Environment and Breast Cancer: Science Review

Evidence From Humans
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Intake of vitamins A, C, and E from diet and supplements and breast cancer in postmenopausal women
Nissen, S. B., Tjonneland, A., Stripp, C., Olsen, A., Christensen, J., Overvad, K., Dragsted, L. O., Thomsen, B. Cancer Causes Control. 2003. 14:8, 695-704.
Study design
Nested case-control
Funding agency
Other: Danish Cancer Society, Europe against Cance
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Controls 394/ Cohort: 29,875
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women of the Danish Diet, Cancer and Health Cohort between the ages 50 and 64, born in Denmark, and not registered with a previous cancer diagnosis in the Danish Cancer Registry. Ex: Lifestyle questionnaire not filled in, missing values in the food frequency questionnaire, reports of menstruation during the last 12 months at baseline, and missing information about hormone replacement therapy
Comment about participation selection
One clinic visit for every participant at baseline
Exposure Investigated
Exposures investigated
Vitamin A, C, and E
How exposure was measured
Questionnaire, self-administered, FFQ
Exposure assessment comment
Questionnaire was long (192 food item each with 12 possible categories of frequency)
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: Family history, 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 IRR with 95% CI, highest versus second lowest quartile of intake, subgroup for vitamin supplement users, interaction of vitamins, follow-up 3-7 years (mean 4.7 years)
Strength of associations reported
Vitamin A: 1.29 (0.81-2.05); vitamin C: 1.69 (1.12-2.57); vitamin E : 0.59 (0.37-0.95)
Results Comments
No evidence of an association with total, dietary or supplement intake of vitamins A and vitamin E. For vitamin E the categorical analyses showed an apparent decrease in breast cancer incidence rate for women with a daily intake of 25 mg or more, but overall the categorical variable was not significant (p=0.13). For vitamin C, the incidence rate of breast cancer increased with increasing total, dietary, and supplemental intake.
Author address
Institute of Cancer Epidemiology, Danish Cancer Society, Denmark.