Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies

Abstract

Objective

To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer.

Methods

Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model.

Results

Among 676,141 men and women, 5,454 colon cancer cases were identified (7–20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76–1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71–0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66–0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81–0.96).

Conclusions

Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

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Financial support

The study was funded by research grants CA55075 from the National Institutes of Health and the National Colorectal Cancer Research Alliance of the Entertainment Industry Foundation.

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Correspondence to Stephanie A. Smith-Warner.

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Park, Y., Spiegelman, D., Hunter, D.J. et al. Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies. Cancer Causes Control 21, 1745–1757 (2010). https://doi.org/10.1007/s10552-010-9549-y

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Keywords

  • Vitamin A
  • Vitamin C
  • Vitamin E
  • Multivitamin
  • Colon cancer
  • Cohort study
  • Pooled analysis