Diet and serum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women.
Cervical cancer is a leading cancer among women in developing countries. Infection with oncogenic human papillomavirus (HPV) types has been recognized as a necessary cause of this disease. Serum carotenoids and tocopherols have also been associated with risk for cervical neoplasia, but results from previous studies were not consistent. We evaluated the association of serum total carotene and tocopherols, and dietary intakes with the risk of newly diagnosed, histologically confirmed cervical intraepithelial neoplasia (CIN) grades 1, 2, 3 and invasive cancer in a hospital-based case-control study in São Paulo, Brazil. The investigation included 453 controls and 4 groups of cases (CIN1, n = 140; CIN2, n = 126; CIN3, n = 231; invasive cancer, n =108) recruited from two major public clinics between 2003 and 2005. Increasing concentrations of serum lycopene were negatively associated with CIN1, CIN3 and cancer, with odds ratios (OR) (95% CI) for the highest compared to the lowest tertile of 0.53 (0.27-1.00, p for trend = 0.05), 0.48 (0.22-1.04, p for trend = 0.05) and 0.18 (0.06-0.52, p for trend = 0.002), respectively, after adjusting for confounding variables and HPV status. Increasing concentrations of serum alpha- and gamma-tocopherols, and higher dietary intakes of dark green and deep yellow vegetables/fruit were associated with nearly 50% decreased risk of CIN3. These results support the evidence that a healthy and balanced diet leading to provide high serum levels of antioxidants may reduce cervical neoplasia risk in low-income women.
Tomita
Luciana Yuki
LY
Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil.
Longatto Filho
Adhemar
A
Costa
Maria Cecília
MC
Andreoli
Maria Antonieta Avilla
MA
Villa
Luisa Lina
LL
Franco
Eduardo Luiz
EL
Cardoso
Marly Augusto
MA
D000230:Adenocarcinoma / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000302:isolation & purification; D001938:Brazil / Q000453:epidemiology; D018196:Carcinoma, Adenosquamous / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D002338:Carotenoids / Q000097:blood*; D016022:Case-Control Studies; D003043:Cocarcinogenesis; D015897:Comorbidity; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D000077276:Lycopene; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology*; D018977:Micronutrients / Q000097:blood*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000097:blood / Q000453:epidemiology; D011203:Poverty; D012959:Socioeconomic Factors; D024505:Tocopherols / Q000097:blood*; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D014675:Vegetables; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000097:blood / Q000453:epidemiology* / Q000821:virology
D018977:Micronutrients; D002338:Carotenoids; D024505:Tocopherols; D000077276:Lycopene