title: 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.
abstract: 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.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Leif
authors.initials: L
authors.lastname: Bergkvist
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Jo L
authors.initials: JL
authors.lastname: Freudenheim
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Lisa
authors.initials: L
authors.lastname: Harnack
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kato
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Limburg
authors.forename: James R
authors.initials: JR
authors.lastname: Marshall
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: McCullough
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Roy
authors.initials: R
authors.lastname: Shore
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Matty
authors.initials: M
authors.lastname: Weijenberg
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.forename: Shumin M
authors.initials: SM
authors.lastname: Zhang
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Smith-Warner
mesh_terms: 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
chemical_list: D014815:Vitamins; D014801:Vitamin A; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid
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