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

Research output: Contribution to journalArticle

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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Cervical Intraepithelial Neoplasia
Carotenoids
Cohort Studies
Prospective Studies
beta Carotene
Serum
Micronutrients
Lutein
alpha-Tocopherol
Confidence Intervals
Smoking
Energy Intake
Vitamin A
Uterine Cervical Neoplasms
Genotype

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

Cite this

Fujii, Takuma ; Takatsuka, Naoyoshi ; Nagata, Chisato ; Matsumoto, Koji ; Oki, Akinori ; Furuta, Reiko ; Maeda, Hiroo ; Yasugi, Toshiharu ; Kawana, Kei ; Mitsuhashi, Akira ; Hirai, Yasuo ; Iwasaka, Tsuyoshi ; Yaegashi, Nobuo ; Watanabe, Yoh ; Nagai, Yutaka ; Kitagawa, Tomoyuki ; Yoshikawa, Hiroyuki. / Association between carotenoids and outcome of cervical intraepithelial neoplasia : A prospective cohort study. In: International Journal of Clinical Oncology. 2013 ; Vol. 18, No. 6. pp. 1091-1101.
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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.",
author = "Takuma Fujii and Naoyoshi Takatsuka and Chisato Nagata and Koji Matsumoto and Akinori Oki and Reiko Furuta and Hiroo Maeda and Toshiharu Yasugi and Kei Kawana and Akira Mitsuhashi and Yasuo Hirai and Tsuyoshi Iwasaka and Nobuo Yaegashi and Yoh Watanabe and Yutaka Nagai and Tomoyuki Kitagawa and Hiroyuki Yoshikawa",
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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, vol. 18, no. 6, pp. 1091-1101. https://doi.org/10.1007/s10147-012-0486-5

Association between carotenoids and outcome of cervical intraepithelial neoplasia : A prospective cohort study. / Fujii, Takuma; Takatsuka, Naoyoshi; Nagata, Chisato; Matsumoto, Koji; Oki, Akinori; Furuta, Reiko; Maeda, Hiroo; Yasugi, Toshiharu; Kawana, Kei; Mitsuhashi, Akira; Hirai, Yasuo; Iwasaka, Tsuyoshi; Yaegashi, Nobuo; Watanabe, Yoh; Nagai, Yutaka; Kitagawa, Tomoyuki; Yoshikawa, Hiroyuki.

In: International Journal of Clinical Oncology, Vol. 18, No. 6, 01.12.2013, p. 1091-1101.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between carotenoids and outcome of cervical intraepithelial neoplasia

T2 - A prospective cohort study

AU - Fujii, Takuma

AU - Takatsuka, Naoyoshi

AU - Nagata, Chisato

AU - Matsumoto, Koji

AU - Oki, Akinori

AU - Furuta, Reiko

AU - Maeda, Hiroo

AU - Yasugi, Toshiharu

AU - Kawana, Kei

AU - Mitsuhashi, Akira

AU - Hirai, Yasuo

AU - Iwasaka, Tsuyoshi

AU - Yaegashi, Nobuo

AU - Watanabe, Yoh

AU - Nagai, Yutaka

AU - Kitagawa, Tomoyuki

AU - Yoshikawa, Hiroyuki

PY - 2013/12/1

Y1 - 2013/12/1

N2 - 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.

AB - 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.

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