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Breast Cancer Research and Treatment

, Volume 119, Issue 3, pp 753–765 | Cite as

Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

  • G. Nagel
  • J. Linseisen
  • C. H. van Gils
  • P. H. Peeters
  • M. C. Boutron-Ruault
  • F. Clavel-Chapelon
  • I. Romieu
  • A. Tjønneland
  • A. Olsen
  • N. Roswall
  • P. M. Witt
  • K. Overvad
  • S. Rohrmann
  • R. Kaaks
  • D. Drogan
  • H. Boeing
  • A. Trichopoulou
  • V. Stratigakou
  • D. Zylis
  • D. Engeset
  • E. Lund
  • G. Skeie
  • F. Berrino
  • S. Grioni
  • A. Mattiello
  • G. Masala
  • R. Tumino
  • R. Zanetti
  • M. M. Ros
  • H. B. Bueno-de-Mesquita
  • E. Ardanaz
  • M. J. Sánchez
  • J. M. Huerta
  • P. Amiano
  • L. Rodríguez
  • J. Manjer
  • E. Wirfält
  • P. Lenner
  • G. Hallmans
  • E. A. Spencer
  • T. J. Key
  • S. Bingham
  • K. T. Khaw
  • S. Rinaldi
  • N. Slimani
  • P. Boffetta
  • V. Gallo
  • T. Norat
  • E. Riboli
Epidemiology

Abstract

So far, studies on dietary antioxidant intake, including β-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of β-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85–1.27), 1.12 (0.92–1.36) and 1.11 (0.84–1.46), respectively] and postmenopausal women [0.93 (0.82–1.04), 0.98 (0.87–1.11) and 0.92 (0.77–1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of β-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66–0.96), P trend 0.06] and vitamin C [0.88 (0.72–1.07), P trend 0.05] was associated with reduced breast cancer risk. In addition, dietary β-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of β-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between β-carotene and vitamin E from food and breast cancer risk cannot be excluded.

Keywords

β-Carotene Vitamin C Vitamin E Breast cancer Diet EPIC 

Notes

Acknowledgments

The EPIC study was funded by “Europe Against Cancer” Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health (RCESP-C03/09); the participating regional governments and institutions of Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Education; Greek Ministry of Health and Social Solidarity; Hellenic Health Foundation and Stavros Niarchos Foundation; Italian Association for Research on Cancer; Italian National Research Council; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society.

Conflict of interest statement

None declared.

Supplementary material

10549_2009_444_MOESM1_ESM.pdf (55 kb)
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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • G. Nagel
    • 1
  • J. Linseisen
    • 2
  • C. H. van Gils
    • 4
  • P. H. Peeters
    • 4
  • M. C. Boutron-Ruault
    • 5
  • F. Clavel-Chapelon
    • 5
  • I. Romieu
    • 5
  • A. Tjønneland
    • 8
  • A. Olsen
    • 8
  • N. Roswall
    • 8
  • P. M. Witt
    • 9
  • K. Overvad
    • 10
  • S. Rohrmann
    • 2
  • R. Kaaks
    • 2
  • D. Drogan
    • 3
  • H. Boeing
    • 3
  • A. Trichopoulou
    • 11
  • V. Stratigakou
    • 11
  • D. Zylis
    • 11
  • D. Engeset
    • 12
  • E. Lund
    • 12
  • G. Skeie
    • 12
  • F. Berrino
    • 13
  • S. Grioni
    • 13
  • A. Mattiello
    • 14
  • G. Masala
    • 15
  • R. Tumino
    • 16
  • R. Zanetti
    • 17
  • M. M. Ros
    • 6
    • 7
  • H. B. Bueno-de-Mesquita
    • 6
  • E. Ardanaz
    • 20
  • M. J. Sánchez
    • 21
  • J. M. Huerta
    • 22
  • P. Amiano
    • 23
  • L. Rodríguez
    • 24
  • J. Manjer
    • 18
  • E. Wirfält
    • 19
  • P. Lenner
    • 25
  • G. Hallmans
    • 26
  • E. A. Spencer
    • 27
  • T. J. Key
    • 27
  • S. Bingham
    • 28
  • K. T. Khaw
    • 29
  • S. Rinaldi
    • 30
  • N. Slimani
    • 30
  • P. Boffetta
    • 30
  • V. Gallo
    • 31
  • T. Norat
    • 31
  • E. Riboli
    • 31
  1. 1.Institute of EpidemiologyUlm UniversityUlmGermany
  2. 2.Department Cancer EpidemiologyGerman Cancer Research CenterHeidelbergGermany
  3. 3.Department of EpidemiologyGerman Institute of Human Nutrition Potsdam-RehbrückeNuthetalGermany
  4. 4.Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
  5. 5.Institut National de la Santé et de la Recherche Médicale (INSERM)IGRVillejuifFrance
  6. 6.National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
  7. 7.Department of Epidemiology, Biostatistics and HTARadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  8. 8.Diet, Cancer and Health, Danish Cancer SocietyCopenhagenDenmark
  9. 9.Department of Oncology, Aalborg HospitalAarhus University HospitalAalborgDenmark
  10. 10.Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
  11. 11.Department of Hygiene and EpidemiologyUniversity of Athens Medical SchoolAthensGreece
  12. 12.Institute of Community MedicineUniversity of TromsøTromsøNorway
  13. 13.Department of Preventive and Predictive MedicineFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  14. 14.Department of Clinical and Experimental Medicine Federico II UniversityNaplesItaly
  15. 15.Molecular and Nutritional Epidemiology UnitCancer Research and Prevention InstituteFlorenceItaly
  16. 16.Cancer Registry, Azienda Ospedaliera “Civile- M.P. Arezzo”RagusaItaly
  17. 17.Piedmont Cancer Registry-CPOTurinItaly
  18. 18.Department of SurgeryMalmö University HospitalMalmöSweden
  19. 19.Department of Clinical Sciences, Malmö and Nutrition EpidemiologyLund UniversityLundSweden
  20. 20.Public Health Institute of Navarra, Pamplona, Spain, and CIBER Epidemiología y Salud Pública (CIBERESP)PamplonaSpain
  21. 21.Andalusian School of Public Health and CIBER de Epidemiología y Salud Pública (CIBERESP)GranadaSpain
  22. 22.CIBER Epidemiología y Salud Pública and Servicio de Epidemiología (CIBERESP)MurciaSpain
  23. 23.Public Health Division of Gipuzkoa, Basque Government, CIBER en Salud PúblicaCIBERSPDonostia-San SebastianSpain
  24. 24.Public Health and Participation DirectorateHealth and Health Care Services CouncilAsturiasSpain
  25. 25.Department of Radiation Sciences, OncologyUmeå UniversityUmeåSweden
  26. 26.Department of Public Health and Clinical Medicine, Nutritional ResearchUmeå UniversityUmeåSweden
  27. 27.Epidemiology Unit, Cancer Research UKUniversity of OxfordOxfordUK
  28. 28.MRC Dunn Human Nutrition Unit and Department of Public Health and Primary CareUniversity of Cambridge, School of Clinical MedicineCambridgeUK
  29. 29.Clinical Gerontology Unit University of CambridgeCambridgeUK
  30. 30.International Agency for Research on CancerLyonFrance
  31. 31.Division of Epidemiology, Public Health and Primary CareImperial College LondonLondonUK

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