title: Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study.
abstract: Some dietary factors could be involved as cofactors in cervical carcinogenesis, but evidence is inconclusive. There are no data about the effect of fruits and vegetables intake (F&V) on cervical cancer from cohort studies. We examined the association between the intake of F&V and selected nutrients and the incidence of carcinoma in situ (CIS) and invasive squamous cervical cancer (ISC) in a prospective study of 299,649 women, participating in the European Prospective Investigation into Cancer and Nutrition study. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CI). A calibration study was used to control measurement errors in the dietary questionnaire. After a mean of 9 years of follow-up, 253 ISC and 817 CIS cases were diagnosed. In the calibrated model, we observed a statistically significant inverse association of ISC with a daily increase in intake of 100 g of total fruits (HR 0.83; 95% CI 0.72-0.98) and a statistically nonsignificant inverse association with a daily increase in intake of 100 g of total vegetables (HR 0.85: 95% CI 0.65-1.10). Statistically nonsignificant inverse associations were also observed for leafy vegetables, root vegetables, garlic and onions, citrus fruits, vitamin C, vitamin E and retinol for ISC. No association was found regarding beta-carotene, vitamin D and folic acid for ISC. None of the dietary factors examined was associated with CIS. Our study suggests a possible protective role of fruit intake and other dietary factors on ISC that need to be confirmed on a larger number of ISC cases.
authors.affiliation: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. cagonzalez@iconcologia.net
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: Noemie
authors.initials: N
authors.lastname: Travier
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authors.lastname: Luján-Barroso
authors.forename: Xavier
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authors.lastname: Castellsagué
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authors.lastname: Roura
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authors.lastname: Bueno-de-Mesquita
authors.forename: Domenico
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authors.lastname: Boeing
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authors.forename: Carlotta
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authors.lastname: Sacerdote
authors.forename: Rosario
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authors.lastname: Tumino
authors.forename: Salvatore
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authors.lastname: Panico
authors.forename: Jonas
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authors.forename: Lennart
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authors.lastname: Kjellberg
authors.forename: María-José
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authors.lastname: Sanchez
authors.forename: Jone M
authors.initials: JM
authors.lastname: Altzibar
authors.forename: Aurelio
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authors.lastname: Barricarte
authors.forename: Carmen
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authors.lastname: Navarro
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodriguez
authors.forename: Naomi
authors.initials: N
authors.lastname: Allen
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Christian
authors.initials: C
authors.lastname: Munk
authors.forename: Susanne Krüger
authors.initials: SK
authors.lastname: Kjaer
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Fränzel J B
authors.initials: FJ
authors.lastname: van Duijnhoven
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Benetou
authors.forename: Androniki
authors.initials: A
authors.lastname: Naska
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Dagrun
authors.initials: D
authors.lastname: Engeset
authors.forename: Guri
authors.initials: G
authors.lastname: Skeie
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005260:Female; D005492:Folic Acid; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014675:Vegetables; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D019207:beta Carotene
chemical_list: D019207:beta Carotene; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid