Environment and Breast Cancer: Science Review

Evidence From Humans
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Premenopausal intakes of vitamins A, C, and E, folate, and carotenoids, and risk of breast cancer
Cho, E., Spiegelman, D., Hunter, D. J., Chen, W. Y., Zhang, S. M., Colditz, G. A., Willett, W. C. Cancer Epidemiol Biomarkers Prev. 2003. 12:8, 713-20.
Study design
Prospective cohort
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal and premenopausal combined
Number in Cohort
Cohort 90,655
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Registered nurses who were 25-42 years of age in 1989, living in 1 of 14 states in the United States, participating in the NHS II and who responded to the 1991 questionnaire. Ex: Implausible energy intake, more than 70 food items left blank, diagnosis of cancer (except non-melanoma skin cancer) before the return of the 1991 questionnaire
Exposures investigated
Premenopausal exposure of vitamins A, C, and E and beta-carotene
How exposure was measured
Questionnaire, self-administered, FFQ
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Not considered: Race
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Adjusted RR with 95% CI, highest versus lowest quintile of cumulative averaged dietary data for vitamin and beta-carotene intake, interaction of smoking, follow-up 8 years
Strength of associations reported
Total vitamin A from food only: 0.92 (0.72-1.17); total vitamin C from food only: 1.30 (1.00-1.69); Vit E from food only: 1.17 (0.92-1.50); Beta-carotene: 0.96 (0.75-1.22)
Results Comments
No strong overall association between intakes of vitamins A, C, and E and beta-carotene and breast cancer.
Author address
Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. eunyoung.cho@channing.harvard.edu