Hunter D J, Manson J E, Colditz G A, Stampfer M J, Rosner B, Hennekens C H, Speizer F E, Willett W C
Channing Laboratory, Department of Medicine, Harvard Medical School, Boston, MA 02115.
N Engl J Med. 1993 Jul 22;329(4):234-40. doi: 10.1056/NEJM199307223290403.
Although it has been hypothesized that large intakes of the antioxidant vitamins C, E, and A reduce the risk of breast cancer, few prospective data are available.
We prospectively studied 89,494 women who were 34 to 59 years old in 1980 and who did not have cancer. Their intakes of vitamins C, E, and A from foods and supplements were assessed at base line and in 1984 with the use of a validated semiquantitative food-frequency questionnaire.
Breast cancer was diagnosed in 1439 women during eight years of follow-up. After multivariate adjustment for known risk factors, the relative risk among women in the highest quintile group for intake of vitamin C as compared with the risk among those in the lowest quintile group was 1.03 (95 percent confidence interval, 0.87 to 1.21); for vitamin E, after vitamin A intake had been controlled for, the relative risk was 0.99 (95 percent confidence interval, 0.83 to 1.19). In contrast, among women in the highest quintile group for intake of total vitamin A the relative risk was 0.84 (95 percent confidence interval, 0.71 to 0.98; P for trend = 0.001). Among women in the lowest quintile group for intake of vitamin A from food, consumption of vitamin A from supplements was associated with a reduced risk (P = 0.03). The significant inverse association of vitamin A intake with the risk of breast cancer was also found on study of data based on the 1984 questionnaire and four years of follow-up.
Large intakes of vitamin C or E did not protect women in our study from breast cancer. A low intake of vitamin A may increase the risk of this disease; any benefit of vitamin A supplements may be limited to women with diets low in vitamin A.
尽管有假说认为大量摄入抗氧化维生素C、E和A可降低患乳腺癌的风险，但前瞻性数据较少。
我们对1980年年龄在34至59岁且无癌症的89494名女性进行了前瞻性研究。在基线期和1984年，使用经过验证的半定量食物频率问卷评估她们从食物和补充剂中摄入维生素C、E和A的情况。
在八年的随访期间，1439名女性被诊断出患有乳腺癌。在对已知风险因素进行多变量调整后，维生素C摄入量处于最高五分位组的女性与最低五分位组女性相比，相对风险为1.03（95%置信区间为0.87至1.21）；对于维生素E，在控制了维生素A摄入量后，相对风险为0.99（95%置信区间为0.83至1.19）。相比之下，总维生素A摄入量处于最高五分位组的女性相对风险为0.84（95%置信区间为0.71至0.98；趋势P值 = 0.001）。在食物中维生素A摄入量处于最低五分位组的女性中，补充剂中维生素A的摄入与风险降低相关（P = 0.03）。基于1984年问卷数据和四年随访的研究也发现维生素A摄入量与乳腺癌风险之间存在显著的负相关。
在我们的研究中，大量摄入维生素C或E并不能保护女性免受乳腺癌侵害。维生素A摄入量低可能会增加患这种疾病的风险；维生素A补充剂的任何益处可能仅限于维生素A饮食摄入低的女性。
