Serum carotenoids and mortality from lung cancer: a case‐control study nested in the Japan Collaborative Cohort (JACC) Study

Abstract

To investigate whether high serum levels of carotenoids, tocopherols, and folic acid decrease risk of lung cancer in Japanese, we conducted a case-control study nested in the Japan Collaborative Cohort (JACC) Study. A total of 39 140 subjects provided serum samples at baseline between 1988 and 1990. We identified 147 cases (113 males and 34 females) of death from lung cancer during an 8-year follow-up. Of the subjects who survived to the end of this follow-up, 311 controls (237 males and 74 females) were selected, matched to each case of lung cancer death for gender, age and participating institution. We measured serum levels of antioxidants in cases of lung cancer death and controls. Odds ratios (ORs) for lung cancer death were estimated using conditional logistic models. The risk of lung cancer death for the highest quartile of serum α α α α-carotene, β β β β-carotene, lycopene, β β β β-cryptoxanthin, and canthaxanthin was significantly or marginally significantly lower than for the lowest quartile: the ORs, adjusted for smoking and other covariates, were 0.35 (95% confidence interval (CI), 0.14-0. any epidemiological studies suggest that dietary vegetables rich in β-carotene decrease human lung cancer risk.1, 2) Several studies have shown that high dietary intake of carotenoids other than β-carotene is associated with low risk of lung cancer.2-5) In Japan, high intake of green and yellow vegetables was found to be significantly associated with low mortality rates of lung cancer among a large-scale cohort followed for over 15 years. 6) However, clinical trials have found no inverse association between administration of synthetic β-carotene and lung cancer incidence.4) Recent studies have found that serum carotenoids such as cryptoxanthin and lutein have clearer inverse associations with lung cancer risk than does β-carotene. 7)This indicates the need for further investigation of the role of carotenoids other than β-carotene. Presently, there is little available data concerning the role of these carotenoids, particularly in Japan.Thus, in order to examine the association between death from lung cancer and serum levels of carotenoids and other antioxidants, we conducted a case-control study nested in a large-scale Japanese cohort. In this cohort, we found that, among male smokers, risk of death from lung cancer was lower for those who frequently consume vegetables and fruits rich in carotenoids. 8) Materials and MethodsSubjects and blood samples. The study subjects were recruited in the Japan Collaborative Cohort (JACC) Study for Evaluation of Cancer Risk Sponsored by Monbukagakusho (the Ministry of Education, Culture, Sports, Science and Technology of Japan). The details of the JACC Study are described elsewhere. 9) A questionnaire about health and lifestyles was distributed to the participants. The questions addressed personal and family medical histories, smoking, alcohol consumption, dietary intake of major foods, and anthropometric factors. 8,9)

Lung Cancer Mortality and Serum Levels of Carotenoids, Retinol, Tocopherols, and Folic Acid in Men and Women: a Case-Control Study Nested in the JACC Study

“…44 We found that serum folic acid levels were not clearly inversely associated with lung cancer death in men or women, as same as previous study. 8 However, further investigation is needed to clarify this issue; the sample size for serum folic acid in the present study was limited.…”

“…7 We previously found that high serum levels of -carotene (AC) and BC can reduce the risk of lung cancer death, in a case-control study nested in a large-scale Japanese cohort. 8 Serum levels of AC and BC are affected by daily lifestyle elements such as diet, smoking and alcohol consumption, 9,10 and this appears to be partly responsible for sex differences in lung cancer risk. Recent intervention studies of BC administration have shown no inverse association between BC administration and lung cancer incidence among non-Asians.…”

Opinion of the Scientific Panel on Dietetic products, nutrition and allergies [NDA] related to an application on the use of a-tocopherol-containing oil suspension of lycopene from Blakeslea trispora as a novel food ingredient

“…Numerous epidemiological studies are available reporting a positive association between decreased risk of chronic diseases such as cancer and cardiovascular disease and lycopene intake through dietary intake of tomatoes and tomato products (Rissanen et al, 2003;Agarwal and Rao, 2000;Bramley, 2000;Giovannucci, 1999;Erhardt et al, 2003;Ito et al, 2003;Sesso et al, 2003). No adverse effects related to tomato and tomato product intakes were reported.…”

Association of Serum Carotenoid Concentration and Dietary Habits among the JACC Study Subjects

“…[4][5][6] During the Japan Collaborative Cohort Study (JACC Study) for Evaluation of Cancer Risk sponsored by the Ministry of Education, Science, Sports and Culture of Japan (Monbusho), a food frequency questionnaire was used to assess dietary habits of the subjects at baseline survey. In addition, blood samples were collected from all subjects at baseline, 7 and serum concentrations of carotenoids were measured to evaluate cancer risk at lung, 8 colon and rectum, 9 and urothelial system (pelvis, ureter, and bladder). 10 To validate these results, we have compared serum carotenoid concentrations with dietary habits in a sample set of the JACC Study.…”

“…A second possibility is that sub-This study was primarily designed to validate the food frequency questionnaire and serum concentrations of carotenoids in the nested case-control studies as parts of the JACC Study. [8][9][10] Controls of those nested case-control studies were thought to represent the general population of the JACC study, and adequate to the sample set of this study. However, discussion applied in a different situation may be limited; e.g., most subjects of the JACC Study lived in rural areas, where dietary habits may be different from those in urban areas; subjects who donated blood samples were around 30% of whole respondents to the baseline questionnaire survey, therefore, they may be more health-conscious.…”