In a previous case‐control study of women with CIN, it has been reported that plasma vitamin levels, especially the carotenoids, ascorbate, and retinol levels, were significantly decreased in cervical cancer patients compared to those in normal controls ( 5–7,11 , 12 ) .…”

Serum retinoic acid, retinol and retinyl palmitate levels in patients with lung cancer

“…21 Nagata et al found that the rate of progression of the cancer in situ or invasive cervical cancer was 4.5-fold higher in women with lower serum retinol levels than in those with higher serum retinol levels. 22 Kohlhaufl et al in a pilot study found a 56% remission rate of metaplasia and dysplasia of respiratory epithelia after a 3-month treatment with retinyl palmitate in the form of an aerosol. 23 In a placebo controlled study on patients with dysplasia and/or metaplasia, Lee et al concluded that isotretinoin, a vitamin A analogue, had no effect on squamous metaplasia, a potential intermediate endpoint of bronchial carcinogenesis.…”

“…Nagata et al . found that the rate of progression of the cancer in situ or invasive cervical cancer was 4.5‐fold higher in women with lower serum retinol levels than in those with higher serum retinol levels 22 . Kohlhaufl et al.…”

Association of Vitamin A Deficiency with Cervical Squamous Intraepithelial Lesions in Human Immunodeficiency Virus–Infected Women

“…More recent studies have not consistently revealed an association. The majority report no difference in mean serum retinol, dietary intake of retinol, or both between women with cervical dysplasia or neoplasia and those without [9][10][11], whereas others find a significant inverse association between serum retinol and cervical disease [12][13][14]. To our knowledge, no studies of this association have been performed in women with human immunodeficiency virus (HIV) infection, a population in which the prevalence of HPV infection and cervical disease is high [15,16].…”