Advertisement

Cancer Causes & Control

, Volume 14, Issue 7, pp 645–655 | Cite as

Prospective study of serum retinol, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin and esophageal and gastric cancers in China

  • Christian C. AbnetEmail author
  • You-Lin Qiao
  • Sanford M. Dawsey
  • Dennis W. Buckman
  • Chung S. Yang
  • William J. Blot
  • Zhi-Wei Dong
  • Philip R. Taylor
  • Steven D. Mark
Article

Abstract

Objective: This study examined the relationship between pretrial serum concentrations of retinol, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin and the subsequent risk of developing esophageal squamous cell carcinoma and gastric cardia or non-cardia adenocarcinoma in subjects selected from a randomized nutritional intervention trial in Linxian, China, a region with epidemic rates of esophageal and gastric cardia cancer. Methods: We used a stratified case–cohort design to select cohort members for inclusion in this study. In all we measured serum concentrations of the above vitamins in 590 esophageal, 395 gastric cardia, and 87 gastric non-cardia case subjects as well as in 1053 control subjects. Relative risks (RRs) were estimated using Cox proportional hazards models. Results: Median values in our cohort were low for serum retinol (33.6 μg/dl), β-carotene (4.3 μg/dl), and β-cryptoxanthin (3.5 μg/dl) , but were high for lutein/zeaxanthin (40.0 μg/dl). Gastric cardia cancer incidence fell 10% for each quartile increase in serum retinol (RR = 0.90, 95% CI = 0.83–0.99). For esophageal cancer, an inverse association with retinol levels was found only in male non-smokers (RR = 0.79 per quartile increase, 95% CI = 0.63–0.99). For gastric non-cardia cancer, an inverse association was limited to subjects 50 years old or younger (RR = 0.58 per quartile, 95% CI = 0.31–0.96). For β-cryptoxanthin there was a borderline significant protective association for gastric non-cardia cancer (RR = 0.88 per quartile, 95% CI = 0.76–1.0). In contrast, we found the incidence of gastric non-cardia cancer increased (RR = 1.2 per quartile, 95% CI = 1.0–1.3) with increasing concentration of serum lutein/zeaxanthin. Conclusions: In this population, we found that low retinol and high lutein/zeaxanthin concentrations increased the risks of gastric cardia and gastric non-cardia cancer respectively. We found that there were no strong associations between any of the other analytes and any of the cancer sites.

