title: Vitamin E intake, alpha-tocopherol status, and pancreatic cancer in a cohort of male smokers.
abstract: BACKGROUND
  Evidence indicates that vitamin E has anticarcinogenic properties for gastrointestinal cancers; however, few studies have examined this with respect to exocrine pancreatic cancer.
  
  
  OBJECTIVE
  The objective was to examine whether vitamin E intake and serum alpha-tocopherol concentrations were prospectively associated with exocrine pancreatic cancer.
  
  
  METHODS
  We conducted a cohort analysis of prediagnostic vitamin E intake (4 tocopherols, 4 tocotrienols), serum alpha-tocopherol concentrations, and pancreatic cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of male Finnish smokers aged 50-69 y at baseline. During follow-up from 1985 to 2004 (maximum: 19.4 y; median: 16 y), 318 incident cases were diagnosed among cohort participants with complete serum samples (n = 29,092); 306 cases had complete dietary data (n = 27,111). Cox proportional hazards models adjusted for age, smoking history, history of diabetes mellitus, and/or serum cholesterol were used to calculate hazard ratios (HRs) and 95% CIs.
  
  
  RESULTS
  Higher alpha-tocopherol concentrations were associated with lower pancreatic cancer risk (highest compared with lowest quintile, HR: 0.52; 95% CI: 0.34, 0.80; P for trend = 0.03; continuous HR: 0.91; 95% CI: 0.84, 0.99). Polyunsaturated fat, a putative prooxidant nutrient, modified the association such that the inverse alpha-tocopherol association was most pronounced in subjects with a high polyunsaturated fat intake (ie, >9.9 g/d; highest compared with lowest quintile, HR: 0.38; 95% CI: 0.20, 0.70; P for trend = 0.03; continuous HR: 0.86; 95% CI: 0.75, 0.97; P for interaction = 0.05 and 0.02, respectively). No associations were observed for dietary tocopherols and tocotrienols.
  
  
  CONCLUSIONS
  Our results support the hypothesis that higher alpha-tocopherol concentrations may play a protective role in pancreatic carcinogenesis in male smokers.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health Human Services, Rockville, MD, USA. rs221z@nih.gov
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.forename: Seth
authors.initials: S
authors.lastname: Sheffler-Collins
authors.forename: Stephanie
authors.initials: S
authors.lastname: Weinstein
authors.forename: David H
authors.initials: DH
authors.lastname: Garabrant
authors.forename: Satu
authors.initials: S
authors.lastname: Mannisto
authors.forename: Philip
authors.initials: P
authors.lastname: Taylor
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000378:metabolism; D015331:Cohort Studies; D016001:Confidence Intervals; D004041:Dietary Fats / Q000008:administration & dosage; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000097:blood*; D014810:Vitamin E / Q000008:administration & dosage*; D024502:alpha-Tocopherol / Q000097:blood*
chemical_list: D000975:Antioxidants; D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D014810:Vitamin E; D024502:alpha-Tocopherol