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Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study^1,2,3

¹ From the Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom (TJK, PNA, NEA, RCT, and AWR); the Nutrition and Hormones Group (MJ, NS, PF, and S Rinaldi) and the Pathology Group (LE), International Agency for Research on Cancer, Lyon, France; the Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark (A Tjønneland and NFJ); the Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark (KO); the Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany (JL and S Rohrmann); the German Institute of Human Nutrition, Potsdam-Rehbücke, Germany (HB and T Pischon); the Department of Hygiene, University of Athens Medical School, Athens, Greece (T Psaltopoulou, A Trichopoulou, and DT); the Molecular and Nutritional Epidemiology Unit, Scientific Institute of Tuscany, Florence, Italy (DP); the Centro di Prevenzione Oncologica, University of Turin, Turin, Italy (PV); the Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom (PV and ER); the Cancer Registry, Azienda Ospedaliera, Civile MP Arezzo, Ragusa, Italy (RT); the Epidemiology Unit, Istituto Tumori, Milan, Italy (FB); the Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands (LK); the Centre for Nutrition and Health, National Institute of Public Health and the Environment, Bilthoven, the Netherlands (HBBdM); the Public Health and Health Planning Directorate, Asturias, Spain (JRQ); the Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain (CAG); the Andalusian School of Public Health, Granada, Spain (CM); the Public Health Department of Gipuzkoa, Gipuzkoa, Spain (NL); the Epidemiology Department, Murcia Health Council, Murcia, Spain (MDC); the Public Health Institute of Navarra, Pamplona, Spain (EA); the Departments of Surgical and Perioperative Sciences, Urology and Andrology (PS) and of Public Health and Clinical Medicine, Nutritional Research (GH), Umeå University Hospital, Umeå, Sweden; and the Department of Gerontology (K-TK) and the Medical Research Council Dunn Human Nutrition Unit and Medical Research Council Centre for Nutritional Epidemiology in Cancer Prevention and Survival, Department of Public Health and Primary Care (SB), University of Cambridge, Cambridge, United Kingdom

Background: Previous studies suggest that high plasma concentrations of carotenoids, retinol, or tocopherols may reduce the risk of prostate cancer.

Objective: We aimed to examine the associations between plasma concentrations of 7 carotenoids, retinol, -tocopherol, and -tocopherol and prostate cancer risk.

Design: A total of 137 001 men in 8 European countries participated. After a mean of 6 y, 966 incident cases of prostate cancer with plasma were available. A total of 1064 control subjects were selected and were matched for study center, age, and date of recruitment. The relative risk of prostate cancer was estimated by conditional logistic regression, which was adjusted for smoking status, alcohol intake, body mass index, marital status, physical activity, and education level.

Results: Overall, none of the micronutrients examined were significantly associated with prostate cancer risk. For lycopene and the sum of carotenoids, there was evidence of heterogeneity between the associations with risks of localized and advanced disease. These carotenoids were not associated with the risk of localized disease but were inversely associated with the risk of advanced disease. The risk of advanced disease for men in the highest fifth of plasma concentrations compared with men in the lowest fifth was 0.40 (95% CI: 0.19, 0.88) for lycopene and 0.35 (95% CI: 0.17, 0.78) for the sum of carotenoids.

Conclusions: We observed no associations between plasma concentrations of carotenoids, retinol, or tocopherols and overall prostate cancer risk. The inverse associations of lycopene and the sum of carotenoids with the risk of advanced disease may involve a protective effect, an association of dietary choice with delayed detection of prostate cancer, reverse causality, or other factors.

Key Words: Carotenoids • retinol • tocopherols • lycopene • prostate cancer • nested case-control study