Prediagnostic Plasma Vitamin C and Risk of Gastric Adenocarcinoma and Esophageal Squamous Cell Carcinoma in a Chinese Population

Overview

Journal Am J Clin Nutr

Publisher Elsevier

Specialty Nutritional Sciences

Date 2013 Sep 13

PMID 24025629

Citations 26

Authors

Tram Kim Lam

Neal D Freedman

Jin-Hu Fan

You-Lin Qiao

Sanford M Dawsey

Philip R Taylor

Christian C Abnet

Affiliations

Soon will be listed here.

Abstract

Background: China has some of the highest incidence rates for gastric adenocarcinoma (GA) and esophageal squamous cell carcinoma (ESCC) in the world. Prospective studies suggested that vitamin C may reduce risks; however, associations are unclear because of limited sample size.

Objective: The objective was to examine the relation between prediagnostic plasma vitamin C and the risk of GA and ESCC.

Design: A case-cohort study was used to assess the association between prediagnostic plasma vitamin C and incidence of GA (n = 467) and ESCC (n = 618) in the General Population Nutrition Intervention Trial. With the use of multivariate Cox proportional hazards models, we estimated the HRs and 95% CIs. We also conducted a meta-analysis of the literature up to 1 October 2012 on the relation between circulating vitamin C and gastric cancer incidence. Two cohort studies and the current study were included to assess the body of evidence.

Results: For GA, each 20-μmol/L increase in plasma vitamin C was associated with a 14% decrease in risk (HR: 0.86; 95% CI: 0.76, 0.96). Compared with individuals with low plasma vitamin C concentrations (≤28 μmol/L), those with normal concentrations (>28 μmol/L) had a 27% reduced risk of GA (HR: 0.73; 95% CI: 0.56, 0.94). No association between vitamin C concentrations and ESCC was seen. Meta-analysis showed that the risk of incident GA among those with the highest concentration of plasma vitamin C was 31% lower (random-effects-pooled-odds ratio 0.69; 95% CI: 0.54, 0.89) than those in the lowest category.

Conclusion: Our data provide evidence that higher circulating vitamin C was associated with a reduced risk of incident GA, but no association was seen for ESCC.

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