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Am J Epidemiol 2002; 156:536-547.
Copyright © 2002 by the Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Dietary Carotenoids, Serum ß-Carotene, and Retinol and Risk of Lung Cancer in the Alpha-Tocopherol, Beta-Carotene Cohort Study

Crystal N. Holick1, Dominique S. Michaud2, Rachael Stolzenberg-Solomon2, Susan T. Mayne1, Pirjo Pietinen3, Philip R. Taylor4, Jarmo Virtamo3 and Demetrius Albanes2

1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
3 Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
4 Center for Cancer Research, National Cancer Institute, Bethesda, MD.

Findings from several ß-carotene supplementation trials were unexpected and conflicted with most observational studies. Carotenoids other than ß-carotene are found in a variety of fruits and vegetables and may play a role in this important malignancy, but previous findings regarding the five major carotenoids are inconsistent. The authors analyzed the associations between dietary ß-carotene, ß-carotene, lutein/zeaxanthin, lycopene, ß-cryptoxanthin, vitamin A, serum ß-carotene, and serum retinol and the lung cancer risk in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort of male smokers conducted in southwestern Finland between 1985 and 1993. Of the 27,084 male smokers aged 50–69 years who completed the 276-food item dietary questionnaire at baseline, 1,644 developed lung cancer during up to 14 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. Consumption of fruits and vegetables was associated with a lower lung cancer risk (relative risk = 0.73, 95% confidence interval: 0.62, 0.86, highest vs. lowest quintile). Lower risks of lung cancer were observed for the highest versus the lowest quintiles of lycopene (28%), lutein/zeaxanthin (17%), ß-cryptoxanthin (15%), total carotenoids (16%), serum ß-carotene (19%), and serum retinol (27%). These findings suggest that high fruit and vegetable consumption, particularly a diet rich in carotenoids, tomatoes, and tomato-based products, may reduce the risk of lung cancer.

beta-carotene; carotenoids; lung neoplasms; prospective studies; vitamin A

Abbreviations: Abbreviations: ATBC, Alpha-Tocopherol, Beta-Carotene; CI, confidence interval; RR, relative risk.


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