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Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies.

Journal article
Authors A Heather Eliassen
Sara J Hendrickson
Louise A Brinton
Julie E Buring
Hannia Campos
Qi Dai
Joanne F Dorgan
Adrian A Franke
Yu-Tang Gao
Marc T Goodman
Göran Hallmans
Kathy J Helzlsouer
Judy Hoffman-Bolton
Kerstin Hultén
Howard D Sesso
Anne L Sowell
Rulla M Tamimi
Paolo Toniolo
Lynne R Wilkens
Anna Winkvist
Anne Zeleniuch-Jacquotte
Wei Zheng
Susan E Hankinson
Published in Journal of the National Cancer Institute
Volume 104
Issue 24
Pages 1905-16
ISSN 1460-2105
Publication year 2012
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 1905-16
Language en
Links dx.doi.org/10.1093/jnci/djs461
Keywords breast cancer, carotenoids, EPIC
Subject categories Public Health, Global Health, Social Medicine and Epidemiology

Abstract

Background Carotenoids, micronutrients in fruits and vegetables, may reduce breast cancer risk. Most, but not all, past studies of circulating carotenoids and breast cancer have found an inverse association with at least one carotenoid, although the specific carotenoid has varied across studies. Methods We conducted a pooled analysis of eight cohort studies comprising more than 80% of the world's published prospective data on plasma or serum carotenoids and breast cancer, including 3055 case subjects and 3956 matched control subjects. To account for laboratory differences and examine population differences across studies, we recalibrated participant carotenoid levels to a common standard by reassaying 20 plasma or serum samples from each cohort together at the same laboratory. Using conditional logistic regression, adjusting for several breast cancer risk factors, we calculated relative risks (RRs) and 95% confidence intervals (CIs) using quintiles defined among the control subjects from all studies. All P values are two-sided. Results Statistically significant inverse associations with breast cancer were observed for α-carotene (top vs bottom quintile RR = 0.87, 95% CI = 0.71 to 1.05, Ptrend = .04), β-carotene (RR = 0.83, 95% CI = 0.70 to 0.98, Ptrend = .02), lutein+zeaxanthin (RR = 0.84, 95% CI = 0.70 to 1.01, Ptrend = .05), lycopene (RR = 0.78, 95% CI = 0.62 to 0.99, Ptrend = .02), and total carotenoids (RR = 0.81, 95% CI = 0.68 to 0.96, Ptrend = .01). β-Cryptoxanthin was not statistically significantly associated with risk. Tests for heterogeneity across studies were not statistically significant. For several carotenoids, associations appeared stronger for estrogen receptor negative (ER(-)) than for ER(+) tumors (eg, β-carotene: ER(-): top vs bottom quintile RR = 0.52, 95% CI = 0.36 to 0.77, Ptrend = .001; ER(+): RR = 0.83, 95% CI = 0.66 to 1.04, Ptrend = .06; Pheterogeneity = .01). Conclusions This comprehensive prospective analysis suggests women with higher circulating levels of α-carotene, β-carotene, lutein+zeaxanthin, lycopene, and total carotenoids may be at reduced risk of breast cancer.

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