Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: A pooled analysis of 18 prospective cohort studies

Xuehong Zhang, Donna Spiegelman, Laura Baglietto, Leslie Bernstein, Deborah A. Boggs, Piet A. Van Den Brandt, Julie E. Buring, Susan M. Gapstur, Graham G. Giles, Edward Giovannucci, Gary Goodman, Susan E. Hankinson, Kathy J. Helzlsouer, Pamela L. Horn-Ross, Manami Inoue, Seungyoun Jung, Polyna Khudyakov, Susanna C. Larsson, Marie Lof, Marjorie L. McCulloughAnthony B. Miller, Marian L. Neuhouser, Julie R. Palmer, Yikyung Park, Kim Robien, Thomas E. Rohan, Julie A. Ross, Leo J. Schouten, James M. Shikany, Shoichiro Tsugane, Kala Visvanathan, Elisabete Weiderpass, Alicja Wolk, Walter C. Willett, Shumin M. Zhang, Regina G. Ziegler, Stephanie A. Smith-Warner

Research output: Contribution to journalArticle

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Abstract

Background: Epidemiologic studies examining associations between carotenoid intakes and risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status are limited. Objective: We investigated these associations in a pooled analysis of 18 cohort studies. Design: Of 1,028,438 participants followed for a maximum follow-up of 26 y across studies, 33,380 incident invasive breast cancers were identified. Study-specific RRs and 95% CIs were estimated by using Cox proportional hazards regression and then pooled by using a random-effects model. Results: α-Carotene, β-carotene, and lutein/zeaxanthin intakes were inversely associated with the risk of ER-negative (ER-) breast cancer (pooled multivariable RRs of the comparison between the highest and lowest quintiles): α-carotene (0.87; 95% CI: 0.78, 0.97), β-carotene (0.84; 95% CI: 0.77, 0.93), and lutein/zeaxanthin (0.87; 95% CI: 0.79, 0.95). These variables were not inversely associated with the risk of ER-positive (ER+) breast cancer (pooled multivariable RRs for the same comparison): α-carotene (1.04; 95% CI: 0.99, 1.09), β-carotene (1.04; 95% CI: 0.98, 1.10), and lutein/zeaxanthin (1.00; 95% CI: 0.93, 1.07). Although the pooled RRs for quintile 5 for β-cryptoxanthin were not significant, inverse trends were observed for ER- and ER+ breast cancer (P-trend ≤ 0.05). Nonsignificant associations were observed for lycopene intake. The associations were largely not appreciably modified by several breast cancer risk factors. Nonsignificant associations were observed for PR-positive and PR-negative breast cancer. Conclusions: Intakes of α-carotene, β-carotene, and lutein/zeaxanthin were inversely associated with risk of ER-, but not ER+, breast cancer. However, the results need to be interpreted with caution because it is unclear whether the observed association is real or due to other constituents in the same food sources.

Original languageEnglish (US)
Pages (from-to)713-725
Number of pages13
JournalAmerican Journal of Clinical Nutrition
Volume95
Issue number3
DOIs
StatePublished - Mar 1 2012
Externally publishedYes

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Progesterone Receptors
Carotenoids
Estrogen Receptors
Cohort Studies
Prospective Studies
Breast Neoplasms
Lutein
Epidemiologic Studies
Food
Zeaxanthins

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status : A pooled analysis of 18 prospective cohort studies. / Zhang, Xuehong; Spiegelman, Donna; Baglietto, Laura; Bernstein, Leslie; Boggs, Deborah A.; Van Den Brandt, Piet A.; Buring, Julie E.; Gapstur, Susan M.; Giles, Graham G.; Giovannucci, Edward; Goodman, Gary; Hankinson, Susan E.; Helzlsouer, Kathy J.; Horn-Ross, Pamela L.; Inoue, Manami; Jung, Seungyoun; Khudyakov, Polyna; Larsson, Susanna C.; Lof, Marie; McCullough, Marjorie L.; Miller, Anthony B.; Neuhouser, Marian L.; Palmer, Julie R.; Park, Yikyung; Robien, Kim; Rohan, Thomas E.; Ross, Julie A.; Schouten, Leo J.; Shikany, James M.; Tsugane, Shoichiro; Visvanathan, Kala; Weiderpass, Elisabete; Wolk, Alicja; Willett, Walter C.; Zhang, Shumin M.; Ziegler, Regina G.; Smith-Warner, Stephanie A.

In: American Journal of Clinical Nutrition, Vol. 95, No. 3, 01.03.2012, p. 713-725.

