Cancer Causes & Control

, Volume 20, Issue 8, pp 1451–1458

Dietary vitamin C, E, and carotenoid intake and risk of renal cell carcinoma

  • Jinfu Hu
  • Carlo La  Vecchia
  • Eva Negri
  • Marie DesMeules
  • Les Mery
  • The Canadian Cancer Registries Epidemiology Research Group
Original paper



The study examines the association between dietary intake of vitamin C, E, and carotenoids and the risk of renal cell carcinoma (RCC).


Between 1994 and 1997 in 8 Canadian provinces, mailed questionnaires were completed by 1,138 incident, histologically confirmed cases of RCC and 5,039 population controls, including information on socio-economic status, lifestyle habits and diet. A 69-item food frequency questionnaire provided data on eating habits 2 years before data collection. Odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression.


Dietary intake of β-carotene and lutein/zeaxanthin was inversely associated with the risk of RCC. The ORs for the highest versus the lowest quartile were 0.74 (95% CI, 0.59–0.92) and 0.77 (95% CI, 0.62–0.95), respectively. The significant inverse association with β-carotene and lutein/zeaxanthin was more pronounced in women, and in overweight or obese subjects. The relation of lutein/zeaxanthin to RCC was stronger in ever smokers. No clear association was observed with vitamin C and E, β-cryptozanthin, and lycopene.


The findings provide evidence that a diet rich in β-carotene and lutein/zeaxanthin may play a role in RCC prevention.


