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Int J Cancer. 2018 Jun 15;142(12):2441-2460. doi: 10.1002/ijc.31268. Epub 2018 Jan 31.

Dietary consumption of antioxidant vitamins and subsequent lung cancer risk: The Japan Public Health Center-based prospective study.

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Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Division of Cancer Statistics and Integration, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Food and Life Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, 252-5201, Japan.
Department of Food Science and Nutrition, Faculty of Human Life and Environment, Nara Women's University, Kitauoya Higashimachi, Nara, 630-8506, Japan.


While many epidemiological studies have studied the association between lung cancer risk and fruits and vegetable consumption (the major sources of antioxidant vitamins), only a few have investigated the direct association with antioxidants in consideration of cancer subtypes and smoking status. Here, we examined the association between consumption of antioxidant vitamins and lung cancer risk in one of the largest prospective cohort studies in Japan. We investigated the association of dietary antioxidant vitamins intake, namely retinol, vitamin C, vitamin E, α-carotene, and β-carotene and subsequent incidence of lung cancer among 38,207 men and 41,498 women in the Japan Public Health Center-based prospective study. Cox proportional hazard regression was performed with adjustment for potential confounders and by strata of cancer subtypes and smoking status. Antioxidant and other dietary intakes were assessed using a food frequency questionnaire (FFQ). During 1,233,096 person-years of follow-up between 1995 and 2013, a total of 1,690 lung cancer cases were newly diagnosed. In a multivariate regression model, while higher retinol intake was positively associated with overall lung cancer risk in men (HR 1.26; 95% CI 1.05-1.51; ptrend  = 0.003), the estimates were more evident with small cell carcinoma (HR 1.92; 95% CI 1.13-3.24; ptrend  < 0.001). Null associations were observed for other antioxidant vitamins. Our prospective study suggests that higher consumption of retinol may be associated with an increased risk of lung cancer in men, especially with small cell carcinoma, although confirmation is required.


antioxidant vitamins; epidemiology; lung cancer; prospective cohort study

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