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Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

  • Epidemiology
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Abstract

So far, studies on dietary antioxidant intake, including β-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of β-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85–1.27), 1.12 (0.92–1.36) and 1.11 (0.84–1.46), respectively] and postmenopausal women [0.93 (0.82–1.04), 0.98 (0.87–1.11) and 0.92 (0.77–1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of β-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66–0.96), P trend 0.06] and vitamin C [0.88 (0.72–1.07), P trend 0.05] was associated with reduced breast cancer risk. In addition, dietary β-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of β-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between β-carotene and vitamin E from food and breast cancer risk cannot be excluded.

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Acknowledgments

The EPIC study was funded by “Europe Against Cancer” Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health (RCESP-C03/09); the participating regional governments and institutions of Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Education; Greek Ministry of Health and Social Solidarity; Hellenic Health Foundation and Stavros Niarchos Foundation; Italian Association for Research on Cancer; Italian National Research Council; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society.

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None declared.

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Authors and Affiliations

  1. Institute of Epidemiology, Ulm University, Helmholtzstr.22, 89081, Ulm, Germany

    G. Nagel

  2. Department Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

    J. Linseisen, S. Rohrmann & R. Kaaks

  3. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    D. Drogan & H. Boeing

  4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    C. H. van Gils & P. H. Peeters

  5. Institut National de la Santé et de la Recherche Médicale (INSERM), IGR, Villejuif, France

    M. C. Boutron-Ruault, F. Clavel-Chapelon & I. Romieu

  6. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    M. M. Ros & H. B. Bueno-de-Mesquita

  7. Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    M. M. Ros

  8. Diet, Cancer and Health, Danish Cancer Society, Copenhagen, Denmark

    A. Tjønneland, A. Olsen & N. Roswall

  9. Department of Oncology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    P. M. Witt

  10. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

    K. Overvad

  11. Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece

    A. Trichopoulou, V. Stratigakou & D. Zylis

  12. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    D. Engeset, E. Lund & G. Skeie

  13. Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    F. Berrino & S. Grioni

  14. Department of Clinical and Experimental Medicine Federico II University, Naples, Italy

    A. Mattiello

  15. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy

    G. Masala

  16. Cancer Registry, Azienda Ospedaliera “Civile- M.P. Arezzo”, Ragusa, Italy

    R. Tumino

  17. Piedmont Cancer Registry-CPO, Turin, Italy

    R. Zanetti

  18. Department of Surgery, Malmö University Hospital, Malmö, Sweden

    J. Manjer

  19. Department of Clinical Sciences, Malmö and Nutrition Epidemiology, Lund University, Lund, Sweden

    E. Wirfält

  20. Public Health Institute of Navarra, Pamplona, Spain, and CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain

    E. Ardanaz

  21. Andalusian School of Public Health and CIBER de Epidemiología y Salud Pública (CIBERESP), Granada, Spain

    M. J. Sánchez

  22. CIBER Epidemiología y Salud Pública and Servicio de Epidemiología (CIBERESP), Murcia, Spain

    J. M. Huerta

  23. Public Health Division of Gipuzkoa, Basque Government, CIBER en Salud Pública, CIBERSP, Donostia-San Sebastian, Spain

    P. Amiano

  24. Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain

    L. Rodríguez

  25. Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden

    P. Lenner

  26. Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden

    G. Hallmans

  27. Epidemiology Unit, Cancer Research UK, University of Oxford, Oxford, UK

    E. A. Spencer & T. J. Key

  28. MRC Dunn Human Nutrition Unit and Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge, UK

    S. Bingham

  29. Clinical Gerontology Unit , University of Cambridge, Cambridge, UK

    K. T. Khaw

  30. International Agency for Research on Cancer, Lyon, France

    S. Rinaldi, N. Slimani & P. Boffetta

  31. Division of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK

    V. Gallo, T. Norat & E. Riboli

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  1. G. Nagel
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  2. J. Linseisen
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  34. P. Amiano
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  35. L. Rodríguez
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  36. J. Manjer
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  37. E. Wirfält
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  38. P. Lenner
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  39. G. Hallmans
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  40. E. A. Spencer
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  41. T. J. Key
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  42. S. Bingham
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  43. K. T. Khaw
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  44. S. Rinaldi
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  45. N. Slimani
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  46. P. Boffetta
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  47. V. Gallo
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  48. T. Norat
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  49. E. Riboli
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Correspondence to G. Nagel.

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Nagel, G., Linseisen, J., van Gils, C.H. et al. Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Breast Cancer Res Treat 119, 753–765 (2010). https://doi.org/10.1007/s10549-009-0444-8

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