© 1995 by Oxford University Press
Journal of the National Cancer Institute, Vol. 87, No. 23, 1767-1776,
December 6, 1995
© 1995 Oxford University Press
Intake of Carotenoids and Retino in Relation to Risk of Prostate Cancer
Channing Laboratory, Department of Medicine, Harvard Medical School, Alberigham and Women's Hospital, Boston, MA, and Department of Nutrition, Hardvard School of Public Health Boston
Department of Nutrition and Department of Epidemiology, Harvard School of Public Health
Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham, Women's Hospital, and Department of Nutrition and Department of Epidemiology, Harvard School of Public Health
Channing Laboratory, Department of Medicine, Harvard Medical School and Brighamand Women's Hospital, and Department of Epidemiology, Harvard School of Public Health
Correspondence to: Edward Giovannucci, M.D., Sc.D., Channing Laboratory, 180 Longwood Ave., Boston, MA 02115.
Background: Several human studies have observed a direct association between retinol (vitamin A) intake and risk of prostate cancer; other studies have found either an inverse association or no association of intake of 
-carotene (the major provitamin A) with risk of prostate cancer. Data regarding carotenoids other than -carotene in relation to prostate cancer risk are sparse. Purpose: We conducted a prospective cohort study to examine the relationship between the intake of various carotenoids, retinol, fruits, and vegetables and the risk of prostate cancer. Methods: Using responses to a validated, semiquantitative food-frequency questionnaire mailed to participants in the Health Professionals Follow-up Study in 1986, we assessed dietary intake for a 1-year period for a cohort of 47 894 eligible subjects initially free of diagnosed cancer. Follow-up questionnaires were sent to the entire cohort in 1988, 1990, and 1992. We calculated the relative risk (RR) for each of the upper categories of intake of a specific food or nutrient by dividing the incidence rate of prostate cancer among men in each of these categories by the rate among men in the lowest intake level. All P values resulted from two-sided tests. Results: Between 1986 and 1992, 812 new cases of prostate cancer, including 773 non-stage A1 cases, were documented. Intakes of the carotenoids -carotene, 
-carotene, lutein, and -cryp-toxanthin were not associated with risk of non-stage A1 prostate cancer; only lycopene intake was related to lower risk (age- and energy-adjusted RR = 0.79; 95% confidence interval [CI] = 0.64–0.99 for high versus low quintile of intake; P for trend =.04). Of 46 vegetables and fruits or related products, four were significantly associated with lower prostate cancer risk; of the four— tomato sauce (P for trend =.001), tomatoes (P for trend =.03), and pizza (P for trend =.05), but not strawberries— were primary sources of lycopene. Combined intake of tomatoes, tomato sauce, tomato juice, and pizza (which accounted for 82% of lycopene intake) was inversely associated with risk of prostate cancer (multivariate RR = 0.65; 95% CI = 0.44–0.95, for consumption frequency greater than 10 versus less than 1.5 servings per week; P for trend =.01) and advanced (stages C and D) prostate cancers (multivariate RR = 0.47; 95% CI = 0.22–1.00; P for trend =.03). No consistent association was observed for dietary retinol and risk of prostate cancer. Conclusions: These findings suggest that intake of lycopene or other compounds in tomatoes may reduce prostate cancer risk, but other measured carotenoids are unrelated to risk. Implications: Our findings support recommendations to increase vegetable and fruit consumption to reduce cancer incidence but suggest that tomato-based foods may be especially beneficial regarding prostate cancer risk.
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