Plasma and Dietary Vitamin C Levels and risk of Gastric Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST).
Jenab, M.; Riboli, E.; Ferrari, P.; Sabate, J.; Slimani, N.; Norat, T.; Friesen, M.; Tjønneland, A.; Olsen, A.; Overvad, K.; Boutron-Ruault, M.C.; Clavel-Chapelon, F.; Touvier, M.; Boeing, H.; Schulz, M.; Linseisen, J.; Nagel, G.; Trichopoulou, A.; Naska, A.; Oikonomou, E.; Krogh, V.; Panico, S.; Masala, G.; Sacerdote, C.; Tumino, R.; Peeters, P.H.; Numans, M.E.; Bueno-de-Mesquita, H.B.; Büchner, F.L.; Lund, E.; Pera, G.; Sanchez, C.N.; Sánchez, M-J.; Arriola, L.; Barricarte, A.; Quirós, J.R.; Hallmans, G.; Stenling, R.; Berglund, G.; Bingham, S.; Khaw, K-T.; Key, T.; Allen, N.; Carneiro, F.; Mahlke, U.; Giudice, G. del; Palli, D.; Kaaks, R.; Gonzalez, C.A.
(2006) Carcinogenesis Advance Access, pp. 1 - 21
(Article)
Abstract
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 is limited, particularly so for blood measures of
vitamin C. The objective of this study
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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 (Hp) 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 (OR=0.55, 95%CI=0.31-0.97,
Ptrend=0.043) which was maintained after exclusion of cases with ≤2yrs 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 sub-site (cardia/non-cardia) or histological sub-type
(diffuse/intestinal) and there was no significant interaction of effect with Hp. 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 Nnitroso
compound production.
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Publisher: Oxford University Press
