Nutrient Intake in Relation to Bladder Cancer among Middle-aged Men and Women

Abstract

This population-based case-control study examined the association between selected nutrients, foods, and diet behaviors and bladder cancer. Bladder cancer cases (n = 262) were identified from the Surveillance, Epidemiology, and End Results Program cancer registry for western Washington, and controls (n = 405) were identified through random digit dialing. Cases were diagnosed between January 1987 and June 1990, and eligible subjects were Caucasian, aged 45-65 years, and residents of King, Pierce, or Snohomish counties. Subjects completed a self-administered, 71-item food frequency questionnaire and a structured telephone interview. Analyses were conducted by logistic regression analysis and included adjustment for age, sex, smoking (current, former, never), and county. Odds ratios and their 95% confidence intervals for highest versus lowest level of intake were examined. An inverse association was found between the risk of bladder cancer and dietary retinol (odds ratio (OR) across quartiles: 1.00, 1.09, 0.97, and 0.52; 95% CI 0.29-0.97; trend p value = 0.03) and dietary vitamin C (OR across quartiles: 1.00, 0.96, 0.67, and 0.50; 95% CI 0.28-0.88; trend p value = 0.009), adjusted for calories. The use of multivitamin supplements daily over the 10-year period ending 2 years before diagnosis versus no use was associated with a decreased risk of bladder cancer (OR = 0.39; 95% CI 0.24-0.63) as was use of supplemental vitamin C (OR for > 502 mg/day over the 10 years vs. none = 0.40; 95% CI 0.21-0.76). Increased intake of fruit was associated with a decreased risk of bladder cancer (OR across quartiles: 1.00, 1.24, 0.72, and 0.53; 95% CI 0.30-0.93; trend p value = 0.01, adjusted for calories), while increased use of fried foods was associated with an increased risk of bladder cancer (OR across quartiles: 1.00, 1.51, 1.81, and 2.24; 95% CI 1.25-4.03; trend p value = 0.006). This study provides modest evidence that certain nutrients, foods, and supplementation may affect the incidence of bladder cancer.

Are retinol, vitamin C, vitamin E, folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study

“…Two previously conducted population based case-control studies found small increased risks of bladder cancer with increasing intake of dietary vitamin C for men and women combined (Risch et al, 1988) or for men only (Nomura et al, 1991) after controlling for cigarette smoking. However, other population based case control studies presented decreased risks for men and women combined (Bruemmer et al, 1996) or for women only (Nomura et al, 1991), or found no association at all (Riboli et al, 1991). One prospective study suggested an inverse association with dose of vitamin C supplement use, but not with dietary vitamin C intake (Michaud et al, 2000), which is in correspondence to the results of the present study.…”

“…With respect to bladder cancer, most epidemiological studies support a possible protective effect of vegetable (Bruemmer et al, 1996;D'Avanzo et al, 1995;Michaud et al, 1999;Mills et al, 1991;Negri et al, 1991) and fruit consumption (Bruemmer et al, 1996;Chyou et al, 1993;Negri et al, 1991;Shibata et al, 1992), although some studies have reported no association for vegetable (Riboli et al, 1991;Shibata et al, 1992) or fruit consumption (Michaud et al, 1999;Riboli et al, 1991). There are many candidate agents in fruits and vegetables that influence bladder cancer risk, including carotenoids, vitamin C, vitamin E, and folate.…”

Intakes of fruits and vegetables, carotenoids and vitamins A, E, C in relation to the risk of bladder cancer in the ATBC cohort study

“…In this study, a quantitative food use questionnaire was administered to participants and assistance was offered to those who had difficulty understanding the questions. While we cannot exclude the possibility that the lack of association may be due to misclassification, it is unlikely that there would be more misclassification in this study than in previous studies that have observed inverse associations using similar dietary assessments (Mills et al, 1991;Shibata et al, 1992;Bruemmer et al, 1996). Confounding by occupational exposures may have occurred if men in high-risk occupations consumed more fruits and vegetables than the rest of the population.…”

“…Furthermore, the association was not observed among smokers, although there was limited power for this analysis. Vitamin E supplement use has been inversely related to bladder cancer risk in two other case -control studies with supplement data (Shibata et al, 1992;Bruemmer et al, 1996) (although only the latter was statistically significant). In addition, although statistically insignificant, our results are consistent with a small decrease in risk among high vitamin E consumers.…”

“…To date, only one case -control study has reported a significant inverse association with total dietary and supplemental vitamin C intake (Bruemmer et al, 1996). Three studies (Shibata et al, 1992;Bruemmer et al, 1996;Michaud et al, 2000) have observed inverse associations with supplement vitamin E (the first was not statistically significant). No associations were observed for intakes of specific carotenoids and risk of bladder cancer in two studies (Michaud et al, 2000;Zeegers et al, 2001a).…”