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ABSTRACT: PURPOSE: The associations between anthropometric factors, physical activity (PA), and breast cancer risk in terms of estrogen-receptor/progesterone-receptor (ER/PgR) status have been unclear in Japanese women. This case-control study was designed to evaluate these associations. METHODS: From among female patients aged 30 years and over admitted to a single hospital in Japan between 1997 and 2009, 1,017 breast cancer cases (538ER+/PgR+, 125ER+/PgR-, 23 ER-/PgR+, 249 ER-/PgR-, and 82 missing) and 2,902 controls were selected. Height, weight, body mass index (BMI) (kg/m(2)), and time spent exercising (hours/week) were assessed using a self-administered questionnaire. Polytomous logistic regression analysis and tests for heterogeneity across ER+/PgR+ and ER-/PgR- were conducted. RESULTS: Higher BMI was associated with a higher risk of ER+/PgR+ cancer among women overall [odds ratio (OR) = 2.41, 95 % confidence interval (CI) 1.37-4.23 for BMI ≥30.0; P trend = 0.0001] and postmenopausal women (OR = 6.24, 95 % CI 2.68-14.53 for BMI ≥30.0; P trend < 0.0001). A longer time spent exercising (more than 5 h/week) showed a decreased risk for any type of breast cancer among overall and pre- and postmenopausal women, although this did not reach statistical significance. Height was not associated with any risk. CONCLUSIONS: Higher BMI is associated with an increased risk of ER+/PgR+ cancer among women overall and postmenopausal women. PA might be associated with a decreased risk of any type. To prevent breast cancer, weight control and PA are important.
Cancer Causes and Control 03/2013; · 2.88 Impact Factor
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ABSTRACT: The associations between menstrual and reproductive factors and breast cancer risk in relation to estrogen/progesterone receptor (ER/PgR) status have been unclear in Japanese women. This case-control study evaluated these associations, overall and separately, by menopausal status. A total of 1092 breast cancer cases and 3160 controls were selected from among female patients aged 30 years and over admitted to a single hospital in Miyagi Prefecture between 1997 and 2009. The receptor status distribution among the cases (missing: 8.4%) was 571 ER+/PgR+, 133 ER+/PgR-, 24 ER-/PgR+ and 271 ER-/PgR-. Menstrual and reproductive factors were assessed using a self-administered questionnaire. Polytomous logistic regression and tests for heterogeneity across ER+/PgR+ and ER-/PgR- were conducted. Later age at menarche was significantly associated with a decreased risk of both ER+/PgR+ and ER-/PgR- cancer among women overall (P(trend) = 0.0016 for ER+/PgR+; P(trend) = 0.015 for ER-/PgR-) and among postmenopausal women (P(trend) = 0.012 for ER+/PgR+; P(trend) = 0.0056 for ER-/PgR-). Nulliparity was associated with an increased risk of ER+/PgR+, but not ER-/PgR- cancer among women overall (P(heterogeneity) = 0.019) and among postmenopausal women (odds ratio for ER+/PgR+ = 2.56, 95% confidence interval = 1.61-4.07; P(heterogeneity) = 0.0095). A longer duration of breastfeeding tended to be associated with a decreased risk in all subtypes among women overall. Later age at menarche has a protective effect against both ER+/PgR+ and ER-/PgR- cancer. However, parity might impact differently on various subtypes of breast cancer. Further studies are needed to clarify the etiology of the rare ER+/PgR- and ER-/PgR+ cancer subtypes.
Cancer Science 07/2012; 103(10):1861-70. · 3.33 Impact Factor
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ABSTRACT: Body mass index (BMI) may be an important factor affecting breast cancer outcome. Studies conducted mainly in Western countries have reported a relationship between higher BMI and a higher risk of all-cause death or breast cancer-specific death among women with breast cancer, but only a few studies have been reported in Japan so far. In the present prospective study, we investigated the associations between BMI and the risk of all-cause and breast cancer-specific death among breast cancer patients overall and by menopausal status and hormone receptor status.
The study included 653 breast cancer patients admitted to a single hospital in Japan, between 1997 and 2005. BMI was assessed using a self-administered questionnaire. The patients were completely followed up until December, 2008. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated according to quartile points of BMI categories, respectively: <21.2, ≥21.2 to <23.3 (reference), ≥23.3 to <25.8 and ≥25.8 kg/m2.
