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  • Title: Cancer of the cervix uteri and vitamin A.
    Author: Harris RW, Forman D, Doll R, Vessey MP, Wald NJ.
    Journal: Br J Cancer; 1986 May; 53(5):653-9. PubMed ID: 3718822.
    Abstract:
    The concentrations of retinol and beta carotene were measured in serum samples taken from 113 women with cervical cancer, 32 with invasive and 81 with pre-invasive disease, and compared with those from 226 age-matched control women. There was little difference in serum retinol levels between women with cancer of the cervix, at any stage, and the control women, after adjusting for potential confounding factors. Serum beta carotene concentrations were likewise similar in women with invasive disease and the controls. However mean beta carotene levels were significantly reduced in women with pre-invasive disease compared to the controls (221.3 cf. 291.6 micrograms l-1, P less than 0.05). This reduction was more evident amongst women with a diagnosis of carcinoma-in-situ (mean 213.1 micrograms l-1 than amongst those with severe dysplasia (mean 228.7 micrograms l-1. There is a negative trend between beta carotene and risk of pre-invasive disease which is of borderline significance. These data have also been used to investigate the effects of smoking and oral contraceptive usage on the serum levels of retinol and beta carotene. Both habits tend to increase retinol and decrease beta carotene concentrations. Women with invasive cancer of the cervix or with preinvasive disease and a control group of women with various benign gynecological problems were interviewed over the 1975-79 period at 2 hospitals and a health center in Oxfordshire, England, as part of a study designed to examine the hypothesis that the etiology of epithelial cancers might be related to a relative deficiency of dietary vitamin A. A sexual, obstetric, and contraceptive history was obtained from each woman. Blood samples were taken at the time of the interview from most of the study participants. Serum samples from 43 women with dysplasia, 38 women with carcinoma-in-situ, 32 women with invasive cancer, and 226 control women (matched for 5-year age group) were used. Serum samples were assayed for retinol and Beta-carotene. Analysis was carried out between 6-9 years after collection and initial freezing. Relative risks were computed for quintiles of serum levels of vitamin A and Beta-carotene as determined by the distributions among the controls, I being the lowest group and V the highest. The mean levels of serum retinol were similar in cases of all the disease categories and in cases and controls after full adjustment. This was the case for mean levels of serum Beta-carotene when comparing invasive cancer cases with controls. For both the preinvasive disease categories, the levels of Beta-carotene were lower among the cases than the controls at a significant level for the carcinoma-in-situ category and for both the preinvasive categories combined after full adjustment. No significant elevations, reductions, or trends in the odds ratios were found with retinol or Beta-carotene in any disease group. In the carcinoma-in-situ group, the odds ratio was greater than 4 in the 3 lowest Beta-carotene quintiles and of borderline significance. The comparison of the lowest 4 quintiles for the carcinoma-in-situ group with the highest gave an odds ratio of 4.0, a ratio of borderline significance. When the 2 preinvasive disease categories were combined, an elevated odds ratio of borderline significance was found for 2 of the 3 lower quintiles for the 4 low quintiles combined. Both smoking and OC use were independently associated with the serum measures; both habits tended to be linked with relatively high retinol and low Beta-carotene levels, respectively. The effect of smoking on Beta-carotene was quite strong. The results were similar in premenopausal and postmenopausal women. In sum, the findings fail to support any association between low levels of serum retinol and an increased risk of cervical cancer. The findings suggest that Beta-carotene might have a weak inverse association with preinvasive cancer but not with invasive cancer.
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