β-carotene β-cryptoxanthin esophageal cancer gastric cancer lutein retinol zeaxanthin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Collins AR (2001) Carotenoids and genomic stability. Mutat Res 475: 21-28.Google Scholar
  2. 2.
    Nomura AM, Stemmermann GN, Chyou PH (1995) Gastric cancer among the Japanese in Hawaii. Jpn J Cancer Res 86: 916-923.Google Scholar
  3. 3.
    You W, Zhang L, Gail MH, et al. (2000) Gastric dysplasia and gastric cancer: Helicobacter pylori, serum vitamin C, and other risk factors. J Natl Cancer Inst 92: 1607-1612.Google Scholar
  4. 4.
    Li B, Taylor PR, Li J-Y, et al. (1993) Linxian nutrition intervention trials. Design, methods, participant characteristics, and compliance. Ann Epidemiol 3: 577-585.Google Scholar
  5. 5.
    Li JY, Taylor PR, Li B, et al. (1993) Nutrition intervention trials in Linxian, China: multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. J Natl Cancer Inst 85: 1492-1498.Google Scholar
  6. 6.
    Blot WJ, Li J-Y, Taylor PR, et al. (1993) Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/ mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 85: 1483-1492.Google Scholar
  7. 7.
    Blot WJ, Li JY (1985) Some considerations in the design of a nutrition intervention trial in Linxian, People's Republic of China. Natl Cancer Inst Monogr 69: 29-34.Google Scholar
  8. 8.
    Mark SD, Qiao YL, Dawsey SM, et al. (2000) Prospective study of serum selenium levels and incident esophageal and gastric cancers. J Natl Cancer Inst 92: 1753-1763.Google Scholar
  9. 9.
    Prentice RL (1986) A case cohort design for epidemiologic cohort studies and disease prevention trials. Biometrika 73: 1-11.Google Scholar
  10. 10.
    Self SG, Prentice RL (1988) Asymptotic distribution theory and efficiency results for case-cohort studies. Ann Stat 16: 64-81.Google Scholar
  11. 11.
    Mark SD, Katki H (2001) Influence function based variance estimation and missing data issues in case-cohort studies. Lifetime Data Anal 7: 331-344.Google Scholar
  12. 12.
    Miller KW, Yang CS (1985) An isocratic high-performance liquid chromatography method for the simultaneous analysis of plasma retinol, alpha-tocopherol, and various carotenoids. Anal Biochem 145: 21-26.Google Scholar
  13. 13.
    Sowell AL, Huff DL, Yeager PR, Caudill SP, Gunter EW (1994) Retinol, alpha-tocopherol, lutein/zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, trans-beta-carotene, and four retinyl esters in serum determined simultaneously by reversed-phase HPLC with multiwavelength detection. Clin Chem 40: 411-416.Google Scholar
  14. 14.
    Yang CS, Sun Y, Yang QU, et al. (1984) Vitamin A and other deficiencies in Linxian, a high esophageal cancer incidence area in northern China. J Natl Cancer Inst 73: 1449-1453.Google Scholar
  15. 15.
    Hastie T, Tibshirani R. Generalized Additive Models. 1st edn. New York: Chapman and Hall, 1990Google Scholar
  16. 16.
    S-Plus 2000 Programmer's Guide. Seattle,WA: MathSoft, Inc., 1999.Google Scholar
  17. 17.
    Shah BV, Barnwell BG, Bieler GS. SUDAAN User's Manual. Release 7.5 edn. Research Triangle Park: Research Triangle Institute, 1997Google Scholar
  18. 18.
    Epicure. Seattle, WA: Hirosoft international Corp., 1998Google Scholar
  19. 19.
    Guo W, Blot WJ, Li JY, et al. (1994) A nested case-control study of oesophageal and stomach cancers in the Linxian nutrition intervention trial. Int J Epidemiol 23: 444-450.Google Scholar
  20. 20.
    Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2000Google Scholar
  21. 21.
    Sommer A, West KP Jr. Vitamin A Deficiency: Health, Survival, and Vision. New York: Oxford University Press, 1996Google Scholar
  22. 22.
    Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000Google Scholar
  23. 23.
    Ershow AG, Zheng SF, Li GY, et al. (1984) Compliance and nutritional status during feasibility study for an intervention trial in China. J Natl Cancer Inst 73: 1477-1481.Google Scholar
  24. 24.
