TY - JOUR
T1 - Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)
AU - Jenab, Mazda
AU - Riboli, Elio
AU - Ferrari, Pietro
AU - Sabate, Joan
AU - Slimani, Nadia
AU - Norat, Teresa
AU - Friesen, Marlin
AU - Tjønneland, Anne
AU - Olsen, Anja
AU - Overvad, Kim
AU - Boutron-Ruault, Marie Christine
AU - Clavel-Chapelon, Françoise
AU - Touvier, Mathilde
AU - Boeing, Heiner
AU - Schulz, Mandy
AU - Linseisen, Jakob
AU - Nagel, Gabriele
AU - Trichopoulou, Antonia
AU - Naska, Androniki
AU - Oikonomou, Eleni
AU - Krogh, Vittorio
AU - Panico, Salvatore
AU - Masala, Giovanna
AU - Sacerdote, Carlotta
AU - Tumino, Rosario
AU - Peeters, Petra H.
AU - Numans, Mattijs E.
AU - Bueno-de-Mesquita, Hendrik B.
AU - Büchner, Frederike L.
AU - Lund, Eiliv
AU - Pera, Guillem
AU - Sanchez, Carmen Navarro
AU - Sánchez, Maria José
AU - Arriola, Larraitz
AU - Barricarte, Aurelio
AU - Quirós, José Ramón
AU - Hallmans, Göran
AU - Stenling, Roger
AU - Berglund, Göran
AU - Bingham, Sheila
AU - Khaw, Kay Tee
AU - Key, Timothy
AU - Allen, Naomi
AU - Carneiro, Fatima
AU - Mahlke, U.
AU - Giudice, Guiseppe Del
AU - Palli, Domenico
AU - Kaaks, Rudolf
AU - Gonzalez, Carlos A.
N1 - Funding Information:
We thank the members of the pathologist panel for their valuable work: R.S., Umea, Sweden; Dr Johan Offerhaus, Amsterdam, The Netherlands; Dr Vicki Save, Cambridge, United Kingdom; Dr Julio Torrado, San Sebastian, Spain; Dr Gabriella Nesi, Firenze, Italy; U.M., Postdam, Germany; Dr Hendrik Bläker, Heildelberg, Germany; Dr Claus Fenger, Denmark; Dr Dimitrious Roukos, Ioannina, Greece, for his collaboration in the collection of pathological material; and Catia Moutinho, Porto, Portugal, for her technical work in the preparation of pathological material. Specific study results of the nested case–control study within EPIC (EUR-GAST) were obtained with financial support from the FP5 of the European Commission (QLG1-CT-2001-01049). The EPIC study was funded by ‘Europe Against Cancer’ Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health (RCESP-C03/09); the participating regional governments and institutions of Spain; The ISCIII Red de Centro RCESP (C03/09); Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer; Italian National Research Council; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society.
PY - 2006/11/15
Y1 - 2006/11/15
N2 - Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95% CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.
AB - Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95% CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.
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U2 - 10.1093/carcin/bgl096
DO - 10.1093/carcin/bgl096
M3 - Article
C2 - 16774936
SN - 0143-3334
VL - 27
SP - 2250
EP - 2257
JO - Carcinogenesis
JF - Carcinogenesis
IS - 11
ER -