Retinol, Antioxidant Vitamins, and Cancers of the Upper Digestive Tract in a Prospective Cohort Study of Postmenopausal Women

Very few prospective studies have reported previously on the association of micronutrient intake and the risk of cancers of the upper digestive tract (mouth, pharynx, esophagus, and stomach) in western populations. During 7 years of follow-up in the Iowa Women's Health Study, from 1986–1992,59 of the 34,691 at-risk cohort members developed cancers of the upper digestive tract. The association of retinol and antioxidant vitamins (carotene and vitamins C and E) were evaluated separately for cancers of the mouth/pharynx/esophagus (n = 33) and stomach (n = 26). After adjustment for age, smoking, and total energy intake, higher intakes of carotene and vitamins C and E were related to lower risks of both oral/pharyngeal/esophageal and gastric cancers, while retinol was associated with lower risk of gastric cancer only. The dose-response relation between gastric cancer risk and intake of carotene was clear and statistically significant, with relative risks of 0.6 and 0.3, respectively, observed among women in the upper two versus the lowest tertiles of intake. This study provides further evidence that higher intake of antioxidant vitamins may be important in the prevention of cancers of the upper digestive organs.