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Research: WIDEROFF and colleagues,
Listed in Issue 39
Abstract
WIDEROFF and colleagues, Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda MD 20892 USA write that earlier case-control studies reported inverse associations of cervical squamous intraepithelial lesions (SIL) with high dietary of biomarker levels of carotenoids, folate, and vitamins C and E . They note, however that most of these studies did not measure the primary causal factor, genital human papillomaviruses (HPV), now detectable by sensitive viral DNA tests. The authors conducted a nested case-control study to assess whether high dietary intakes of these nutrients, plus zinc and vitamin A reduced SIL risk in cancer-associated HPV DNA-positive women.
Background
Methodology
Participants in this analysis were 33 incident cases with high-grade lesions, 121 women with low-grade lesions, 98 with equivocal SIL and 806 cytologically normal controls from a large prospective cohort study. Nutrient estimates were obtained using a 60-item food-frequency questionnaire. Baseline cervicovaginal lavages were tested for HPV DNA using the polymerase chain reaction.
Results
In the 68 DNA-positive women and the 69 controls, the age-adjusted odds ratios (ORs) of SIL in the highest vs the lowest nutrient quartiles were 1.4 for vitamin A, 0.6 for beta-carotene, 1.3 for vitamin C, 1.0 for vitamin E 0.7 for folate and 0.8 for zinc. ORs for HPV DNA-negative women approximated 1.0, except for vitamin E (OR = 0.5).
Conclusion
These data do not support a protective role for the above nutrients against low-grade or equivocal SIL, which constitute the majority of diagnoses.
References
Wideroff L et al. A nested case-control study of dietary factors and the risk of incident cytological abnormalities of the cervix. Nutr Cancer 30(2): 130-6 1998.
Comment
Food frequency questionnaires have been notoriously unreliable in establishing accurate dietary and thence, blood levels of nutrients. This study needs to be repeated with clinically determined levels of the vitamins and other nutrients mentioned.