During the follow-up period, 136 all-cause and 108 breast cancer-specific deaths were observed. After adjustment for clinical and confounding factors, higher BMI was associated with an increased risk of all-cause death (HR = 2.61; 95% CI: 1.01-6.78 for BMI ≥25.8 vs. ≥21.2 to <23.3 kg/m2) among premenopausal patients. According to hormonal receptor status, BMI ≥25.8 kg/m2 was associated with breast cancer-specific death (HR = 4.95; 95% CI: 1.05-23.35) and BMI <21.2 kg/m2 was associated with all-cause (HR = 2.91; 95% CI: 1.09-7.77) and breast cancer-specific death (HR = 7.23; 95% CI: 1.57-33.34) among patients with ER + or PgR + tumors. Analysis by hormonal receptor status also showed a positive association between BMI and mortality risk among patients with ER + or PgR + tumors and with BMI ≥21.2 kg/m2 (p for trend: 0.020 and 0.031 for all-cause and breast cancer-specific death, respectively).
Our results suggest that both higher BMI and lower BMI are associated with an increased risk of mortality, especially among premenopausal patients or among patients with hormonal receptor positive tumors. Breast cancer patients should be informed of the potential importance of maintaining an appropriate body weight after they have been diagnosed.
BMC Cancer 04/2012; 12:149. · 3.01 Impact Factor
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ABSTRACT: Being breastfed in infancy has been hypothesized to influence subsequent breast cancer risk. In a hospital-based case-control study, we investigated the relationship between having been breastfed and breast cancer risk, both overall and separately among female subjects with different birth years.
The study subjects included 571 cases and 2,155 controls admitted to a single hospital in Miyagi Prefecture, Japan, between 1997 and 2005. History of having been breastfed was assessed with a self-administered questionnaire. Odds ratios (ORs) and 95% confidence interval (CI) were estimated using logistic regression.
After adjustment for known risk factors, no association for having been breastfed was observed overall (OR = 1.20; 95% CI: 0.82-1.76). Analysis stratified according to birth year (<1950, ≥1950) demonstrated heterogeneity in the association for having been breastfed between the two birth-year groups (p for interaction = 0.0006); having been breastfed was significantly associated with a decreased risk among subjects who were born before 1950 (OR = 0.59; 95% CI: 0.35-0.99), whereas no such risk reduction was observed for subjects born after 1950 (OR = 1.60; 95% CI: 0.88-2.90).
Although having been breastfed is not related to overall risk, birth year may modify the association between having been breastfed in infancy and breast cancer risk. In Japan, sociodemographic changes have occurred since the end of World War II. The use of standard formula supplement began to spread around 1950. The difference of breast cancer risk between birth-year groups may be attributable to these environmental changes.
Cancer Causes and Control 12/2011; 23(2):389-98. · 2.88 Impact Factor
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ABSTRACT: Intakes of selected vitamins and dietary fiber may influence the clinical course of systemic lupus erythematosus (SLE). Using a cohort study method, we investigated the associations of dietary intake of vitamin B6 and B12, folate, and dietary fiber with the risk of active disease and atherosclerotic vascular events in SLE.
The study included female SLE patients in the Miyagi Lupus Cohort, which was founded in 1995. Dietary nutrients at baseline were estimated by a semiquantitative food frequency questionnaire. The association of each nutrient intake with the risk of active disease was investigated in 216 patients who had inactive disease at baseline. The association with atherosclerotic vascular events was assessed in 196 women who had inactive disease and no history of atherosclerotic diseases at baseline.
Forty-three cases of active disease were identified during 9966 person-months of follow-up (1995-1999). During 19 575 person-months of follow-up (1995-2005), 20 atherosclerotic vascular events were documented. The Cox proportional hazards model revealed an inverse association between vitamin B6 intake and the risk of active disease (hazard ratio for the highest as compared with the lowest tertile, 0.41; 95% confidence interval, 0.18-0.97; P for trend = 0.04). An inverse association was also found for dietary fiber intake (P for trend = 0.01). However, no significant association was observed between intakes of these nutrients and the risk of atherosclerotic vascular events.
Higher intake of vitamin B6 and dietary fiber may prevent the occurrence of active disease in SLE.
