Tomato consumption and intake of lycopene as predictors of the incidence of prostate cancer: the Adventist Health Study-2

Abstract

Purpose

Studies have controversially suggested that prostate cancer, the most common cancer among Western men, is less common among those with a high intake of tomato products and lycopene. We examine multivariable associations between the intake of tomatoes and lycopene, and risk of prostate cancer.

Methods

In a prospective study of 27,934 Adventist men without prevalent cancer, Cox proportional hazard regression analyses were used to address the objectives. Dietary measurement error was partially corrected with regression calibration.

Results

1226 incident cases of prostate cancer, 355 of them aggressive, were identified during 7.9 years of follow-up. Consumption of canned and cooked tomatoes more than four times a week was associated with a HR = 0.72 (95% CI 0.55, 0.94, P = 0.02) comparing to risk in those never consuming this food. Treating this as a continuous variable, adjusting for confounders, produces a similar result, HR = 0.86 (95% CI 0.75, 0.99), comparing 64 g/day with zero intakes (questionnaire data). Regression calibration, although less precise, suggests a yet stronger and statistically significant inverse relationship, comparing a 24-h dietary recall intake of 71 g/day canned and cooked tomato product, with zero intake. Uncalibrated multivariable-adjusted competing risk analyses do not find differences in tomato associations between aggressive and non-aggressive prostate cancers although power for aggressive cancers is limited.

Conclusion

Consumption of canned and cooked tomatoes may reduce the risk of prostate cancer. These products contain more available lycopene. However, an observational study cannot exclude confounding by some unidentified, prostate cancer preventive factor.

Clinical Trial Registry: ClinicalTrials.gov Identifier: NCT03615599

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Fig. 1

Abbreviations

PSA:

Prostate-specific antigen

AICR/WCRF:

The American Institute for Cancer Research/World Cancer Research Fund

AHS-1:

The Adventist Health Study-1

AHS-2:

The Adventist Health Study-2

NDSR:

Nutrition data system for research software versions 4, and 5

NCC:

Nutrition Coordinating Center

ICD-10:

International classification of diseases-10

SEER:

Surveillance epidemiology and end results

BPH:

Benign prostate hypertrophy

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Acknowledgements

The present analyses were supported by grants from the National Cancer Institute (5R01 CA094594) and World Cancer Research Fund Grant (2009/93), to the Adventist Health Study. These funding agencies had no further role in the collection of data, statistical analysis or writing. Cancer incidence data have been provided by the “Alaska Cancer Registry”, “Alberta Health Services”, “Alabama State Cancer Registry”, “Arizona Cancer Registry”, “Arkansas Cancer Registry”, “British Columbia Cancer Agency”, “California Cancer Registry”, “Cancer Care Ontario”, “Colorado Cancer Registry”, “Connecticut Tumor Registry”, “District of Columbia Cancer Registry”, “Delaware Cancer Registry”, “Florida Cancer Data System”, “Georgia Department of Public Health”, “Hawaii Tumor Registry”, “Cancer Data Registry of Idaho (NCI Contract HHSN261201800006I)”, “Iowa Cancer Registry”, “Illinois State Cancer Registry”, “Indiana State Cancer Registry”, “Kansas Cancer Registry”, “Kentucky Cancer Registry”, “Louisiana Tumor Registry”, “Maryland Cancer Registry”, “Massachusetts Cancer Registry”, “Michigan Cancer Surveillance System”, “Minnesota Cancer Surveillance System”, “Mississippi Cancer Registry”, “Missouri Cancer Registry and Research Center”, “Montana Central Tumor Registry”, “Nebraska Cancer Registry”, “Nevada Central Cancer Registry”, “New Hampshire State Cancer Registry”, “New Jersey State Cancer Registry”, “New Mexico Tumor Registry”, “New York State Cancer Registry”, “North Carolina Central Cancer Registry”, “North Dakota Statewide Cancer Registry”, “Cancer Data Registry of Ohio”, “Oklahoma Central Cancer Registry”, “Oregon State Cancer Registry”, “Pennsylvania Cancer Registry”, “Rhode Island Cancer Registry”, “South Carolina Cancer Registry”, “South Dakota Cancer Registry”, “Tennessee Cancer Registry”, “Texas Cancer Registry”, “Utah Cancer Registry, NCI Contract HHSN261201300071”, “Vermont Cancer Registry”, “Virginia Cancer Registry”, “Washington State Cancer Registry”, “West Virginia Cancer Registry”, “Wisconsin Cancer Reporting System”, “Wyoming Cancer Surveillance Program”. The results reported here and the conclusions based on them are the sole responsibility of the authors.

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GEF designed research, conducted research, wrote paper, had primary responsibility for final content; BKJ designed research, wrote paper; SFK conducted research; JIL and AM performed statistical analyses. All authors have read and approved the final manuscript.

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Correspondence to Gary E. Fraser.

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Fraser, G.E., Jacobsen, B.K., Knutsen, S.F. et al. Tomato consumption and intake of lycopene as predictors of the incidence of prostate cancer: the Adventist Health Study-2. Cancer Causes Control 31, 341–351 (2020). https://doi.org/10.1007/s10552-020-01279-z

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Keywords

  • Tomatoes
  • Prostate cancer
  • Seventh-day adventists
  • Lycopene
  • Cohort study