Tobacco use and associations of beta-carotene and vitamin intakes with colorectal adenoma risk

J Nutr. 2005 Oct;135(10):2468-72. doi: 10.1093/jn/135.10.2468.

Abstract

The effects of vitamins and beta-carotene on the risk of colorectal adenomas have not been fully investigated. Recent data suggest that smoking could modulate the effect of beta-carotene supplements on adenoma recurrence. We investigated the effect of dietary vitamins and beta-carotene on the risk of adenomas, and a potential interaction with smoking status as part of a case-control study of environmental factors associated with the risk of colorectal adenomas and cancers. We compared nutrient intakes in polyp-free controls (n = 427) and adenoma cases (n = 362) globally and using models stratified by smoking status, adjusted for age, sex, BMI, and energy and alcohol intakes. Folate and vitamins C and B-6 were inversely related to adenoma risk (P for trend = 0.005, 0.03, and 0.02, respectively), whereas vitamin D tended to be inversely associated with risk (P for trend = 0.05). There was a significant interaction between beta-carotene and smoking (P interaction = 0.04). In nonsmokers, beta-carotene was inversely associated with adenoma risk, especially that of colon adenomas [odds ratios (ORs) in low vs. high consumers and 95% CI 0.4 (0.2-0.9)], whereas in past or current smokers, beta-carotene was associated with a nonsignificant (P for trend = 0.19) increase in the risk of colon adenomas [corresponding OR = 1.9 (95% CI = 0.9-4.1)]. Our findings support a protective effect of folate and vitamins C and B-6 irrespective of smoking habits, and a protective effect of beta-carotene in nonsmokers only. They suggest an adverse effect of beta-carotene in smokers, who should be cautious about taking high doses of this micronutrient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / epidemiology*
  • Adenoma / prevention & control
  • Adult
  • Case-Control Studies
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / prevention & control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Risk Reduction Behavior
  • Smoking / epidemiology*
  • Vitamins / administration & dosage*
  • beta Carotene / administration & dosage*

Substances

  • Vitamins
  • beta Carotene