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.
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.
Park
Yikyung
Y
Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Spiegelman
Donna
D
Hunter
David J
DJ
Albanes
Demetrius
D
Bergkvist
Leif
L
Buring
Julie E
JE
Freudenheim
Jo L
JL
Giovannucci
Edward
E
Goldbohm
R Alexandra
RA
Harnack
Lisa
L
Kato
Ikuko
I
Krogh
Vittorio
V
Leitzmann
Michael F
MF
Limburg
Paul J
PJ
Marshall
James R
JR
McCullough
Marjorie L
ML
Miller
Anthony B
AB
Rohan
Thomas E
TE
Schatzkin
Arthur
A
Shore
Roy
R
Sieri
Sabina
S
Stampfer
Meir J
MJ
Virtamo
Jarmo
J
Weijenberg
Matty
M
Willett
Walter C
WC
Wolk
Alicja
A
Zhang
Shumin M
SM
Smith-Warner
Stephanie A
SA
D001205:Ascorbic Acid / Q000008:administration & dosage / Q000494:pharmacology; D016022:Case-Control Studies; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005060:Europe / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D009656:North America / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D018570:Risk Assessment; D014801:Vitamin A / Q000008:administration & dosage / Q000494:pharmacology; D014810:Vitamin E / Q000008:administration & dosage / Q000494:pharmacology; D014815:Vitamins / Q000008:administration & dosage* / Q000494:pharmacology
D014815:Vitamins; D014801:Vitamin A; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid
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