Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer: A pooled analysis of prospective cohort studies

Yikyung Park, Donna Spiegelman, David J. Hunter, Demetrius Albanes, Leif Bergkvist, Julie E. Buring, Jo L. Freudenheim, Edward Giovannucci, R. Alexandra Goldbohm, Lisa Harnack, Ikuko Kato, Vittorio Krogh, Michael F. Leitzmann, Paul J. Limburg, James R. Marshall, Marjorie L. McCullough, Anthony B. Miller, Thomas E. Rohan, Arthur Schatzkin, Roy ShoreSabina Sieri, Meir J. Stampfer, Jarmo Virtamo, Matty Weijenberg, Walter C. Willett, Alicja Wolk, Shumin M. Zhang, Stephanie A. Smith-Warner

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Objective: To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. Methods: Using the primary data from 13 cohort studies, we estimated study-and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model. Results: Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76-1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66-0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81-0.96). Conclusions: Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

Original languageEnglish (US)
Pages (from-to)1745-1757
Number of pages13
JournalCancer Causes and Control
Issue number11
StatePublished - Nov 2010

Bibliographical note

Funding Information:
Financial support The study was funded by research grants CA55075 from the National Institutes of Health and the National Colorectal Cancer Research Alliance of the Entertainment Industry Foundation.


  • Cohort study
  • Colon cancer
  • Multivitamin
  • Pooled analysis
  • Vitamin A
  • Vitamin C
  • Vitamin E


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