Kidney cancer Risk Carotenoids Canada 



Body mass index


Odds ratio


Confidence interval


National Enhanced Cancer Surveillance System


Renal cell carcinoma


Food frequency questionnaire


  1. 1.
    Mathew A, Devesa SS, Fraumeni JF Jr, Chow WH (2002) Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev 11:171–178. doi:10.1097/00008469-200204000-00010 PubMedCrossRefGoogle Scholar
  2. 2.
    Statistics Canada (2007) Cancer incidence in Canada, Statistics Canada Catalogue no. 82–231-XIE-2007001. Minister of Industry, OttawaGoogle Scholar
  3. 3.
    Pischon T, Lahmann PH, Boeing H et al (2004) Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer 118:728–738. doi:10.1002/ijc.21398 CrossRefGoogle Scholar
  4. 4.
    IARC (2004) IARC Monographs on the evaluation of carcinogenic risk to humans, Vol. 83, Tobacco smoke and involuntary smoking. IARC Press, LyonGoogle Scholar
  5. 5.
    Faramawi MF, Johnson E, Fry MW, Sall M, Zhou Y (2007) Consumption of different types of meat and the risk of renal cancer: meta-analysis of case-control studies. Cancer Causes Control 18:125–133. doi:10.1007/s10552-006-0104-9 PubMedCrossRefGoogle Scholar
  6. 6.
    Bravi F, Bosetti C, Scotti L et al (2006) Food group and renal cell carcinoma: a case-control study from Italy. Int J Cancer 120:681–685. doi:10.1002/ijc.22225 CrossRefGoogle Scholar
  7. 7.
    Rashidkhani B, Akesson A, Lindblad P, Wolk A (2005) Major dietary patterns and risk of renal cell carcinoma in a prospective cohort of Swedish women. J Nutr 135:1757–1762PubMedGoogle Scholar
  8. 8.
    Weikert S, Boing H, Pischon T et al (2006) Fruits and vegetables and renal cell carcinoma: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer 118:3133–3139. doi:10.1002/ijc.21765 PubMedCrossRefGoogle Scholar
  9. 9.
    Clark SF (2002) The biochemistry of antioxidants revisited. Nutr Clin Pract 17:5–7. doi:10.1177/011542650201700105 PubMedCrossRefGoogle Scholar
  10. 10.
    International Agency for Research on Cancer (2003) Fruit and vegetables. IARC Handbook of cancer prevention. Vol 8. IARC, LyonGoogle Scholar
  11. 11.
    Lee E, Giovannucci E, Smith-Warner SA, Spiegelman D, Willett WC, Curhan GC (2006) Intake of fruits, vegetables, vitamin A, C, and E, and carotenoids and risk of renal cell cancer. Cancer Epidemiol Biomarkers Prev 15:2445–2452. doi:10.1158/1055-9965.EPI-06-0553 PubMedCrossRefGoogle Scholar
  12. 12.
    Bosetti C, Scotti L, Dal Maso L et al (2006) Micronutrients and the risk of renal cell cancer: a case-control study from Italy. Int J Cancer 120:892–896. doi:10.1002/ijc.22374 CrossRefGoogle Scholar
  13. 13.
    Nicodemus KK, Sweeney C, Folsom AR (2004) Evaluation of dietary, medical and lifestyle risk factors for incident kidney cancer in postmenopausal women. Int J Cancer 108:115–121. doi:10.1002/ijc.11532 PubMedCrossRefGoogle Scholar
  14. 14.
    Wolk A, Gridley G, Niwa S et al (1996) International renal-cell cancer study. VII. Role of diet. Int J Cancer 65:67–73. doi:10.1002/(SICI)1097-0215(19960103)65:1<67::AID-IJC12>3.0.CO;2-F PubMedCrossRefGoogle Scholar
  15. 15.
    Chow WH, Gridley G, McLaughlin JK et al (1994) Protein intake and risk of renal cell cancer. J Natl Cancer Inst 86:1131–1139. doi:10.1093/jnci/86.15.1131 PubMedCrossRefGoogle Scholar
  16. 16.
    Prineas RJ, Folsom AR, Zhang ZM, Sellers TA, Potter J (1997) Nutrition and other risk factors for renal cell carcinoma in postmenopausal women. Epidemiology 8:31–36. doi:10.1097/00001648-199701000-00005 PubMedCrossRefGoogle Scholar
  17. 17.
    van Dijk BAC, Schouten LJ, Oosterwijk E et al (2008) Carotenoid and vitamin intake, von Hippel-Lindau gene mutations and sporadic renal cell carcinoma. Cancer Causes Control 19:125–134. doi:10.1007/s10552-007-9078-5 PubMedCrossRefGoogle Scholar
  18. 18.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington, DCGoogle Scholar
  19. 19.
    Johnson KC, Mao Y, Argo J, Dubois S, Semenciw R, Lava J, The Canadian Cancer Registries Epidemiology Research Group (1998) The National Enhanced Cancer Surveillance System: a case-control approach to environmental-related cancer surveillance in Canada. Environmetrics 9:495–504. doi:10.1002/(SICI)1099-095X(199809/10)9:5<495::AID-ENV318>3.0.CO;2-H CrossRefGoogle Scholar
  20. 20.
    Percy C, Holten VV, Muir C (1990) International classification of diseases for oncology, 2nd edn. World Health Organization, GenevaGoogle Scholar
  21. 21.
    World Health Organization (2000) Obesity: preventing and managing the global epidemic. World Health Organization Technical Report Series, No. 894. Report of a WHO consultation. World Health Organization, GenevaGoogle Scholar
  22. 22.
    Block G, Hartman AM, Naughton D (1990) A reduced dietary questionnaire: development and validation. Epidemiology 1:58–64. doi:10.1097/00001648-199001000-00013 PubMedCrossRefGoogle Scholar
  23. 23.
