Dietary carotene and vitamin A and risk of lung cancer among white men in New Jersey

Abstract

A population-based incident case-control study of lung cancer in white males was conducted during 1980-81 in six high-risk areas of New Jersey. Interviews were completed with 763 cases and 900 controls or with their next of kin. In order to assess whether dietary intake of carotene, preformed retinol, or total vitamin A modified the risk of lung cancer, subjects were asked about their usual frequency of consumption, several years earlier, of 44 food items, which provides 83% of the vitamin A in the American diet, and about their use of vitamin supplements. The men in the lowest quartile of carotene intake had 1.3 the risk (P-value for trend = .05) of those in the highest quartile after adjustment was made for smoking duration and intensity and education. No association was seen for retinol (P-value for trend = .11) or total vitamin A (P-value for trend = .30). The inverse association between carotene intake and lung cancer was most compelling for squamous cell carcinoma, with the smoking-and education-adjusted risk of those in the lowest quartile reaching 1.4 (P-value for trend = .03) the risk of those men in the highest quartile. Risk of lung adenocarcinoma was not related to carotene intake. The reduction in risk of squamous cell lung cancer with increasing carotene intake was noted in pipe and cigar smokers and cigarette smokers of different intensities. Among nonsmokers adenocarcinoma predominated. The inverse association between carotene and risk of squamous cell lung cancer was not especially strong or graded in response; but it was consistent and could be noted in each stratum when the subjects were divided by education, age, or mode of interview (direct vs. next of kin). The results of the other 4 case-control and 3 cohort studies that have looked at diet and risk of lung cancer are not consistent, and the question whether dietary carotene or total vitamin A reduces the risk of lung cancer is not yet resolved.