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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

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Author: Park, Y. · Spiegelman, D. · Hunter, D.J. · Albanes, D. · Bergkvist, L. · Buring, J.E. · Freudenheim, J.L. · Giovannucci, E. · Goldbohm, R.A. · Harnack, L. · Kato, I. · Krogh, V. · Leitzmann, M.F. · Limburg, P.J. · Marshall, J.R. · McCullough, M.L. · Miller, A.B. · Rohan, T.E. · Schatzkin, A. · Shore, R. · Sieri, S. · Stampfer, M.J. · Virtamo, J. · Weijenberg, M. · Willett, W.C. · Wolk, A. · Zhang, S.M. · Smith-Warner, S.A.
Institution: TNO Kwaliteit van Leven
Source:Cancer Causes and Control, 11, 21, 1745-1757
Identifier: 425496
Keywords: Health · Leefomgeving en gezondheid · Cohort study · Colon cancer · Multivitamin · Pooled analysis · Vitamin A · Vitamin C · Vitamin E


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. © 2010 Springer Science+Business Media B.V.