title: Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12.
abstract: OBJECTIVE
  A case-control study was conducted among a population of multiethnic women identified from clinics on Oahu, Hawaii between 1992 and 1996 to explore the relationship between diet and cervical dysplasia.
  
  
  METHODS
  Two-hundred and fourteen women with biopsy-confirmed high and low grade squamous intraepithelial lesions of the cervix (SIL) and 271 controls were identified. Exfoliated cervical cells were collected for HPV DNA testing. Surveys were administered to assess non-dietary risk factors and intake of nutrients from over 250 specific food items as well as nutritional supplements.
  
  
  RESULTS
  Riboflavin and thiamin from food sources, vitamin B12 supplements, and total (food and supplements) folate displayed inverse, dose-responsive associations with high-grade SIL (HSIL). Riboflavin from food sources and total folate also demonstrated inverse, dose-responsive associations with low-grade SIL (LSIL). The odds ratios for LSIL and HSIL were reduced by 50-90% for the highest compared to the lowest levels of intake of these nutrients. A number of major food sources of these vitamins, including all types of breads, bran cereal, and fruit juice, also demonstrated inverse associations with HSIL. There was some evidence that the increased risk of HSIL associated with low nutrient intake was most pronounced among drinkers and smokers.
  
  
  CONCLUSIONS
  This investigation provides evidence that thiamin, riboflavin, folate, and vitamin B12 may play a protective role in cervical carcinogenesis.
authors.affiliation: Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, Hawaii 96813, USA. brenda@crch.hawaii.edu
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.forename: Katharine
authors.initials: K
authors.lastname: McDuffie
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Lori
authors.initials: L
authors.lastname: Kamemoto
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016022:Case-Control Studies; D004034:Diet Surveys; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D015995:Prevalence; D012256:Riboflavin / Q000008:administration & dosage; D012307:Risk Factors; D013831:Thiamine / Q000008:administration & dosage; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D014626:Vaginal Smears; D014805:Vitamin B 12 / Q000008:administration & dosage; D014803:Vitamin B Complex / Q000008:administration & dosage*
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid; D014805:Vitamin B 12; D012256:Riboflavin; D013831:Thiamine