Association between carotenoids and outcome of cervical intraepithelial neoplasia: A prospective cohort study

Takuma Fujii, Naoyoshi Takatsuka, Chisato Nagata, Koji Matsumoto, Akinori Oki, Reiko Furuta, Hiroo Maeda, Toshiharu Yasugi, Kei Kawana, Akira Mitsuhashi, Yasuo Hirai, Tsuyoshi Iwasaka, Nobuo Yaegashi, Yoh Watanabe, Yutaka Nagai, Tomoyuki Kitagawa, Hiroyuki Yoshikawa

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Abstract

Background: It has been suggested that micronutrients such as alpha-tocopherol, retinol, lutein, cryptoxanthin, lycopene, and alpha- and beta-carotene may help in the prevention of cervical cancer. Our aim was to investigate whether serum concentrations and/or dietary intake of micronutrients influence the regression or progression of low-grade cervical abnormalities. Methods: In a prospective cohort study of 391 patients with cervical intraepithelial neoplasia (CIN) grade 1-2 lesions, we measured serum micronutrient concentrations in addition to a self-administered questionnaire about dietary intake. We evaluated the hazard ratio (HR) adjusted for CIN grade, human papillomavirus genotype, total energy intake and smoking status. Results: In non-smoking regression subjects, regression was significantly associated with serum levels of zeaxanthin/lutein (HR 1.25, 0.78-2.01, p = 0.024). This benefit was abolished in current smokers. Regression was inhibited by high serum levels of alpha-tocopherol in smokers (p = 0.042). In progression subjects, a significant protective effect against progression to CIN3 was observed in individuals with a medium level of serum beta-carotene [HR 0.28, 95 % confidence interval (CI) 0.11-0.71, p = 0.007), although any protective effect from a higher level of serum beta-carotene was weaker or abolished (HR 0.52, 95 % CI 0.24-1.13, p = 0.098). Increasing beta-carotene intake did not show a protective effect (HR 2.30, 95 % CI 0.97-5.42, p = 0.058). Conclusions: Measurements of serum levels of carotenoids suggest that regression is modulated by smoking status. Maintaining a medium serum level of beta-carotene has a protective effect for progression; however, carotene intake is not correlated with serum levels of carotenoids.

Original languageEnglish
Pages (from-to)1091-1101
Number of pages11
JournalInternational Journal of Clinical Oncology
Volume18
Issue number6
DOIs
Publication statusPublished - 01-12-2013

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

Cite this

Fujii, T., Takatsuka, N., Nagata, C., Matsumoto, K., Oki, A., Furuta, R., Maeda, H., Yasugi, T., Kawana, K., Mitsuhashi, A., Hirai, Y., Iwasaka, T., Yaegashi, N., Watanabe, Y., Nagai, Y., Kitagawa, T., & Yoshikawa, H. (2013). Association between carotenoids and outcome of cervical intraepithelial neoplasia: A prospective cohort study. International Journal of Clinical Oncology, 18(6), 1091-1101. https://doi.org/10.1007/s10147-012-0486-5