    Willett WC (1998) Nutritional epidemiology, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  24. 24.
    Health Canada (2005) Canadian nutrient file compilation of Canadian food composition data. Users’ Guide. Nutrition Research Division and Office of Information Management Technology Health Products and Food Branch, Health CanadaGoogle Scholar
  25. 25.
    Hu J, Yang M, White K, The Canadian Registries Epidemiology Research Group (2003) Diet and vitamin or mineral supplements and risk of renal cell carcinoma in Canada. Cancer Causes Control 14:705–714. doi:10.1023/A:1026310323882 PubMedCrossRefGoogle Scholar
  26. 26.
    Hu J, La Vecchia C, DesMeules M, Negri E, Mery L, Canadian Cancer Registries Epidemiology Research Group (2008) Nutrient and fiber intake and risk of renal cell carcinoma. Nutr Cancer 60:720–728. doi:10.1080/01635580802283335 PubMedCrossRefGoogle Scholar
  27. 27.
    SAS Institute Inc (2002) The SAS System for Windows Release 9.01. SAS Institute Inc, Carey (NC)Google Scholar
  28. 28.
    Salganik RI (2001) The benefits and hazards of antioxidants: controlling apoptosis and other protective mechanisms in cancer patients and the human population. J Am Coll Nutr 20:464S–472S (discussion 73S–75S)PubMedGoogle Scholar
  29. 29.
    Yuan JM, Gago-Dominguez M, Castelao JE, Hankin JH, Ross RK, Yu MC (1998) Cruciferous vegetables in relation to renal cell carcinoma. Int J Cancer 77:211–216. doi:10.1002/(SICI)1097-0215(19980717)77:2<211::AID-IJC7>3.0.CO;2-T PubMedCrossRefGoogle Scholar
  30. 30.
    Maclure M, Willet W (1990) A case-control study of diet and risk of renal adenocarcinoma. Epidemiology 1:430–440PubMedCrossRefGoogle Scholar
  31. 31.
    Lindblad P, Wolk A, Bergstrom R, Adami HO (1997) Diet and risk of renal cell cancer: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 6:215–223PubMedGoogle Scholar
  32. 32.
    Mellemgaard A, McLaughlin JK, Overvad K, Olsen JH (1996) Dietary risk factors for renal cell carcinoma in Demark. Eur J Cancer 32A:673–682. doi:10.1016/0959-8049(95)00633-8 PubMedCrossRefGoogle Scholar
  33. 33.
    van Dijk BA, Schouten LJ, Kiemeney LA, Goldbohm RA, van den Brandt PA (2005) Vegetable and fruit consumption and risk of renal cell carcinoma: results from the Netherlands cohort study. Int J Cancer 117:648–654. doi:10.1002/ijc.21203 PubMedCrossRefGoogle Scholar
  34. 34.
    Rashidkhani B, Lindblad P, Wolk A (2005) Fruit, vegetables and risk of renal cell carcinoma: a prospective study of Swedish women. Int J Cancer 113:451–455. doi:10.1002/ijc.20577 PubMedCrossRefGoogle Scholar
  35. 35.
    Potter JD, Steinmetz K (1996) Vegetables, fruit and phytoestrogens as preventive agents. In: Stewart BW, McGregor D, Kleihues P (eds) Principles of chemoprevention, Publication No. 139. International Agency for Research on Cancer, Lyon, pp 61–69Google Scholar
  36. 36.
    Rao AV, Ray MR, Rao LG (2006) Lycopene. Adv Food Nutr Res 51:99–164. doi:10.1016/S1043-4526(06)51002-2 PubMedCrossRefGoogle Scholar
  37. 37.
    Coulter ID, Hardy ML, Morton SC et al (2006) Antioxidants vitamin C and vitamin E for the prevention and treatment of cancer. J Gen Intern Med 21:735–744. doi:10.1111/j.1525-1497.2006.00483.x PubMedCrossRefGoogle Scholar
  38. 38.
    Bardia A, Tleyjeh IM, Cerhan JR et al (2008) Efficacy of antioxidant supplementation in reducing primary cancer incidence and mortality: systematic review and meta-analysis. Mayo Clin Proc 83:23–34. doi:10.4065/83.1.23 PubMedCrossRefGoogle Scholar
  39. 39.
    Copeland KT, Checkoway H, McMichale AJ, Holbrook RH (1977) Bias due to misclassification in the estimate of relative risk. Am J Epidemiol 105:488–495PubMedGoogle Scholar
  40. 40.
    Hu J, Mery L, DesMeules M, Macleod M, The Canadian Cancer Registries Epidemiology Research Group (2007) Diet and vitamin or mineral supplementation and risk of rectal cancer in Canada. Acta Oncol 46:342–354. doi:10.1080/02841860600746982 PubMedCrossRefGoogle Scholar
  41. 41.
    Hu J, Morrison H, Mery L, Desmeules M, Macleod M, The Canadian Cancer Registries Epidemiology Research Group (2007) Diet and vitamin or mineral supplementation and risk of colon cancer by subsite in Canada. Eur J Cancer Prev 16:275–291. doi:10.1097/01.cej.0000228411.21719.25 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Jinfu Hu
    • 1
  • Carlo La  Vecchia
    • 2
    • 3
  • Eva Negri
    • 2
  • Marie DesMeules
    • 1
  • Les Mery
    • 4
  • The Canadian Cancer Registries Epidemiology Research Group
  1. 1.Evidence and Risk Assessment Division, Centre for Chronic Disease Prevention and ControlPublic Health Agency of CanadaOttawaCanada
  2. 2.Istituto Di Ricerche Farmacologiche “Mario Negri”MilanItaly
  3. 3.Istituto di Statistica Medica e BiometriaUniversità degli Studi di MilanoMilanItaly
  4. 4.Canadian Partnership Against CancerOttawaCanada

Personalised recommendations