title: Carotenoids, vitamin A and risk of adenomatous polyp recurrence in the polyp prevention trial.
abstract: One trial reported beta-carotene supplementation was protective of adenomatous polyp recurrence in nonsmokers. We now examine the relation of serum and dietary carotenoids and vitamin A to adenomatous polyp recurrence in a subcohort of 834 participants in a low fat, high fiber, high fruit and vegetable dietary intervention, the Polyp Prevention Trial. Multivariate odds ratio (OR) and 95% confidence intervals (CI) of polyp recurrence were obtained using baseline or the average (first 3 years of the trial) carotenoid and vitamin A values after adjustment for covariates. Compared to the lowest quartile of baseline alpha-carotene concentrations, the OR of multiple polyp recurrence for the highest quartile was 0.55 (95% CI = 0.30-0.99) and the OR of right-sided recurrence was 0.60 (95% CI = 0.37-0.95). Baseline dietary intakes of alpha-carotene and vitamin A from food with/without supplements were inversely associated with any recurrence (p for linear trend = 0.03-alpha-carotene; p = 0.004 and p = 0.007 -intakes of vitamin A). Compared to the lowest quartile of averaged beta-carotene concentrations, the OR of multiple adenomas for the highest quartile was 0.40 (95% CI = 0.22-0.75) with an inverse trend (p = 0.02). The risk was inversely related to averaged: alpha-carotene concentrations and right-sided polyps; alpha-carotene intake and recurrence of any, multiple and right-sided polyps; beta-carotene intake and multiple adenoma recurrence; vitamin A from food (with supplements) and each adverse endpoint. Thus, alpha-carotene and vitamin A may protect against recurrence in nonsmokers and nondrinkers or be indicative of compliance or another healthy lifestyle factor that reduces risk.
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 57299, USA. susan_scott@unc.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Steck-Scott
authors.forename: Michele R
authors.initials: MR
authors.lastname: Forman
authors.forename: Anne
authors.initials: A
authors.lastname: Sowell
authors.forename: Craig B
authors.initials: CB
authors.lastname: Borkowf
authors.forename: Paul S
authors.initials: PS
authors.lastname: Albert
authors.forename: Martha
authors.initials: M
authors.lastname: Slattery
authors.forename: Brenda
authors.initials: B
authors.lastname: Brewer
authors.forename: Bette
authors.initials: B
authors.lastname: Caan
authors.forename: Electra
authors.initials: E
authors.lastname: Paskett
authors.forename: Frank
authors.initials: F
authors.lastname: Iber
authors.forename: Walt
authors.initials: W
authors.lastname: Kikendall
authors.forename: James
authors.initials: J
authors.lastname: Marshall
authors.forename: Moshe
authors.initials: M
authors.lastname: Shike
authors.forename: Joel
authors.initials: J
authors.lastname: Weissfeld
authors.forename: Kirk
authors.initials: K
authors.lastname: Snyder
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Elaine
authors.initials: E
authors.lastname: Lanza
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology* / Q000517:prevention & control*; D000368:Aged; D000428:Alcohol Drinking; D000975:Antioxidants / Q000494:pharmacology*; D002338:Carotenoids / Q000494:pharmacology*; D003110:Colonic Neoplasms / Q000473:pathology* / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D016017:Odds Ratio; D010349:Patient Compliance; D012307:Risk Factors; D012907:Smoking; D019207:beta Carotene / Q000494:pharmacology*
chemical_list: D000975:Antioxidants; D019207:beta Carotene; D002338:Carotenoids