Research output: Contribution to journalArticle

Zhang, X, Spiegelman, D, Baglietto, L, Bernstein, L, Boggs, DA, Van Den Brandt, PA, Buring, JE, Gapstur, SM, Giles, GG, Giovannucci, E, Goodman, G, Hankinson, SE, Helzlsouer, KJ, Horn-Ross, PL, Inoue, M, Jung, S, Khudyakov, P, Larsson, SC, Lof, M, McCullough, ML, Miller, AB, Neuhouser, ML, Palmer, JR, Park, Y, Robien, K, Rohan, TE, Ross, JA, Schouten, LJ, Shikany, JM, Tsugane, S, Visvanathan, K, Weiderpass, E, Wolk, A, Willett, WC, Zhang, SM, Ziegler, RG & Smith-Warner, SA 2012, 'Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: A pooled analysis of 18 prospective cohort studies', American Journal of Clinical Nutrition, vol. 95, no. 3, pp. 713-725. https://doi.org/10.3945/ajcn.111.014415
Zhang, Xuehong ; Spiegelman, Donna ; Baglietto, Laura ; Bernstein, Leslie ; Boggs, Deborah A. ; Van Den Brandt, Piet A. ; Buring, Julie E. ; Gapstur, Susan M. ; Giles, Graham G. ; Giovannucci, Edward ; Goodman, Gary ; Hankinson, Susan E. ; Helzlsouer, Kathy J. ; Horn-Ross, Pamela L. ; Inoue, Manami ; Jung, Seungyoun ; Khudyakov, Polyna ; Larsson, Susanna C. ; Lof, Marie ; McCullough, Marjorie L. ; Miller, Anthony B. ; Neuhouser, Marian L. ; Palmer, Julie R. ; Park, Yikyung ; Robien, Kim ; Rohan, Thomas E. ; Ross, Julie A. ; Schouten, Leo J. ; Shikany, James M. ; Tsugane, Shoichiro ; Visvanathan, Kala ; Weiderpass, Elisabete ; Wolk, Alicja ; Willett, Walter C. ; Zhang, Shumin M. ; Ziegler, Regina G. ; Smith-Warner, Stephanie A. / Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status : A pooled analysis of 18 prospective cohort studies. In: American Journal of Clinical Nutrition. 2012 ; Vol. 95, No. 3. pp. 713-725.
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title = "Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: A pooled analysis of 18 prospective cohort studies",
abstract = "Background: Epidemiologic studies examining associations between carotenoid intakes and risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status are limited. Objective: We investigated these associations in a pooled analysis of 18 cohort studies. Design: Of 1,028,438 participants followed for a maximum follow-up of 26 y across studies, 33,380 incident invasive breast cancers were identified. Study-specific RRs and 95{\%} CIs were estimated by using Cox proportional hazards regression and then pooled by using a random-effects model. Results: α-Carotene, β-carotene, and lutein/zeaxanthin intakes were inversely associated with the risk of ER-negative (ER-) breast cancer (pooled multivariable RRs of the comparison between the highest and lowest quintiles): α-carotene (0.87; 95{\%} CI: 0.78, 0.97), β-carotene (0.84; 95{\%} CI: 0.77, 0.93), and lutein/zeaxanthin (0.87; 95{\%} CI: 0.79, 0.95). These variables were not inversely associated with the risk of ER-positive (ER+) breast cancer (pooled multivariable RRs for the same comparison): α-carotene (1.04; 95{\%} CI: 0.99, 1.09), β-carotene (1.04; 95{\%} CI: 0.98, 1.10), and lutein/zeaxanthin (1.00; 95{\%} CI: 0.93, 1.07). Although the pooled RRs for quintile 5 for β-cryptoxanthin were not significant, inverse trends were observed for ER- and ER+ breast cancer (P-trend ≤ 0.05). Nonsignificant associations were observed for lycopene intake. The associations were largely not appreciably modified by several breast cancer risk factors. Nonsignificant associations were observed for PR-positive and PR-negative breast cancer. Conclusions: Intakes of α-carotene, β-carotene, and lutein/zeaxanthin were inversely associated with risk of ER-, but not ER+, breast cancer. However, the results need to be interpreted with caution because it is unclear whether the observed association is real or due to other constituents in the same food sources.",
author = "Xuehong Zhang and Donna Spiegelman and Laura Baglietto and Leslie Bernstein and Boggs, {Deborah A.} and {Van Den Brandt}, {Piet A.} and Buring, {Julie E.} and Gapstur, {Susan M.} and Giles, {Graham G.} and Edward Giovannucci and Gary Goodman and Hankinson, {Susan E.} and Helzlsouer, {Kathy J.} and Horn-Ross, {Pamela L.} and Manami Inoue and Seungyoun Jung and Polyna Khudyakov and Larsson, {Susanna C.} and Marie Lof and McCullough, {Marjorie L.} and Miller, {Anthony B.} and Neuhouser, {Marian L.} and Palmer, {Julie R.} and Yikyung Park and Kim Robien and Rohan, {Thomas E.} and Ross, {Julie A.} and Schouten, {Leo J.} and Shikany, {James M.} and Shoichiro Tsugane and Kala Visvanathan and Elisabete Weiderpass and Alicja Wolk and Willett, {Walter C.} and Zhang, {Shumin M.} and Ziegler, {Regina G.} and Smith-Warner, {Stephanie A.}",
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TY - JOUR

T1 - Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status

T2 - A pooled analysis of 18 prospective cohort studies

AU - Zhang, Xuehong

AU - Spiegelman, Donna

AU - Baglietto, Laura

AU - Bernstein, Leslie

AU - Boggs, Deborah A.

