Research: LAM and COLLEAGUES,

Listed in Issue 243

Abstract

LAM and COLLEAGUES,  (1)Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Genetic Epidemiology Branch (TKL and PRT), Nutritional Epidemiology Branch (NDF,  SMD, and CCA), and the Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program (TKL), Rockville, MD; and the Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College,  Beijing, People's Republic of China (J-HF and Y-LQ) examined the relation between pre-diagnostic plasma vitamin C and the risk of gastric adenocarcinoma (GA) and oesophageal squamous cell carcinoma (ESCC).

Background

China has some of the highest incidence rates for gastric adenocarcinoma (GA) and oesophageal squamous cell carcinoma (ESCC) in the world. Prospective studies suggested that vitamin C may reduce risks; however, associations are unclear because of limited sample size.

Methodology

A case-cohort study was used to assess the association between prediagnostic plasma vitamin C and incidence of GA (n = 467) and ESCC (n = 618) in the General Population Nutrition Intervention Trial. With the use of multivariate Cox proportional hazards models, we estimated the HRs and 95% CIs. The authors also conducted a meta-analysis of the literature up to 1 October 2012 on the relation between circulating vitamin C and gastric cancer incidence. Two cohort studies and the current study were included to assess the body of evidence.

Results

For GA, each 20-μmol/L increase in plasma vitamin C was associated with a 14% decrease in risk (HR: 0.86; 95% CI: 0.76, 0.96). Compared with individuals with low plasma vitamin C concentrations (≤28 μmol/L), those with normal concentrations (>28 μmol/L) had a 27% reduced risk of GA (HR: 0.73; 95% CI: 0.56, 0.94). No association between vitamin C concentrations and ESCC was seen. Meta-analysis showed that the risk of incident GA among those with the highest concentration of plasma vitamin C was 31% lower (random-effects-pooled-odds ratio 0.69; 95% CI: 0.54, 0.89) than those in the lowest category.

Conclusion

The data provide evidence that higher circulating vitamin C was associated with a reduced risk of incident GA, but no association was seen for ESCC.

References

Lam TK(1), Freedman ND, Fan JH, Qiao YL, Dawsey SM, Taylor PR, Abnet CC. Pre-diagnostic plasma vitamin C and risk of gastric adenocarcinoma and oesophageal  squamous cell carcinoma in a Chinese population.  Am J Clin Nutr.98(5):1289-97. doi: 10.3945/ajcn.113.061267. Nov 2013. Epub Sep 11 2013.

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