Abstract
Objectives
To provide information on the relation between intake of carotenoids and retinol and endometrial cancer, since available data are inconsistent. Further, carotenoids other than beta-carotene have been rarely investigated.
Methods
We conducted a multi-centric case–control study in various areas of Italy between 1992 and 2006 on 454 women with incident, histologically confirmed endometrial cancer and 908 controls admitted to the same network of hospitals of cases for acute, non-neoplastic conditions. Intake of carotenoids and retinol was computed from a validated and reproducible food frequency questionnaire. We adjusted for selected covariates, including energy intake, and calculated multivariate odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression.
Results
Comparing the highest to the lowest quartile of intake, the ORs of endometrial cancer were 0.69 (95% CI, 0.48–0.99) for beta-carotene, 0.65 (95% CI, 0.45–0.94) for beta-cryptoxanthin, and 0.59 (95% CI, 0.41–0.85) for lutein plus zeaxanthin intake. No association emerged with retinol (OR = 1.31, 95% CI, 0.94–1.84), alpha-carotene (OR = 0.94, 95% CI, 0.66–1.34), and lycopene (OR = 0.95, 95% CI, 0.68–1.34).
Conclusions
Our results support a favorable role of selected dietary carotenoids on endometrial cancer risk.
Similar content being viewed by others
References
Salazar-Martinez E, Lazcano-Ponce E, Sanchez-Zamorano LM, Gonzalez-Lira G, Escudero-De Los Rios P, Hernandez-Avila M (2005) Dietary factors and endometrial cancer risk. Results of a case-control study in Mexico. Int J Gynecol Cancer 15:938–945. doi:10.1111/j.1525-1438.2005.00253.x
Petridou E, Kedikoglou S, Koukoulomatis P, Dessypris N, Trichopoulos D (2002) Diet in relation to endometrial cancer risk: a case-control study in Greece. Nutr Cancer 44:16–22. doi:10.1207/S15327914NC441_3
McCann SE, Freudenheim JL, Marshall JR, Brasure JR, Swanson MK, Graham S (2000) Diet in the epidemiology of endometrial cancer in western New York (United States). Cancer Causes Control 11:965–974. doi:10.1023/A:1026551309873
Xu WH, Dai Q, Xiang YB et al (2007) Nutritional factors in relation to endometrial cancer: a report from a population-based case-control study in Shanghai, China. Int J Cancer 120:1776–1781. doi:10.1002/ijc.22456
Negri E, La Vecchia C, Franceschi S, Levi F, Parazzini F (1996) Intake of selected micronutrients and the risk of endometrial carcinoma. Cancer 77:917–23. doi:10.1002/(SICI)1097-0142(19960301)77:5<917::AID-CNCR17>3.0.CO;2-6
Jain MG, Rohan TE, Howe GR, Miller AB (2000) A cohort study of nutritional factors and endometrial cancer. Eur J Epidemiol 16:899–905. doi:10.1023/A:1011012621990
Jain MG, Howe GR, Rohan TE (2000) Nutritional factors and endometrial cancer in Ontario, Canada. Cancer Control 7:288–296
Potischman N, Swanson CA, Brinton LA et al (1993) Dietary associations in a case-control study of endometrial cancer. Cancer Causes Control 4:239–250
Barbone F, Austin H, Partridge EE (1993) Diet and endometrial cancer: a case-control study. Am J Epidemiol 137:393–403
Shu XO, Zheng W, Potischman N et al (1993) A population-based case-control study of dietary factors and endometrial cancer in Shanghai, People’s Republic of China. Am J Epidemiol 137:155–165
Steinmetz KA, Potter JD (1991) Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 2:427–442. doi:10.1007/BF00054304
Lucenteforte E, Talamini R, Montella M et al (2008) Macronutrients, fatty acids and cholesterol intake and endometrial cancer risk. Ann Oncol 19:168–172. doi:10.1093/annonc/mdm446
Osservatorio Nazionale sull’impiego dei medicinali, OSMED (2007) L’uso dei farmaci in Italia. Rapporto Nazionale anno 2006. Osservatorio Nazionale sull’impiego dei medicinali. Available online at: http://www.aifa.gov.it/
Botto LD, Lisi A, Robert-Gnansia E et al (2005) International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? BMJ 330:571. doi:10.1136/bmj.38336.664352.82
Salvini S, Parpinel M, Gnagnarella P, Maisonneuve P, Turrini A (1998) Banca dati di composizione degli alimenti per studi epidemiologici in Italia. Istituto Europeo di Oncologia, Milano
Gnagnarella P, Parpinel M, Salvini S, Franceschi S, Palli D, Boyle P (2004) The update of the Italian food composition database. J Food Compost Anal 17:509–522. doi:10.1016/j.jfca.2004.02.009
