Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study.
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.
González
Carlos A
CA
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. cagonzalez@iconcologia.net
Travier
Noemie
N
Luján-Barroso
Leila
L
Castellsagué
Xavier
X
Bosch
F Xavier
FX
Roura
Esther
E
Bueno-de-Mesquita
H Bas
HB
Palli
Domenico
D
Boeing
Heiner
H
Pala
Valeria
V
Sacerdote
Carlotta
C
Tumino
Rosario
R
Panico
Salvatore
S
Manjer
Jonas
J
Dillner
Joakim
J
Hallmans
Göran
G
Kjellberg
Lennart
L
Sanchez
María-José
MJ
Altzibar
Jone M
JM
Barricarte
Aurelio
A
Navarro
Carmen
C
Rodriguez
Laudina
L
Allen
Naomi
N
Key
Timothy J
TJ
Kaaks
Rudolf
R
Rohrmann
Sabine
S
Overvad
Kim
K
Olsen
Anja
A
Tjønneland
Anne
A
Munk
Christian
C
Kjaer
Susanne Krüger
SK
Peeters
Petra H M
PH
van Duijnhoven
Fränzel J B
FJ
Clavel-Chapelon
Françoise
F
Boutron-Ruault
Marie-Christine
MC
Trichopoulou
Antonia
A
Benetou
Vasiliki
V
Naska
Androniki
A
Lund
Eiliv
E
Engeset
Dagrun
D
Skeie
Guri
G
Franceschi
Silvia
S
Slimani
Nadia
N
Rinaldi
Sabina
S
Riboli
Elio
E
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
D019207:beta Carotene; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid