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

• Published in: International journal of clinical oncology Vol. 18; no. 6; pp. 1091 - 1101
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2013; Springer Nature B.V
• Subjects: Adult; Aged; Cancer Research; Cancer surgery; Carotenoids - blood; Cervical cancer; Cervical Intraepithelial Neoplasia - blood; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; Female; Human papillomavirus; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Grading; Oncology; Original Article; Papillomaviridae - pathogenicity; Prospective Studies; Risk Factors; Smoking; Surgical Oncology; Surgical outcomes; Low-grade squamous intraepithelial lesion; Micronutrients; Human papillomavirus; Carotenoids; Cervical intraepithelial neoplasia
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-012-0486-5

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.