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- Title
Association between carotenoids and outcome of cervical intraepithelial neoplasia: a prospective cohort study.
- Authors
Fujii, Takuma; Takatsuka, Naoyoshi; Nagata, Chisato; Matsumoto, Koji; Oki, Akinori; Furuta, Reiko; Maeda, Hiroo; Yasugi, Toshiharu; Kawana, Kei; Mitsuhashi, Akira; Hirai, Yasuo; Iwasaka, Tsuyoshi; Yaegashi, Nobuo; Watanabe, Yoh; Nagai, Yutaka; Kitagawa, Tomoyuki; Yoshikawa, Hiroyuki
- Abstract
Background: It has been suggested that micronutrients such as alpha-tocopherol, retinol, lutein, cryptoxanthin, lycopene, and alpha- and beta-carotene may help in the prevention of cervical cancer. Our aim was to investigate whether serum concentrations and/or dietary intake of micronutrients influence the regression or progression of low-grade cervical abnormalities. Methods: In a prospective cohort study of 391 patients with cervical intraepithelial neoplasia (CIN) grade 1-2 lesions, we measured serum micronutrient concentrations in addition to a self-administered questionnaire about dietary intake. We evaluated the hazard ratio (HR) adjusted for CIN grade, human papillomavirus genotype, total energy intake and smoking status. Results: In non-smoking regression subjects, regression was significantly associated with serum levels of zeaxanthin/lutein (HR 1.25, 0.78-2.01, p = 0.024). This benefit was abolished in current smokers. Regression was inhibited by high serum levels of alpha-tocopherol in smokers ( p = 0.042). In progression subjects, a significant protective effect against progression to CIN3 was observed in individuals with a medium level of serum beta-carotene [HR 0.28, 95 % confidence interval (CI) 0.11-0.71, p = 0.007), although any protective effect from a higher level of serum beta-carotene was weaker or abolished (HR 0.52, 95 % CI 0.24-1.13, p = 0.098). Increasing beta-carotene intake did not show a protective effect (HR 2.30, 95 % CI 0.97-5.42, p = 0.058). Conclusions: Measurements of serum levels of carotenoids suggest that regression is modulated by smoking status. Maintaining a medium serum level of beta-carotene has a protective effect for progression; however, carotene intake is not correlated with serum levels of carotenoids.
- Subjects
CANCER prevention; CERVICAL cancer; CAROTENOIDS; HEALTH outcome assessment; CERVICAL intraepithelial neoplasia; COHORT analysis; MICRONUTRIENTS; CANCER invasiveness; THERAPEUTIC use of carotenes; THERAPEUTICS
- Publication
International Journal of Clinical Oncology, 2013, Vol 18, Issue 6, p1091
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-012-0486-5