Plasma carotenoids and vitamin C concentrations and risk of urothelial cell carcinoma in the European Prospective Investigation into Cancer and Nutrition

Martine M. Ros, H. Bas Bueno-de-Mesquita, Ellen Kampman, Katja K H Aben, Frederike L. Buc̈hner, Eugene H J M Jansen, Carla H. Van Gils, Lars Egevad, Kim Overvad, Anne Tjnøneland, Nina Roswall, Marie Christine Boutron-Ruault, Marina Kvaskoff, Florence Perquier, Rudolf Kaaks, Jenny Chang-Claude, Steffen Weikert, Heiner Boeing, Antonia Trichopoulou, Pagona LagiouVardis Dilis, Domenico Palli, Valeria Pala, Carlotta Sacerdote, Rosario Tumino, Salvatore Panico, Petra H M Peeters, Inger T. Gram, Guri Skeie, José María Huerta, Aurelio Barricarte, José Ramón Quirós, María José Sánchez, Genevieve Buckland, Nerea Larrañaga, Roy Ehrnström, Peter Wallström, Börje Ljungberg, Göran Hallmans, Timothy J. Key, Naomi E. Allen, Kay Tee Khaw, Nick Wareham, Paul Brennan, Elio Riboli, Lambertus A. Kiemeney

Research output: Contribution to journalArticlepeer-review


Background: Published associations between dietary carotenoids and vitamin C and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. Objective: We investigated the association between plasma carotenoids and vitamin C and risk of urothelial cell carcinoma (UCC) in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Design: A total of 856 patients with newly diagnosed UCC were matched with 856 cohort members by sex, age at baseline, study center, date and time of blood collection, and fasting status. Plasma carotenoids (α- and β-carotene, β-cryptoxanthin, lycopene, lutein, and zeaxanthin) were measured by using reverse-phase HPLC, and plasma vitamin C was measured by using a colorimetric assay. Incidence rate ratios (IRRs) were estimated by using conditional logistic regression with adjustment for smoking status, duration, and intensity. Results: UCC risk decreased with higher concentrations of the sum of plasma carotenoids (IRR for the highest compared with the lowest quartile: 0.64; 95% CI: 0.44, 0.93; P-trend = 0.04). Plasma α-carotene was inversely associated with aggressive UCC (IRR: 0.51; 95% CI: 0.30, 0.88; P-trend = 0.02). Plasma lutein was inversely associated with risk of nonaggressive UCC (IRR: 0.56; 95% CI: 0.32, 0.98; P-trend = 0.05). No association was observed between plasma vitamin C and risk of UCC. Conclusions: Although residual confounding by smoking or other factors cannot be excluded, higher concentrations of plasma carotenoids may reduce risk of UCC, in particular aggressive UCC. Plasma lutein may reduce risk of nonaggressive UCC.

Original languageEnglish
Pages (from-to)902-910
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Issue number4
Publication statusPublished - Oct 1 2012

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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