Journal Article

Dual Association of β-Carotene With Risk of Tobacco-Related Cancers in a Cohort of French Women

Mathilde Touvier, Emmanuelle Kesse, Françoise Clavel-Chapelon and Marie-Christine Boutron-Ruault

in JNCI: Journal of the National Cancer Institute

Volume 97, issue 18, pages 1338-1344
Published in print September 2005 | ISSN: 0027-8874
Published online September 2005 | e-ISSN: 1460-2105 | DOI: http://dx.doi.org/10.1093/jnci/dji276
Dual Association of β-Carotene With Risk of Tobacco-Related Cancers in a Cohort of French Women

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Background: Intervention studies have demonstrated that, in smokers, β-carotene supplements had a deleterious effect on risk of lung cancer and may have a deleterious effect on digestive cancers as well. We investigated a potential interaction between β-carotene intake and smoking on the risk of tobacco-related cancers in women. Methods: A total of 59 910 women from the French Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective investigation were studied from 1994. After a median follow-up of 7.4 years, 700 women had developed cancers known to be associated with smoking. Diet, supplement use, and smoking status at baseline were assessed by self-report. β-carotene intake was classified into four groups: first (low intake), second, and third tertiles of dietary intake, and use of supplements (high intake). Unadjusted and multivariable Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals (CIs) for cancer risk. All statistical tests were two-sided. Results: Among never smokers, multivariable hazard ratios of all smoking-related cancers were 0.72 (95% CI = 0.57 to 0.92), 0.80 (95% CI = 0.64 to 1.01), and 0.44 (95% CI = 0.18 to 1.07) for the second and third tertiles of dietary intake, and high β-carotene intake, respectively, compared with low intake (Ptrend = .03). Among ever smokers, multivariable hazard ratios were 1.43 (95% CI = 1.05 to 1.96), 1.20 (95% CI = 0.86 to 1.67), and 2.14 (95% CI = 1.16 to 3.97) for the second and third tertiles of dietary intake, and high β-carotene intake, respectively, compared with low intake (Ptrend = .09). Tests for interaction between β-carotene intake and smoking were statistically significant (Ptrend =.017). In this population, the absolute rates over 10 years in those with low and high β-carotene intake were 181.8 and 81.7 cases per 10 000 women in never smokers and 174.0 and 368.3 cases per 10 000 women in ever smokers. Conclusions: β-carotene intake was inversely associated with risk of tobacco-related cancers among nonsmokers with a statistically significant dose-dependent relationship, whereas high β-carotene intake was directly associated with risk among smokers.

Journal Article.  5847 words. 

Subjects: Medical Oncology

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