AU - Van Den Brandt, Piet A.

AU - Buring, Julie E.

AU - Gapstur, Susan M.

AU - Giles, Graham G.

AU - Giovannucci, Edward

AU - Goodman, Gary

AU - Hankinson, Susan E.

AU - Helzlsouer, Kathy J.

AU - Horn-Ross, Pamela L.

AU - Inoue, Manami

AU - Jung, Seungyoun

AU - Khudyakov, Polyna

AU - Larsson, Susanna C.

AU - Lof, Marie

AU - McCullough, Marjorie L.

AU - Miller, Anthony B.

AU - Neuhouser, Marian L.

AU - Palmer, Julie R.

AU - Park, Yikyung

AU - Robien, Kim

AU - Rohan, Thomas E.

AU - Ross, Julie A.

AU - Schouten, Leo J.

AU - Shikany, James M.

AU - Tsugane, Shoichiro

AU - Visvanathan, Kala

AU - Weiderpass, Elisabete

AU - Wolk, Alicja

AU - Willett, Walter C.

AU - Zhang, Shumin M.

AU - Ziegler, Regina G.

AU - Smith-Warner, Stephanie A.

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Background: Epidemiologic studies examining associations between carotenoid intakes and risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status are limited. Objective: We investigated these associations in a pooled analysis of 18 cohort studies. Design: Of 1,028,438 participants followed for a maximum follow-up of 26 y across studies, 33,380 incident invasive breast cancers were identified. Study-specific RRs and 95% CIs were estimated by using Cox proportional hazards regression and then pooled by using a random-effects model. Results: α-Carotene, β-carotene, and lutein/zeaxanthin intakes were inversely associated with the risk of ER-negative (ER-) breast cancer (pooled multivariable RRs of the comparison between the highest and lowest quintiles): α-carotene (0.87; 95% CI: 0.78, 0.97), β-carotene (0.84; 95% CI: 0.77, 0.93), and lutein/zeaxanthin (0.87; 95% CI: 0.79, 0.95). These variables were not inversely associated with the risk of ER-positive (ER+) breast cancer (pooled multivariable RRs for the same comparison): α-carotene (1.04; 95% CI: 0.99, 1.09), β-carotene (1.04; 95% CI: 0.98, 1.10), and lutein/zeaxanthin (1.00; 95% CI: 0.93, 1.07). Although the pooled RRs for quintile 5 for β-cryptoxanthin were not significant, inverse trends were observed for ER- and ER+ breast cancer (P-trend ≤ 0.05). Nonsignificant associations were observed for lycopene intake. The associations were largely not appreciably modified by several breast cancer risk factors. Nonsignificant associations were observed for PR-positive and PR-negative breast cancer. Conclusions: Intakes of α-carotene, β-carotene, and lutein/zeaxanthin were inversely associated with risk of ER-, but not ER+, breast cancer. However, the results need to be interpreted with caution because it is unclear whether the observed association is real or due to other constituents in the same food sources.

AB - Background: Epidemiologic studies examining associations between carotenoid intakes and risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status are limited. Objective: We investigated these associations in a pooled analysis of 18 cohort studies. Design: Of 1,028,438 participants followed for a maximum follow-up of 26 y across studies, 33,380 incident invasive breast cancers were identified. Study-specific RRs and 95% CIs were estimated by using Cox proportional hazards regression and then pooled by using a random-effects model. Results: α-Carotene, β-carotene, and lutein/zeaxanthin intakes were inversely associated with the risk of ER-negative (ER-) breast cancer (pooled multivariable RRs of the comparison between the highest and lowest quintiles): α-carotene (0.87; 95% CI: 0.78, 0.97), β-carotene (0.84; 95% CI: 0.77, 0.93), and lutein/zeaxanthin (0.87; 95% CI: 0.79, 0.95). These variables were not inversely associated with the risk of ER-positive (ER+) breast cancer (pooled multivariable RRs for the same comparison): α-carotene (1.04; 95% CI: 0.99, 1.09), β-carotene (1.04; 95% CI: 0.98, 1.10), and lutein/zeaxanthin (1.00; 95% CI: 0.93, 1.07). Although the pooled RRs for quintile 5 for β-cryptoxanthin were not significant, inverse trends were observed for ER- and ER+ breast cancer (P-trend ≤ 0.05). Nonsignificant associations were observed for lycopene intake. The associations were largely not appreciably modified by several breast cancer risk factors. Nonsignificant associations were observed for PR-positive and PR-negative breast cancer. Conclusions: Intakes of α-carotene, β-carotene, and lutein/zeaxanthin were inversely associated with risk of ER-, but not ER+, breast cancer. However, the results need to be interpreted with caution because it is unclear whether the observed association is real or due to other constituents in the same food sources.

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