    Roth MJ, Strickland KL, Wang GQ, et al. (1998) High levels of carcinogenic polycyclic aromatic hydrocarbons present within food from Linxian, China may contribute to that region's high incidence of oesophageal cancer. Eur J Cancer 34: 757-758.Google Scholar
  25. 25.
    Yang CS (1980) Research on esophageal cancer in China: a review. Cancer Res 40: 2633-2644.Google Scholar
  26. 26.
    Ratnasinghe D, Forman MR, Tangrea JA, et al. (2000) Serum carotenoids are associated with increased lung cancer risk among alcohol drinkers, but not among non-drinkers in a cohort of tin miners. Alcohol Alcohol 35: 355-360.Google Scholar
  27. 27.
    Yu Y, Taylor PR, Li JY, et al. (1993) Retrospective cohort study of risk-factors for esophageal cancer in Linxian, People's Republic of China. Cancer Causes Control 4: 195-202.Google Scholar
  28. 28.
    Marasas WF, Jaskiewicz K, Venter FS, van Schalkwyk DJ (1988) Fusarium moniliforme contamination of maize in oesophageal cancer areas in Transkei. S Afr Med J 74: 110-114.Google Scholar
  29. 29.
    Abnet CC, Borkowf CB, Qiao Y-L, et al. (2001) Sphingolipids as a Biomarker of Fumonisin Exposure and Risk of Esophageal Squamous Cell Carcinoma in China. Cancer Causes Control 12: 821-828.Google Scholar
  30. 30.
    Albanes D, Heinonen OP, Taylor PR, et al. (1996) Alpha-Tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance. J Natl Cancer Inst 88: 1560-1570.Google Scholar
  31. 31.
    Omenn GS, Goodman GE, Thornquist MD, et al. (1996) Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial. J Natl Cancer Inst 88: 1550-1559.Google Scholar
  32. 32.
    Omaye ST, Krinsky NI, Kagan VE, et al. (1997) beta-carotene: friend or foe? Fundam Appl Toxicol 40: 163-174.Google Scholar
  33. 33.
    Perocco P, Paolini M, Mazzullo M, Biagi GL, Cantelli-Forti G (1999) beta-carotene as enhancer of cell transforming activity of powerful carcinogens and cigarette-smoke condensate on BALB/c 3T3 cells in vitro. Mutat Res 440: 83-90.Google Scholar
  34. 34.
    Paolini M, Cantelli-Forti G, Perocco P, et al. (1999) Co-carcinogenic effect of beta-carotene. Nature 398: 760-761.Google Scholar
  35. 35.
    Li JY, Chen ZJ, Ershow AG, Blot WJ (1985) A case-control study of esophageal cancer in Linxian, People's Republic of China. Natl Cancer Inst Monogr 69: 5-7.Google Scholar
  36. 36.
    Limburg PJ, Qiao Y-L, Mark SD, et al. (2001) Helicobacter pylori seropositivity and subsite-specific cancer risks in Linxian, China. J Natl Cancer Inst 93: 226-233.Google Scholar
  37. 37.
    Hoffmeister A, Rothenbacher D, Bode G, et al. (2001) Current infection with Helicobacter pylori, but not seropositivity to Chlamydia pneumoniae or cytomegalovirus, is associated with an atherogenic, modified lipid profile. Arterioscler Thromb Vasc Biol 21: 427-432.Google Scholar
  38. 38.
    Zhang ZW, Patchett SE, Perrett D, Domizio P, Farthing MJ (2000) Gastric alpha-tocopherol and beta-carotene concentrations in association with Helicobacter pylori infection. Eur J Gastroenterol Hepatol 12: 497-503.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Christian C. Abnet
    • 1
    Email author
  • You-Lin Qiao
    • 2
  • Sanford M. Dawsey
    • 3
  • Dennis W. Buckman
    • 4
  • Chung S. Yang
    • 5
  • William J. Blot
    • 6
    • 7
  • Zhi-Wei Dong
    • 2
  • Philip R. Taylor
    • 3
  • Steven D. Mark
    • 8
  1. 1.Cancer Prevention Studies Branch, Center for Cancer ResearchNational Cancer InstituteBethesdaUSA
  2. 2.Department of EpidemiologyCancer Institute, Chinese Academy of Medical SciencesBeijingPeople's Republic of China
  3. 3.Cancer Prevention Studies Branch, Center for Cancer ResearchNational Cancer InstituteBethesdaUSA
  4. 4.Information Management ServicesRockvilleUSA
  5. 5.Laboratory for Cancer Research, College of Pharmacy, RutgersThe State University of New JerseyPiscatawayUSA
  6. 6.International Epidemiology InstituteRockvilleUSA
  7. 7.Department of Medicine, Vanderbilt-Ingram Cancer CenterVanderbilt UniversityNashvilleUSA
  8. 8.Biostatistics Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA

Personalised recommendations