Decarli A, Franceschi S, Ferraroni M et al (1996) Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. Ann Epidemiol 6:110–118. doi:10.1016/1047-2797(95)00129-8
Franceschi S, Barbone F, Negri E et al (1995) Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients. Ann Epidemiol 5:69–75. doi:10.1016/1047-2797(95)92893-D
Breslow NE, Day NE (1980) Statistical methods in cancer research. vol 1: the analysis of case-control studies. IARC Science Publication, Geneva, p 32
Willett WC, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27
Stahl W, Nicolai S, Briviba K et al (1997) Biological activities of natural and synthetic carotenoids: induction of gap junctional communication and singlet oxygen quenching. Carcinogenesis 18:89–92. doi:10.1093/carcin/18.1.89
Muller K, Carpenter KL, Challis IR, Skepper JN, Arends MJ (2002) Carotenoids induce apoptosis in the T-lymphoblast cell line Jurkat E6.1. Free Radic Res 36:791–802. doi:10.1080/1071576021000005339
Chew BP, Park JS (2004) Carotenoid action on the immune response. J Nutr 134:257S–261S
Bendich A (2004) From 1989 to 2001: what have we learned about the “biological actions of beta-carotene”? J Nutr 134:225S–230S
Mares-Perlman JA, Millen AE, Ficek TL, Hankinson SE (2002) The body of evidence to support a protective role for lutein and zeaxanthin in delaying chronic disease. Overview. J Nutr 132:518S–524S
Cook LS, Weiss NS, Doherty JA, Chen C (2006) Endometrial cancer. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention, 3rd edn. Oxford University Press, New York, pp 1027–1043
Bosetti C, Altieri A, La Vecchia C (2002) Diet and environmental carcinogenesis in breast/gynaecological cancers. Curr Opin Obstet Gynecol 14:13–18. doi:10.1097/00001703-200202000-00003
Menkes MS, Comstock GW, Vuilleumier JP, Helsing KJ, Rider AA, Brookmeyer R (1986) Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer. N Engl J Med 315:1250–1254
Peto R, Doll R, Buckley JD, Sporn MB (1981) Can dietary beta-carotene materially reduce human cancer rates? Nature 290:201–208. doi:10.1038/290201a0
van Poppel G, Goldbohm RA (1995) Epidemiologic evidence for beta-carotene and cancer prevention. Am J Clin Nutr 62:1393S–1402S
Omenn GS, Goodman GE, Thornquist MD et al (1996) Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 334:1150–1155. doi:10.1056/NEJM199605023341802
Hennekens CH, Buring JE, Manson JE et al (1996) Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 334:1145–1149. doi:10.1056/NEJM199605023341801
The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035. doi:10.1056/NEJM199404143301501
Lee IM, Cook NR, Manson JE, Buring JE, Hennekens CH (1999) Beta-carotene supplementation and incidence of cancer and cardiovascular disease: the women’s health study. J Natl Cancer Inst 91:2102–2106. doi:10.1093/jnci/91.24.2102
Negri E, La Vecchia C, Franceschi S (2002) Relations between vegetable, fruit and micronutrient intake. Implications for odds ratios in a case-control study. Eur J Clin Nutr 56:166–170
Favero A, Salvini S, Russo A et al (1997) Sources of macro- and micronutrients in Italian women: results from a food frequency questionnaire for cancer studies. Eur J Cancer Prev 6:277–287. doi:10.1097/00008469-199706000-00005
Garcia-Closas R, Berenguer A, Jose Tormo M et al (2004) Dietary sources of vitamin C, vitamin E and specific carotenoids in Spain. Br J Nutr 91:1005–1011. doi:10.1079/BJN20041130
D’Avanzo B, La Vecchia C, Katsouyanni K, Negri E, Trichopoulos D (1997) An assessment, and reproducibility of food frequency data provided by hospital controls. Eur J Cancer Prev 6:288–293. doi:10.1097/00008469-199706000-00006
Acknowledgments
The authors thank Ms I. Garimoldi for editorial assistance.
Financial support
This work was conducted with contribution from the Italian Association for Cancer Research (AIRC), Italian League Against Cancer and Italian Ministry of Research (PRIN 2005). The work in this paper was undertaken while CLV was a Senior Fellow at the International Agency for Research on Cancer.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pelucchi, C., Dal Maso, L., Montella, M. et al. Dietary intake of carotenoids and retinol and endometrial cancer risk in an Italian case–control study. Cancer Causes Control 19, 1209–1215 (2008). https://doi.org/10.1007/s10552-008-9190-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-008-9190-1