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Cancer Causes & Control

, Volume 21, Issue 11, pp 1745–1757 | Cite as

Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies

  • Yikyung Park
  • Donna Spiegelman
  • David J. Hunter
  • Demetrius Albanes
  • Leif Bergkvist
  • Julie E. Buring
  • Jo L. Freudenheim
  • Edward Giovannucci
  • R. Alexandra Goldbohm
  • Lisa Harnack
  • Ikuko Kato
  • Vittorio Krogh
  • Michael F. Leitzmann
  • Paul J. Limburg
  • James R. Marshall
  • Marjorie L. McCullough
  • Anthony B. Miller
  • Thomas E. Rohan
  • Arthur Schatzkin
  • Roy Shore
  • Sabina Sieri
  • Meir J. Stampfer
  • Jarmo Virtamo
  • Matty Weijenberg
  • Walter C. Willett
  • Alicja Wolk
  • Shumin M. Zhang
  • Stephanie A. Smith-Warner
Original paper

Abstract

Objective

To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer.

Methods

Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model.

Results

Among 676,141 men and women, 5,454 colon cancer cases were identified (7–20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76–1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71–0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66–0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81–0.96).

Conclusions

Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

Keywords

Vitamin A Vitamin C Vitamin E Multivitamin Colon cancer Cohort study Pooled analysis 

Notes

Financial support

The study was funded by research grants CA55075 from the National Institutes of Health and the National Colorectal Cancer Research Alliance of the Entertainment Industry Foundation.

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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Yikyung Park
    • 1
    • 2
  • Donna Spiegelman
    • 3
    • 4
  • David J. Hunter
    • 1
    • 3
    • 5
  • Demetrius Albanes
    • 2
  • Leif Bergkvist
    • 7
  • Julie E. Buring
    • 3
    • 6
  • Jo L. Freudenheim
    • 8
  • Edward Giovannucci
    • 1
    • 3
    • 5
  • R. Alexandra Goldbohm
    • 9
  • Lisa Harnack
    • 10
  • Ikuko Kato
    • 11
  • Vittorio Krogh
    • 12
  • Michael F. Leitzmann
    • 13
  • Paul J. Limburg
    • 14
  • James R. Marshall
    • 15
  • Marjorie L. McCullough
    • 16
  • Anthony B. Miller
    • 17
  • Thomas E. Rohan
    • 18
  • Arthur Schatzkin
    • 2
  • Roy Shore
    • 19
    • 20
  • Sabina Sieri
    • 12
  • Meir J. Stampfer
    • 1
    • 3
    • 5
  • Jarmo Virtamo
    • 21
  • Matty Weijenberg
    • 22
  • Walter C. Willett
    • 1
    • 3
    • 5
  • Alicja Wolk
    • 23
  • Shumin M. Zhang
    • 3
    • 6
  • Stephanie A. Smith-Warner
    • 1
    • 3
  1. 1.Department of NutritionHarvard School of Public HealthBostonUSA
  2. 2.Nutritional Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer Institute, NIH, DHHSBethesdaUSA
  3. 3.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  4. 4.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  5. 5.Channing LaboratoryBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  6. 6.Division of Preventive MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  7. 7.Department of Surgery and Centre for Clinical ResearchCentral HospitalVästeråsSweden
  8. 8.Department of Social and Preventive MedicineUniversity at Buffalo, State University of New YorkBuffaloUSA
  9. 9.Department of Prevention and HealthTNO Quality of LifeLeidenThe Netherlands
  10. 10.Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisUSA
  11. 11.Department of Pathology, Karmanos Cancer InstituteWayne State UniversityDetroitUSA
  12. 12.Nutritional Epidemiology UnitNational Cancer InstituteMilanItaly
  13. 13.Institute of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
  14. 14.Division of Gastroenterology and HepatologyMayo Clinic College of MedicineRochesterUSA
  15. 15.Department of Cancer Prevention and Population ScienceRoswell Park Cancer InstituteBuffaloUSA
  16. 16.Epidemiology Research ProgramAmerican Cancer SocietyAtlantaUSA
  17. 17.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  18. 18.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  19. 19.Department of Environmental MedicineNew York UniversityNew YorkUSA
  20. 20.Radiation Effects Research FoundationHiroshimaJapan
  21. 21.Department of Health Promotion and Chronic Disease PreventionNational Public Health InstituteHelsinkiFinland
  22. 22.Department of Epidemiology, School of Oncology and Developmental Biology (GROW)Maastricht UniversityMaastrichtThe Netherlands
  23. 23.Division of Nutritional Epidemiology, The National Institute of Environmental MedicineKarolinska InstitutetStockholmSweden

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