Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer

A pooled analysis of prospective cohort studies

Yikyung Park, Donna Spiegelman, David J. Hunter, Demetrius Albanes, Leif Bergkvist, Julie E. Buring, Jo L. Freudenheim, Edward Giovannucci, R. Alexandra Goldbohm, Lisa Harnack, Ikuko Kato, Vittorio Krogh, Michael F. Leitzmann, Paul J. Limburg, James R. Marshall, Marjorie L. McCullough, Anthony B. Miller, Thomas E. Rohan, Arthur Schatzkin, Roy Shore & 8 others Sabina Sieri, Meir J. Stampfer, Jarmo Virtamo, Matty Weijenberg, Walter C. Willett, Alicja Wolk, Shumin M. Zhang, Stephanie A. Smith-Warner

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. Methods: Using the primary data from 13 cohort studies, we estimated study-and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model. Results: Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76-1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66-0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81-0.96). Conclusions: Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

Original languageEnglish (US)
Pages (from-to)1745-1757
Number of pages13
JournalCancer Causes and Control
Volume21
Issue number11
DOIs
StatePublished - Nov 2010

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Vitamin A
Vitamin E
Vitamins
Colonic Neoplasms
Ascorbic Acid
Cohort Studies
Prospective Studies
Folic Acid
Dietary Supplements
Proportional Hazards Models
Eating

Keywords

  • Cohort study
  • Colon cancer
  • Multivitamin
  • Pooled analysis
  • Vitamin A
  • Vitamin C
  • Vitamin E

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer : A pooled analysis of prospective cohort studies. / Park, Yikyung; Spiegelman, Donna; Hunter, David J.; Albanes, Demetrius; Bergkvist, Leif; Buring, Julie E.; Freudenheim, Jo L.; Giovannucci, Edward; Goldbohm, R. Alexandra; Harnack, Lisa; Kato, Ikuko; Krogh, Vittorio; Leitzmann, Michael F.; Limburg, Paul J.; Marshall, James R.; McCullough, Marjorie L.; Miller, Anthony B.; Rohan, Thomas E.; Schatzkin, Arthur; Shore, Roy; Sieri, Sabina; Stampfer, Meir J.; Virtamo, Jarmo; Weijenberg, Matty; Willett, Walter C.; Wolk, Alicja; Zhang, Shumin M.; Smith-Warner, Stephanie A.

In: Cancer Causes and Control, Vol. 21, No. 11, 11.2010, p. 1745-1757.

Research output: Contribution to journalArticle

Park, Y, Spiegelman, D, Hunter, DJ, Albanes, D, Bergkvist, L, Buring, JE, Freudenheim, JL, Giovannucci, E, Goldbohm, RA, Harnack, L, Kato, I, Krogh, V, Leitzmann, MF, Limburg, PJ, Marshall, JR, McCullough, ML, Miller, AB, Rohan, TE, Schatzkin, A, Shore, R, Sieri, S, Stampfer, MJ, Virtamo, J, Weijenberg, M, Willett, WC, Wolk, A, Zhang, SM & Smith-Warner, SA 2010, 'Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer: A pooled analysis of prospective cohort studies', Cancer Causes and Control, vol. 21, no. 11, pp. 1745-1757. https://doi.org/10.1007/s10552-010-9549-y
Park, Yikyung ; Spiegelman, Donna ; Hunter, David J. ; Albanes, Demetrius ; Bergkvist, Leif ; Buring, Julie E. ; Freudenheim, Jo L. ; Giovannucci, Edward ; Goldbohm, R. Alexandra ; Harnack, Lisa ; Kato, Ikuko ; Krogh, Vittorio ; Leitzmann, Michael F. ; Limburg, Paul J. ; Marshall, James R. ; McCullough, Marjorie L. ; Miller, Anthony B. ; Rohan, Thomas E. ; Schatzkin, Arthur ; Shore, Roy ; Sieri, Sabina ; Stampfer, Meir J. ; Virtamo, Jarmo ; Weijenberg, Matty ; Willett, Walter C. ; Wolk, Alicja ; Zhang, Shumin M. ; Smith-Warner, Stephanie A. / Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer : A pooled analysis of prospective cohort studies. In: Cancer Causes and Control. 2010 ; Vol. 21, No. 11. pp. 1745-1757.
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abstract = "Objective: To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. Methods: Using the primary data from 13 cohort studies, we estimated study-and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model. Results: Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95{\%} CI) were 0.88 (0.76-1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66-0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95{\%} CI: 0.81-0.96). Conclusions: Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.",
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T2 - A pooled analysis of prospective cohort studies

AU - Park, Yikyung

AU - Spiegelman, Donna

AU - Hunter, David J.

AU - Albanes, Demetrius

AU - Bergkvist, Leif

AU - Buring, Julie E.

AU - Freudenheim, Jo L.

AU - Giovannucci, Edward

AU - Goldbohm, R. Alexandra

AU - Harnack, Lisa

AU - Kato, Ikuko

AU - Krogh, Vittorio

AU - Leitzmann, Michael F.

AU - Limburg, Paul J.

AU - Marshall, James R.

AU - McCullough, Marjorie L.

AU - Miller, Anthony B.

AU - Rohan, Thomas E.

AU - Schatzkin, Arthur

AU - Shore, Roy

AU - Sieri, Sabina

AU - Stampfer, Meir J.

AU - Virtamo, Jarmo

AU - Weijenberg, Matty

AU - Willett, Walter C.

AU - Wolk, Alicja

AU - Zhang, Shumin M.

AU - Smith-Warner, Stephanie A.

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