Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Mazda Jenab, Elio Riboli, Pietro Ferrari, Joan Sabate, Nadia Slimani, Teresa Norat, Marlin Friesen, Anne Tjønneland, Anja Olsen, Kim Overvad, Marie Christine Boutron-Ruault, Françoise Clavel-Chapelon, Mathilde Touvier, Heiner Boeing, Mandy Schulz, Jakob Linseisen, Gabriele Nagel, Antonia Trichopoulou, Androniki Naska, Eleni Oikonomou & 29 others Vittorio Krogh, Salvatore Panico, Giovanna Masala, Carlotta Sacerdote, Rosario Tumino, Petra H. Peeters, Mattijs E. Numans, Hendrik B. Bueno-de-Mesquita, Frederike L. Büchner, Eiliv Lund, Guillem Pera, Carmen Navarro Sanchez, Maria José Sánchez, Larraitz Arriola, Aurelio Barricarte, José Ramón Quirós, Göran Hallmans, Roger Stenling, Göran Berglund, Sheila Bingham, Kay Tee Khaw, Timothy Key, Naomi Allen, Fatima Carneiro, U. Mahlke, Guiseppe Del Giudice, Domenico Palli, Rudolf Kaaks, Carlos A. Gonzalez

Research output: Contribution to journalArticle

Abstract

Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95% CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.

Original languageEnglish (US)
Pages (from-to)2250-2257
Number of pages8
JournalCarcinogenesis
Volume27
Issue number11
DOIs
StatePublished - Nov 15 2006
Externally publishedYes

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Ascorbic Acid
Stomach Neoplasms
Nitroso Compounds
Neoplasms
Case-Control Studies
Logistic Models
Odds Ratio
Confidence Intervals
Cardia
Pylorus
Helicobacter Infections
Energy Intake
Helicobacter pylori
Stomach
Body Mass Index
Antioxidants
Smoking
Prospective Studies

ASJC Scopus subject areas

  • Cancer Research

Cite this

Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). / Jenab, Mazda; Riboli, Elio; Ferrari, Pietro; Sabate, Joan; Slimani, Nadia; Norat, Teresa; Friesen, Marlin; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Boutron-Ruault, Marie Christine; Clavel-Chapelon, Françoise; Touvier, Mathilde; Boeing, Heiner; Schulz, Mandy; Linseisen, Jakob; Nagel, Gabriele; Trichopoulou, Antonia; Naska, Androniki; Oikonomou, Eleni; Krogh, Vittorio; Panico, Salvatore; Masala, Giovanna; Sacerdote, Carlotta; Tumino, Rosario; Peeters, Petra H.; Numans, Mattijs E.; Bueno-de-Mesquita, Hendrik B.; Büchner, Frederike L.; Lund, Eiliv; Pera, Guillem; Sanchez, Carmen Navarro; Sánchez, Maria José; Arriola, Larraitz; Barricarte, Aurelio; Quirós, José Ramón; Hallmans, Göran; Stenling, Roger; Berglund, Göran; Bingham, Sheila; Khaw, Kay Tee; Key, Timothy; Allen, Naomi; Carneiro, Fatima; Mahlke, U.; Giudice, Guiseppe Del; Palli, Domenico; Kaaks, Rudolf; Gonzalez, Carlos A.

In: Carcinogenesis, Vol. 27, No. 11, 15.11.2006, p. 2250-2257.

