Fairfield K M, Hankinson S E, Rosner B A, Hunter D J, Colditz G A, Willett W C
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
Cancer. 2001 Nov 1;92(9):2318-26. doi: 10.1002/1097-0142(20011101)92:9<2318::aid-cncr1578>3.0.co;2-7.
Antioxidant vitamins may decrease risk of cancer by limiting oxidative DNA damage leading to cancer initiation. Few prospective studies have assessed relations between antioxidant vitamins and ovarian carcinoma.
The authors prospectively assessed consumption of vitamins A, C, and E and specific carotenoids, as well as fruit and vegetable intake, in relation to ovarian carcinoma risk among 80,326 participants in the Nurses' Health Study who had no history of cancer other than nonmelanoma skin carcinoma. Women reported on known and suspected ovarian carcinoma risk factors including reproductive factors, smoking, and use of vitamin supplements on biennial mailed questionnaires from 1976 to 1996. Food frequency questionnaires were included in 1980, 1984, 1986, and 1990. The authors confirmed 301 incident cases of invasive epithelial ovarian carcinoma during 16 years of dietary follow-up (1980-1996). Pooled logistic regression was used to control for age, oral contraceptive use, body mass index, smoking history, parity, and tubal ligation.
The authors observed no association between ovarian carcinoma risk and antioxidant vitamin consumption from foods, or foods and supplements together. The multivariate relative risks (95% confidence intervals [CIs]) for ovarian carcinoma among women in the highest versus lowest quintile of intake were 1.04 (95% CI, 0.72-1.51) for vitamin A from foods and supplements; 1.01 (95% CI, 0.69-1.47) for vitamin C; 0.88 (95% CI, 0.61-1.27) for vitamin E; and 1.10 (95% CI, 0.76-1.59) for beta-carotene. Among users of vitamin supplements, the authors found no evidence of an association between dose or duration of any specific vitamin and ovarian carcinoma risk, although the authors had limited power to assess these relations. No specific fruits or vegetables were associated significantly with ovarian carcinoma risk. The authors found no association between ovarian carcinoma and consumption of total fruits or vegetables, or specific subgroups including cruciferous vegetables, green leafy vegetables, legumes, or citrus fruits. Women who consumed at least 2.5 total servings of fruits and vegetables as adolescents had a 46% reduction in ovarian carcinoma risk (relative risk, 0.54, 95% CI, 0.29-1.03; P value for trend 0.04).
These data do not support an important relation between consumption of antioxidant vitamins from foods or supplements, or intake of fruits and vegetables, and incidence of ovarian carcinoma in this cohort. However, modest associations cannot be excluded, and the authors' finding of an inverse association for total fruit and vegetable intake during adolescence raises the possibility that the pertinent exposure period may be much earlier than formerly anticipated.
抗氧化维生素可能通过限制导致癌症发生的氧化性DNA损伤来降低癌症风险。很少有前瞻性研究评估抗氧化维生素与卵巢癌之间的关系。
作者前瞻性评估了80326名护士健康研究参与者中维生素A、C、E和特定类胡萝卜素的摄入量，以及水果和蔬菜的摄入量与卵巢癌风险的关系，这些参与者除了非黑色素瘤皮肤癌外无其他癌症病史。女性在1976年至1996年每两年邮寄一次的问卷中报告已知和可疑的卵巢癌风险因素，包括生殖因素、吸烟和维生素补充剂的使用情况。1980年、1984年、1986年和1990年的问卷中包含了食物频率问卷。在16年的饮食随访（1980 - 1996年）期间，作者确认了301例侵袭性上皮性卵巢癌的发病病例。采用汇总逻辑回归来控制年龄、口服避孕药使用情况、体重指数、吸烟史、产次和输卵管结扎等因素。
作者观察到食物中抗氧化维生素的摄入量，或食物与补充剂的总摄入量与卵巢癌风险之间无关联。摄入量处于最高五分位数与最低五分位数的女性中，卵巢癌的多变量相对风险（95%置信区间[CI]）分别为：食物和补充剂中的维生素A为1.04（95%CI，0.72 - 1.51）；维生素C为1.01（95%CI，0.69 - 1.47）；维生素E为0.88（95%CI，0.61 - 1.27）；β - 胡萝卜素为1.10（95%CI，0.76 - 1.59）。在维生素补充剂使用者中，作者未发现任何特定维生素的剂量或服用时长与卵巢癌风险之间存在关联的证据，尽管作者评估这些关系的能力有限。没有特定的水果或蔬菜与卵巢癌风险有显著关联。作者发现卵巢癌与总水果或蔬菜摄入量，或包括十字花科蔬菜、绿叶蔬菜、豆类或柑橘类水果在内的特定亚组之间无关联。青少年时期至少食用2.5份水果和蔬菜的女性，卵巢癌风险降低46%（相对风险，0.54，95%CI，0.29 - 1.03；趋势P值为0.04）。
这些数据不支持该队列中食物或补充剂中抗氧化维生素的摄入量、水果和蔬菜的摄入量与卵巢癌发病率之间存在重要关系。然而，不能排除适度关联的可能性，并且作者发现青少年时期总水果和蔬菜摄入量呈负相关，这增加了相关暴露期可能比之前预期更早的可能性。
