Epidemiology

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Diet and serum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women

  1. Luciana Yuki Tomita1,
  2. Adhemar Longatto Filho2,3,
  3. Maria Cecília Costa4,
  4. Maria Antonieta Avilla Andreoli4,
  5. Luisa Lina Villa4,
  6. Eduardo Luiz Franco5,
  7. Marly Augusto Cardoso1,†,*

Article first published online: 29 JUL 2009

DOI: 10.1002/ijc.24793

Issue

International Journal of Cancer

International Journal of Cancer

Volume 126, Issue 3, pages 703–714, 1 February 2010

Additional Information

How to Cite

Tomita, L. Y., Filho, A. L., Costa, M. C., Andreoli, M. A. A., Villa, L. L., Franco, E. L. and Cardoso, M. A. (2010), Diet and serum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women. Int. J. Cancer, 126: 703–714. doi: 10.1002/ijc.24793

Author Information

  1. 1

    Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, Brazil

  2. 2

    Pathology Department, Adolfo Lutz Institute, São Paulo, Brazil

  3. 3

    Life Sciences and Health, Research Institute, School of Health Sciences, University of Minho, Braga, Portugal

  4. 4

    Ludwig Institute for Cancer Research, São Paulo, Brazil

  5. 5

    Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada

  1. †

    Phone/fax: 55 (11) 3061-7863

*School of Public Health. University of São Paulo, SP, Brazil. Av. Dr. Arnaldo, 715, São Paulo, SP, CEP: 01246-904, Brazil

  1. †

    Phone/fax: 55 (11) 3061-7863

Publication History

  1. Issue published online: 8 DEC 2009
  2. Article first published online: 29 JUL 2009
  3. Accepted manuscript online: 29 JUL 2009 12:00AM EST
  4. Manuscript Accepted: 16 JUL 2009
  5. Manuscript Received: 13 MAR 2009

Funded by

  • FAPESP. Grant Number: 03/03013-4
  • CNPq. Grant Numbers: 473043/03-3, 300167/97-0
  • FAPESP. Grant Number: 02/11184-0
  • CAPES. Grant Number: BEX3775/05-4

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Keywords:

  • cervical neoplasia;
  • uterine cervical neoplasms;
  • antioxidants;
  • diet;
  • circulating micronutrients

Abstract

Cervical cancer is a leading cancer among women in developing countries. Infection with oncogenic human papillomavirus (HPV) types has been recognized as a necessary cause of this disease. Serum carotenoids and tocopherols have also been associated with risk for cervical neoplasia, but results from previous studies were not consistent. We evaluated the association of serum total carotene and tocopherols, and dietary intakes with the risk of newly diagnosed, histologically confirmed cervical intraepithelial neoplasia (CIN) grades 1, 2, 3 and invasive cancer in a hospital-based case-control study in São Paulo, Brazil. The investigation included 453 controls and 4 groups of cases (CIN1, n = 140; CIN2, n = 126; CIN3, n = 231; invasive cancer, n =108) recruited from two major public clinics between 2003 and 2005. Increasing concentrations of serum lycopene were negatively associated with CIN1, CIN3 and cancer, with odds ratios (OR) (95% CI) for the highest compared to the lowest tertile of 0.53 (0.27–1.00, p for trend = 0.05), 0.48 (0.22–1.04, p for trend = 0.05) and 0.18 (0.06–0.52, p for trend = 0.002), respectively, after adjusting for confounding variables and HPV status. Increasing concentrations of serum α- and γ-tocopherols, and higher dietary intakes of dark green and deep yellow vegetables/fruit were associated with nearly 50% decreased risk of CIN3. These results support the evidence that a healthy and balanced diet leading to provide high serum levels of antioxidants may reduce cervical neoplasia risk in low-income women.

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