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 Kühn; Antonia 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

doi:10.3945/ajcn.114.101659

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

^*Corresponding author for this work

Human Nutrition and Health

Research output: Contribution to journal › Article › Academic › peer-review

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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 language	English
Pages (from-to)	454-464
Journal	The American journal of clinical nutrition
Volume	103
Issue number	2
DOIs	https://doi.org/10.3945/ajcn.114.101659
Publication status	Published - 20 Jan 2016

Keywords

Antioxidants
Breast cancer
Carotenoids
EPIC
Plasma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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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

@article{e08e6df0e74c448caec56d053f2efc4b,

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

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.",

keywords = "Antioxidants, Breast cancer, Carotenoids, EPIC, Plasma",

author = "Bakker, {Marije F.} and Peeters, {Petra H.M.} and Klaasen, {Veronique M.} and Bueno-de-Mesquita, {Bas H.} and Jansen, {Eugene H.J.M.} and Ros, {Martine M.} and No{\'e}mie Travier and Anja Olsen and Anne Tj{\o}nneland and Kim Overvad and Sabina Rinaldi and Isabelle Romieu and Paul Brennan and Marie-Christine Boutron-Ruault and Florence Perquier and Claire Cadeau and Heiner Boeing and Krasimira Aleksandrova and Rudolf Kaaks and Tilman K{\"u}hn and Antonia Trichopoulou and Pagona Lagiou and Dimitrios Trichopoulos and Paolo Vineis and Vittorio Krogh and Salvatore Panico and Giovanna Masala and Rosario Tumino and Elisabete Weiderpass and Guri Skeie and Eiliv Lund and Ram{\'o}n Quir{\'o}s and Eva Ardanaz and Carmen Navarro and Pilar Amiano and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Genevieve Buckland and Ulrika Ericson and Emily Sonestedt and Matthias Johansson and Malin Sund and Travis, {Ruth C.} and Key, {Timothy J.} and Kay-Tee Khaw and Nick Wareham and Elio Riboli and {Van Gils}, {Carla H.}",

year = "2016",

month = jan,

day = "20",

doi = "10.3945/ajcn.114.101659",

language = "English",

volume = "103",

pages = "454--464",

journal = "The American journal of clinical nutrition",

issn = "0002-9165",

publisher = "Elsevier",

number = "2",

}

Bakker, MF, Peeters, PHM, Klaasen, VM, Bueno-de-Mesquita, BH, Jansen, EHJM, Ros, MM, 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, Kühn, T, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Vineis, P, Krogh, V, Panico, S, Masala, G, Tumino, R, Weiderpass, E, Skeie, G, Lund, E, Quirós, R, Ardanaz, E, Navarro, C, Amiano, P, Sánchez, M-J, Buckland, G, Ericson, U, Sonestedt, E, Johansson, M, Sund, M, Travis, RC, Key, TJ, Khaw, K-T, Wareham, N, Riboli, E & Van Gils, CH 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, vol. 103, no. 2, pp. 454-464. https://doi.org/10.3945/ajcn.114.101659

Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort1,2. / Bakker, Marije F.; Peeters, Petra H.M.; Klaasen, Veronique M. et al.
In: The American journal of clinical nutrition, Vol. 103, No. 2, 20.01.2016, p. 454-464.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort1,2

AU - Bakker, Marije F.

AU - Peeters, Petra H.M.

AU - Klaasen, Veronique M.

AU - Bueno-de-Mesquita, Bas H.

AU - Jansen, Eugene H.J.M.

AU - Ros, Martine M.

AU - Travier, Noémie

AU - Olsen, Anja

AU - Tjønneland, Anne

AU - Overvad, Kim

AU - Rinaldi, Sabina

AU - Romieu, Isabelle

AU - Brennan, Paul

AU - Boutron-Ruault, Marie-Christine

AU - Perquier, Florence

AU - Cadeau, Claire

AU - Boeing, Heiner

AU - Aleksandrova, Krasimira

AU - Kaaks, Rudolf

AU - Kühn, Tilman

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Trichopoulos, Dimitrios

AU - Vineis, Paolo

AU - Krogh, Vittorio

AU - Panico, Salvatore

AU - Masala, Giovanna

AU - Tumino, Rosario

AU - Weiderpass, Elisabete

AU - Skeie, Guri

AU - Lund, Eiliv

AU - Quirós, Ramón

AU - Ardanaz, Eva

AU - Navarro, Carmen

AU - Amiano, Pilar

AU - Sánchez, María-José

AU - Buckland, Genevieve

AU - Ericson, Ulrika

AU - Sonestedt, Emily

AU - Johansson, Matthias

AU - Sund, Malin

AU - Travis, Ruth C.

AU - Key, Timothy J.

AU - Khaw, Kay-Tee

AU - Wareham, Nick

AU - Riboli, Elio

AU - Van Gils, Carla H.

PY - 2016/1/20

Y1 - 2016/1/20

N2 - 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.

AB - 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.

KW - Antioxidants

KW - Breast cancer

KW - Carotenoids

KW - EPIC

KW - Plasma

U2 - 10.3945/ajcn.114.101659

DO - 10.3945/ajcn.114.101659

M3 - Article

SN - 0002-9165

VL - 103

SP - 454

EP - 464

JO - The American journal of clinical nutrition

JF - The American journal of clinical nutrition

IS - 2

ER -

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

Abstract

Keywords

UN SDGs

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