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Cancer Causes & Control

, Volume 20, Issue 5, pp 699–711 | Cite as

Antioxidant vitamins and the risk of endometrial cancer: a dose–response meta-analysis

  • Elisa V. BanderaEmail author
  • Dina M. Gifkins
  • Dirk F. Moore
  • Marjorie L. McCullough
  • Lawrence H. Kushi
Original Paper

Abstract

Antioxidant vitamins may reduce cancer risk by limiting oxidative DNA damage. To summarize and quantify the current epidemiologic evidence of an association between antioxidant vitamin intake and endometrial cancer, we conducted a systematic literature review and meta-analysis. One cohort and 12 case–control studies presenting relevant risk estimates were identified by conducting bibliographical searches through June 2008. Dose–response meta-analyses were conducted for beta-carotene, vitamin C, and vitamin E from food sources. Intake from supplements was not considered in the meta-analyses because of the few studies that reported relevant information. Based on case–control data, the random-effects summary odds ratios (OR) were, for beta-carotene: 0.88 (95% CI: 0.79–0.98) per 1,000 mcg/1,000 kcal (I2: 77.7%; p < 0.01); for vitamin C: 0.85 (95% CI: 0.73–0.98) per 50 mg/1,000 kcal (I2: 66.1%; p < 0.01); and, for vitamin E: 0.91 (95% CI: 0.84–0.99) per 5 mg/1,000 kcal (I2: 0.0%; p: 0.45). In contrast, the only prospective study identified provided little indication of an association. Although the current case–control data suggest an inverse relationship of endometrial cancer risk with dietary intakes of beta-carotene, vitamin C, and vitamin E from food sources, additional studies are needed, particularly cohort studies, to confirm an association.

Keywords

Endometrial carcinoma Diet Vitamins Antioxidants Vitamin E Vitamin C Carotenoids Meta-analysis Systematic literature review 

Abbreviations

WCRF

World Cancer Research Fund International

AICR

American Institute for Cancer Research

SLR

Systematic Literature Review

OR

Odds Ratio

RR

Relative Risk

CI

Confidence Interval

FFQ

Food frequency questionnaire

BMI

Body mass index

HRT

Hormone replacement therapy

Notes

Acknowledgments

We would like to thank James Thomas for his valuable help with the data extraction access program. This work was funded in part by the WCRF and by the National Cancer Institute (NIH-K07 CA095666 to Dr. Bandera). However, interpretation of the evidence does not represent the views of WCRF, AICR, or the NCI.

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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Elisa V. Bandera
    • 1
    • 2
    Email author
  • Dina M. Gifkins
    • 1
    • 2
  • Dirk F. Moore
    • 2
  • Marjorie L. McCullough
    • 3
  • Lawrence H. Kushi
    • 4
  1. 1.The Cancer Institute of New Jersey, Robert Wood Johnson Medical SchoolNew BrunswickUSA
  2. 2.School of Public HealthUniversity of Medicine and Dentistry of New JerseyPiscatawayUSA
  3. 3.Epidemiology and Surveillance Research, American Cancer SocietyAtlantaUSA
  4. 4.Division of ResearchKaiser PermanenteOaklandUSA

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