Low Levels of Serum Vitamins A and E in Blood and Subsequent Risk for Cervical Cancer: Interaction With HPV Seropositivity

Nutritional factors have been associated with risk of cervical cancer, but it is unclear whether the associations are of etiological significance or secondary to human papillomavirus (HPV) exposure. A delineation of this question requires a prospective study with invasive cancer as the end point. We...

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Bibliographic Details
Published in:Nutrition and cancer 1999-01, Vol.34 (2), p.229-234
Main Authors: Lehtinen, Matti, Luostarinen, Tapio, Youngman, Linda D., Anttila, Tarja, Dillner, Joakim, Hakulinen, Timo, Koskela, Pentti, Lenner, Per, Hallmans, Göran
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Case-Control Studies
Female
Female genital diseases
Finland
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Medicin och hälsovetenskap
Middle Aged
Papillomaviridae - immunology
Risk Factors
Tumors
Uterine Cervical Neoplasms - blood
Vitamin A - blood
Vitamin E - blood
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Summary:Nutritional factors have been associated with risk of cervical cancer, but it is unclear whether the associations are of etiological significance or secondary to human papillomavirus (HPV) exposure. A delineation of this question requires a prospective study with invasive cancer as the end point. We conducted a nested case-control study in Finland and Sweden within a joint cohort of 405,000 women followed up for, on average, 4 years. Blood samples from 38 prospective cases of invasive cervical cancer diagnosed between 1985 and 1994 and 116 controls matched for age, country, and sample storage time were available for the study. Levels of retinol or unoxidized a-tocopherol in the blood were not risk factors for cervical cancer. However, joint-effect analysis of low levels of retinol disclosed statistically significant (p = 0.023) synergistic (more than multiplicative) interaction with HPV (HPV16, HPV18, or HPV33) seropositivity (observed relative risk = 2.6, 95% confidence interval = 0.7-8.8, expected relative risk = 0.3). Retinol might act as an effect modifier of the HPV-associated risk for cervical cancer; exposed women may require adequate levels for immunologic surveillance of HPV.
ISSN:0163-5581
1532-7914
DOI:10.1207/S15327914NC3402_15