Plasma and dietary carotenoids and vitamins A, C and E and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

International Journal of Cancer, Wiley, ISSN 0020-7136

Volume 135, 12, 2014

DOI:10.1002/ijc.28938, Dimensions: pub.1034109877, PMID: 24771392,



  1. (1) Utrecht University, grid.5477.1
  2. (2) University Medical Center Utrecht, grid.7692.a
  3. (3) National Institute for Public Health and the Environment, grid.31147.30
  4. (4) Wageningen University & Research, grid.4818.5
  5. (5) Department for Health Evidence; Radboud University Medical Center; Nijmegen the Netherland
  6. (6) Julius Center for Health Sciences and Primary Care; University Medical Center; Utrecht the Netherlands
  7. (7) Aarhus University, grid.7048.b, AU
  8. (8) Danish Cancer Society, grid.417390.8
  9. (9) Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team; Villejuif France
  10. (10) Institut Gustave Roussy, grid.14925.3b
  11. (11) University of Paris-Sud, grid.5842.b
  12. (12) German Cancer Research Center, grid.7497.d
  13. (13) German Institute of Human Nutrition, grid.418213.d
  14. (14) National and Kapodistrian University of Athens, grid.5216.0
  15. (15) Hellenic Health Foundation, grid.424637.0
  16. (16) Istituto per lo Studio e la Prevenzione Oncologica, grid.417623.5
  17. (17) Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
  18. (18) Center for Cancer Prevention (CPO-Piemonte); Turin Italy
  19. (19) Human Genetics Foundation, grid.428948.b
  20. (20) Cancer Registry and Histopathology Unit; “Civile M.P. Arezzo” Hospital; Ragusa Italy
  21. (21) University of Naples Federico II, grid.4691.a
  22. (22) Department of Community Medicine; Faculty of Health Sciences; University of Tromsø-THE ARCTIC UNIVERSITY OF NORWAY; Tromsø Norway
  23. (23) Cancer Registry of Norway, grid.418941.1
  24. (24) Department of Research; Cancer Registry of Norway; Oslo Norway
  25. (25) Folkhälsans Forskningscentrum, grid.428673.c
  26. (26) Karolinska Institute, grid.4714.6
  27. (27) Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO); Barcelona Spain
  28. (28) Instituto de Salud Pública de Navarra, grid.419126.9
  29. (29) Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, grid.466571.7
  30. (30) Department of Epidemiology; Murcia Regional Health Council; Murcia Spain
  31. (31) Andalusian School of Public Health, grid.413740.5
  32. (32) Public Health Directorate; Asturias Spain
  33. (33) Umeå University, grid.12650.30
  34. (34) University of Oxford, grid.4991.5
  35. (35) University of Cambridge, grid.5335.0
  36. (36) International Agency For Research On Cancer, grid.17703.32
  37. (37) Imperial College London, grid.7445.2


Carotenoids and vitamins A, C and E are possibly associated with a reduced colorectal cancer (CRC) risk through antioxidative properties. The association of prediagnostic plasma concentrations and dietary consumption of carotenoids and vitamins A, C and E with the risk of colon and rectal cancer was examined in this case-control study, nested within the European Prospective Investigation into Cancer and Nutrition study. Plasma concentrations of carotenoids (α- and β-carotene, canthaxanthin, β-cryptoxanthin, lutein, lycopene, zeaxanthin) and vitamins A (retinol), C and E (α-, β- and γ- and δ-tocopherol) and dietary consumption of β-carotene and vitamins A, C and E were determined in 898 colon cancer cases, 501 rectal cancer cases and 1,399 matched controls. Multivariable conditional logistic regression models were performed to estimate incidence rate ratios (IRR) and corresponding 95% confidence intervals (CIs). An association was observed between higher prediagnostic plasma retinol concentration and a lower risk of colon cancer (IRR for highest quartile = 0.63, 95% CI: 0.46, 0.87, p for trend = 0.01), most notably proximal colon cancer (IRR for highest quartile = 0.46, 95% CI: 0.27, 0.77, p for trend = 0.01). Additionally, inverse associations for dietary β-carotene and dietary vitamins C and E with (distal) colon cancer were observed. Although other associations were suggested, there seems little evidence for a role of these selected compounds in preventing CRC through their antioxidative properties.


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