title: Dietary antioxidants and the aetiology of pancreatic cancer: a cohort study using data from food diaries and biomarkers.
abstract: OBJECTIVE
  To investigate whether the dietary antioxidants vitamins C and E, selenium and zinc decrease the risk of developing pancreatic cancer, for the first time using 7-day food diaries, the most accurate dietary methodology in prospective work.
  
  
  METHODS
  23,658 participants, aged 40-74 years, recruited into the EPIC-Norfolk Study completed 7-day food diaries which recorded foods, brands and portion sizes. Nutrient intakes were calculated in those later diagnosed with pancreatic cancer and in 3970 controls, using a computer program with information on 11,000 foods. Vitamin C was measured in serum samples. The HRs of developing pancreatic cancer were estimated across quartiles of intake and thresholds of the lowest quartile (Q1) against a summation of the three highest (Q2-4).
  
  
  RESULTS
  Within 10 years, 49 participants (55% men), developed pancreatic cancer. Those eating a combination of the highest three quartiles of all of vitamins C and E and selenium had a decreased risk (HR=0.33, 95% CI 0.13 to 0.84, p<0.05). There were threshold effects (Q2-4 vs Q1) for selenium (HR=0.49, 95% CI 0.26 to 0.93, p<0.05) and vitamin E (HR=0.57, 95% CI 0.29 to 1.09, p<0.10). The HRs of quartiles for antioxidants, apart from zinc, were <1, but not statistically significant. For vitamin C, there was an inverse association with serum measurements (HR trend=0.67, 95% CI 0.49 to 0.91, p=0.01), but the threshold effect from diaries was not significant (HR=0.68, 95% CI 0.37 to 1.26).
  
  
  CONCLUSIONS
  The results support measuring antioxidants in studies investigating the aetiology of pancreatic cancer. If the association is causal, 1 in 12 cancers might be prevented by avoiding the lowest intakes.
authors: Department of Medicine, University of East Anglia, Norwich, UK.
authors: Paul J R
authors: PJ
authors: Banim
authors: Robert
authors: R
authors: Luben
authors: Alison
authors: A
authors: McTaggart
authors: Ailsa
authors: A
authors: Welch
authors: Nicholas
authors: N
authors: Wareham
authors: Kay-Tee
authors: KT
authors: Khaw
authors: Andrew R
authors: AR
authors: Hart
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004032:Diet / Q000706:statistics & numerical data*; D015930:Diet Records; D004739:England / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D012643:Selenium / Q000008:administration & dosage; D014810:Vitamin E / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D014810:Vitamin E; D012643:Selenium; D015032:Zinc; D001205:Ascorbic Acid