Cancer Causes & Control

, Volume 24, Issue 2, pp 343–355 | Cite as

Parental nutrient intake and risk of retinoblastoma resulting from new germline RB1 mutation

  • Greta R. Bunin
  • Yimei Li
  • Arupa Ganguly
  • Anna T. Meadows
  • Marilyn Tseng
Original paper



We conducted a case–control study to examine the role of parents’ nutrient intake before their child’s conception in the child’s risk of sporadic bilateral retinoblastoma, which results from a new germline RB1 mutation.


Parents of 206 cases from 9 North American institutions and 269 friend and relative controls participated; fathers of 182 cases and 223 controls and mothers of 202 cases and 260 controls provided useable information in telephone interviews on their diet in the year before the child’s conception. We also asked parents about supplements, a significant source of nutrients in users.


Father’s intake of dairy-associated nutrients and his use of calcium supplements were associated with decreased risk, while his intake of copper, manganese, and vitamin E was associated with increased risk. Mother’s use of multivitamins close to conception was associated with lower risk as was her intake of several micronutrients found in these supplements. In analyses to elucidate the primary factor from multiple correlated factors, the most robust findings were for father’s calcium intake (adjusted OR = 0.46–0.63 for 700 mg increase) and calcium supplement use (OR = 0.35–0.41) and mother’s multivitamin use (ORs 0.28–0.48).


There are few directly relevant studies but some data indirectly support the biologic plausibility of the inverse associations with father’s calcium intake and mother’s use of multivitamins; however, we cannot rule out contributions of bias, confounding, or chance. Our findings provide a starting point for further investigation of diet in the etiology of retinoblastoma and new germline mutation generally.


Germline mutation Diet Retinoblastoma Case–control studies Pediatric cancer 



Confidence interval


Food frequency questionnaire


Nurses’ Health Study


Odds ratio



This work was supported by grants from the US National Institutes of Health (R01CA081012 and R01CA118580). We are grateful to the families of the patients and their relatives and friends for their participation. We thank Drs. Debra Friedman, Carol Shields, Kim Nichols, Ann Leahey, Ira Dunkel, Rima Jubran, Carlos Rodriguez-Galindo, Mary Lou Schmidt, Joanna Weinstein, Stewart Goldman, David Abramson, Matthew Wilson, Brenda Gallie, Helen Chan, and Michael Shapiro for enrolling and caring for the patients and Drs. Avital Cnaan and Larry Kushi for their assistance in the design of the study. We also thank the clinical research staff at the participating centers and study staff at Children’s Hospital of Philadelphia for their diligent efforts particularly Bethany Barone, Jaclyn Bosco, Greta Anschuetz, Sheila Kearney, and the late Jean Rodwell.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Greta R. Bunin
    • 1
  • Yimei Li
    • 1
  • Arupa Ganguly
    • 2
  • Anna T. Meadows
    • 1
  • Marilyn Tseng
    • 3
  1. 1.Division of Oncology, Center for Childhood Cancer ResearchChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of GeneticsUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of KinesiologyCalifornia Polytechnic UniversitySan Luis ObispoUSA

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