Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort1,2

Marije F. Bakker, Petra H.M. Peeters, Veronique M. Klaasen, Bas H. Bueno-de-Mesquita, Eugene H.J.M. Jansen, Martine M. Ros, Noémie Travier, Anja Olsen, Anne Tjønneland, Kim Overvad, Sabina Rinaldi, Isabelle Romieu, Paul Brennan, Marie-Christine Boutron-Ruault, Florence Perquier, Claire Cadeau, Heiner Boeing, Krasimira Aleksandrova, Rudolf Kaaks, Tilman KühnAntonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Paolo Vineis, Vittorio Krogh, Salvatore Panico, Giovanna Masala, Rosario Tumino, Elisabete Weiderpass, Guri Skeie, Eiliv Lund, Ramón Quirós, Eva Ardanaz, Carmen Navarro, Pilar Amiano, María-José Sánchez, Genevieve Buckland, Ulrika Ericson, Emily Sonestedt, Matthias Johansson, Malin Sund, Ruth C. Travis, Timothy J. Key, Kay-Tee Khaw, Nick Wareham, Elio Riboli, Carla H. Van Gils

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Abstract

Background: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.

Objective: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer.

Design: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor–negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for α-carotene, β-carotene, lycopene, lutein, zeaxanthin, β-cryptoxanthin, retinol, α-tocopherol, γ-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided.

Results: In quintile 5 compared with quintile 1, α-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and β-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor–positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for β-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor–negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).

Conclusion: Our results indicate that higher concentrations of plasma β-carotene and α-carotene are associated with lower breast cancer risk of ER- tumors.
Original languageEnglish
Pages (from-to)454-464
JournalThe American journal of clinical nutrition
Volume103
Issue number2
DOIs
Publication statusPublished - 20 Jan 2016

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    Bakker, M. F., Peeters, P. H. M., Klaasen, V. M., Bueno-de-Mesquita, B. H., Jansen, E. H. J. M., Ros, M. M., Travier, N., Olsen, A., Tjønneland, A., Overvad, K., Rinaldi, S., Romieu, I., Brennan, P., Boutron-Ruault, M-C., Perquier, F., Cadeau, C., Boeing, H., Aleksandrova, K., Kaaks, R., ... Van Gils, C. H. (2016). Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort1,2. The American journal of clinical nutrition, 103(2), 454-464. https://doi.org/10.3945/ajcn.114.101659