Research output: Contribution to journalArticle

Jenab, M, Riboli, E, Ferrari, P, Sabate, J, Slimani, N, Norat, T, Friesen, M, Tjønneland, A, Olsen, A, Overvad, K, Boutron-Ruault, MC, Clavel-Chapelon, F, Touvier, M, Boeing, H, Schulz, M, Linseisen, J, Nagel, G, Trichopoulou, A, Naska, A, Oikonomou, E, Krogh, V, Panico, S, Masala, G, Sacerdote, C, Tumino, R, Peeters, PH, Numans, ME, Bueno-de-Mesquita, HB, Büchner, FL, Lund, E, Pera, G, Sanchez, CN, Sánchez, MJ, Arriola, L, Barricarte, A, Quirós, JR, Hallmans, G, Stenling, R, Berglund, G, Bingham, S, Khaw, KT, Key, T, Allen, N, Carneiro, F, Mahlke, U, Giudice, GD, Palli, D, Kaaks, R & Gonzalez, CA 2006, 'Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)', Carcinogenesis, vol. 27, no. 11, pp. 2250-2257. https://doi.org/10.1093/carcin/bgl096
Jenab, Mazda ; Riboli, Elio ; Ferrari, Pietro ; Sabate, Joan ; Slimani, Nadia ; Norat, Teresa ; Friesen, Marlin ; Tjønneland, Anne ; Olsen, Anja ; Overvad, Kim ; Boutron-Ruault, Marie Christine ; Clavel-Chapelon, Françoise ; Touvier, Mathilde ; Boeing, Heiner ; Schulz, Mandy ; Linseisen, Jakob ; Nagel, Gabriele ; Trichopoulou, Antonia ; Naska, Androniki ; Oikonomou, Eleni ; Krogh, Vittorio ; Panico, Salvatore ; Masala, Giovanna ; Sacerdote, Carlotta ; Tumino, Rosario ; Peeters, Petra H. ; Numans, Mattijs E. ; Bueno-de-Mesquita, Hendrik B. ; Büchner, Frederike L. ; Lund, Eiliv ; Pera, Guillem ; Sanchez, Carmen Navarro ; Sánchez, Maria José ; Arriola, Larraitz ; Barricarte, Aurelio ; Quirós, José Ramón ; Hallmans, Göran ; Stenling, Roger ; Berglund, Göran ; Bingham, Sheila ; Khaw, Kay Tee ; Key, Timothy ; Allen, Naomi ; Carneiro, Fatima ; Mahlke, U. ; Giudice, Guiseppe Del ; Palli, Domenico ; Kaaks, Rudolf ; Gonzalez, Carlos A. / Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). In: Carcinogenesis. 2006 ; Vol. 27, No. 11. pp. 2250-2257.
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abstract = "Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95{\%} confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95{\%} CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.",
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T1 - Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

AU - Jenab, Mazda

AU - Riboli, Elio

AU - Ferrari, Pietro

AU - Sabate, Joan

AU - Slimani, Nadia

AU - Norat, Teresa

AU - Friesen, Marlin

AU - Tjønneland, Anne

AU - Olsen, Anja

AU - Overvad, Kim

AU - Boutron-Ruault, Marie Christine

AU - Clavel-Chapelon, Françoise

AU - Touvier, Mathilde

AU - Boeing, Heiner

AU - Schulz, Mandy

AU - Linseisen, Jakob

AU - Nagel, Gabriele

AU - Trichopoulou, Antonia

AU - Naska, Androniki

AU - Oikonomou, Eleni

AU - Krogh, Vittorio

AU - Panico, Salvatore

AU - Masala, Giovanna

AU - Sacerdote, Carlotta

AU - Tumino, Rosario

AU - Peeters, Petra H.

AU - Numans, Mattijs E.

AU - Bueno-de-Mesquita, Hendrik B.

AU - Büchner, Frederike L.

AU - Lund, Eiliv

AU - Pera, Guillem

AU - Sanchez, Carmen Navarro

AU - Sánchez, Maria José

AU - Arriola, Larraitz

AU - Barricarte, Aurelio

AU - Quirós, José Ramón

AU - Hallmans, Göran

AU - Stenling, Roger

AU - Berglund, Göran

AU - Bingham, Sheila

AU - Khaw, Kay Tee

AU - Key, Timothy

AU - Allen, Naomi

AU - Carneiro, Fatima

AU - Mahlke, U.

AU - Giudice, Guiseppe Del

AU - Palli, Domenico

AU - Kaaks, Rudolf

AU - Gonzalez, Carlos A.

PY - 2006/11/15

Y1 - 2006/11/15

N2 - Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95% CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.

AB - Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/ duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, Ptrend = 0.043], which was maintained after exclusion of cases with ≤2 years follow-up (OR = 0.40, 95% CI = 0.19-0.83, Ptrend = 0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical subsite (cardia/non-cardia) or histological subtype (diffuse/intestinal), and there was no significant interaction of effect with H.pylori. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production.

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