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Antioxidant vitamins and the risk of endometrial cancer: a dose–response meta-analysis

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Abstract

Antioxidant vitamins may reduce cancer risk by limiting oxidative DNA damage. To summarize and quantify the current epidemiologic evidence of an association between antioxidant vitamin intake and endometrial cancer, we conducted a systematic literature review and meta-analysis. One cohort and 12 case–control studies presenting relevant risk estimates were identified by conducting bibliographical searches through June 2008. Dose–response meta-analyses were conducted for beta-carotene, vitamin C, and vitamin E from food sources. Intake from supplements was not considered in the meta-analyses because of the few studies that reported relevant information. Based on case–control data, the random-effects summary odds ratios (OR) were, for beta-carotene: 0.88 (95% CI: 0.79–0.98) per 1,000 mcg/1,000 kcal (I2: 77.7%; p < 0.01); for vitamin C: 0.85 (95% CI: 0.73–0.98) per 50 mg/1,000 kcal (I2: 66.1%; p < 0.01); and, for vitamin E: 0.91 (95% CI: 0.84–0.99) per 5 mg/1,000 kcal (I2: 0.0%; p: 0.45). In contrast, the only prospective study identified provided little indication of an association. Although the current case–control data suggest an inverse relationship of endometrial cancer risk with dietary intakes of beta-carotene, vitamin C, and vitamin E from food sources, additional studies are needed, particularly cohort studies, to confirm an association.

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Abbreviations

WCRF:

World Cancer Research Fund International

AICR:

American Institute for Cancer Research

SLR:

Systematic Literature Review

OR:

Odds Ratio

RR:

Relative Risk

CI:

Confidence Interval

FFQ:

Food frequency questionnaire

BMI:

Body mass index

HRT:

Hormone replacement therapy

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Acknowledgments

We would like to thank James Thomas for his valuable help with the data extraction access program. This work was funded in part by the WCRF and by the National Cancer Institute (NIH-K07 CA095666 to Dr. Bandera). However, interpretation of the evidence does not represent the views of WCRF, AICR, or the NCI.

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Correspondence to Elisa V. Bandera.

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Bandera, E.V., Gifkins, D.M., Moore, D.F. et al. Antioxidant vitamins and the risk of endometrial cancer: a dose–response meta-analysis. Cancer Causes Control 20, 699–711 (2009). https://doi.org/10.1007/s10552-008-9283-x

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  • DOI: https://doi.org/10.1007/s10552-008-9283-x

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