Journal of Epidemiology 04/2011; 21(4):246-54. · 1.86 Impact Factor
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ABSTRACT: Alcohol consumption is known to be a risk factor for breast cancer in Western countries, but few epidemiologic data have been available in Japan. This population-based prospective cohort study evaluated the associations of alcohol consumption with breast cancer risk in a Japanese population. A total of 19,227 women aged 40-64 years were followed from 1990 to 2003. During 246,703 person-years of follow-up, 241 breast cancer cases were identified. Hazard ratios (HRs) were estimated by the Cox proportional-hazard regression model. After adjustment for potential risk factors of breast cancer and nutritional factors, the HR and 95% confidence interval (CI) for current drinkers was 1.00 (0.74-1.34) compared with never drinkers. According to the amount of alcohol intake per day, a higher amount (≥15.0 g/day) had no significant relation to breast cancer risk (HR = 0.87, 95% CI: 0.40-1.91; P for trend = 0.85). Age upon starting to drink, and the frequency of drinking, were not associated with breast cancer risk. In analysis stratified according to exogenous female hormone use, a higher alcohol intake (≥15.0 g/day) was associated with an increased risk of breast cancer among hormone users (HR = 1.67, 95% CI: 0.17-16.73); however, this was not statistically significant. Stratification according to folate intake with energy adjustment (<219, ≥ 219 μg/day) found that breast cancer risk tended to increase with increasing alcohol consumption among women with a low intake of folate (P for trend = 0.09). Our findings suggest that alcohol consumption has no overall effect on breast cancer risk among Japanese women, whereas nutritional factors such as folate intake may modify the alcohol-breast cancer risk relationship.
Breast Cancer Research and Treatment 02/2011; 128(3):817-25. · 4.43 Impact Factor
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ABSTRACT: The incidence of breast cancer among Japanese women is substantially increasing. This population-based prospective cohort study in Japan evaluated the associations of reproductive factors and exogenous female hormone use with breast cancer risk, both overall and separately among premenopausal and postmenopausal women. A total of 24,064 women aged 40-64 were followed from 1990 to 2003. During 309,424 person-years of follow-up, 285 breast cancer cases were documented. In overall evaluation, nulliparity was significantly associated with an increased risk of breast cancer. There was a significant decrease in risk with increasing parity number among parous women (trend P = 0.008). No association was observed between age at menarche or age at first birth and breast cancer risk. Neither oral contraceptive (OC) use nor the use of exogenous female hormones other than OC was associated with breast cancer risk. The evaluation according to menopausal status revealed that nulliparity and parity number were significantly related to breast cancer risk only among postmenopausal women. Later age at natural menopause was associated with an increased risk of breast cancer among postmenopausal women (trend P = 0.02). Our findings suggest that parity number and age at menopause have great effects on breast cancer risk among Japanese women.
Cancer Causes and Control 10/2009; 21(1):135-45. · 2.88 Impact Factor
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Yukika Kakuta,
Naoki Nakaya,
Satoru Nagase,
Megumi Fujita,
Toshimitsu Koizumi,
Chikako Okamura,
Hitoshi Niikura,
Kaori Ohmori,
Shinichi Kuriyama,
Toru Tase,
Kiyoshi Ito, Yuko Minami,
Nobuo Yaegashi,
Ichiro Tsuji
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ABSTRACT: To investigate the association between green tea consumption and the risk of endometrial cancer restricted to endometrial endometrioid adenocarcinoma (EEA) using a case-control design in Japan.
The cases were 152 patients with histopathologically diagnosed EEA, and the controls were 285 healthy women who were matched for age and area of residence with individual cases. The subjects completed a questionnaire regarding health-related lifestyle and reproductive history, and a food frequency questionnaire. Odds ratios (ORs) of EEA for frequency of green tea consumption were calculated by conditional logistic regression analysis.
We observed a significant inverse association between green tea consumption and the risk of EEA with a dose-response relationship. The multivariate-adjusted OR of EEA was 0.77 (95% CI: 0.37-1.58) for those in the second quartile of green tea consumption (5-6 cups/week-1 cup/day), 0.61 (0.30-1.23) in the third quartile (2-3 cups/day), and 0.33 (0.15-0.75) in the highest quartile (> or = 4 cups/day), as referenced with those in the lowest quartile (< or = 4 cups/week; p for trend = 0.007). This inverse association was consistently observed regardless of the presence or absence of factors such as obesity and menopause.
Green tea consumption may be associated with a lower risk of EEA.
Cancer Causes and Control 01/2009; 20(5):617-24. · 2.88 Impact Factor
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ABSTRACT: During recent decades, the incidence of gynecologic cancers, i.e., cancers of the cervix, endometrium and ovary, has increased in Japan. However, risk factors of gynecologic cancers have not been fully clarified in Japan. To investigate common and site-specific risk factors among gynecologic cancers, we conducted a hospital-based case-control study. The cases, i.e., 151 cervical, 103 endometrial and 141 ovarian cancer cases and the controls (n = 2016) were selected from female patients aged 30 and over, who were admitted to a single hospital in Miyagi Prefecture from 1997 to 2003. Information on reproductive factors, exogenous hormone use, and lifestyles including smoking was collected using a self-administered questionnaire. Smoking was significantly associated with an increased risk of cervical cancer. A dose-response relationship with the number of cigarettes per day was also observed (p for trend = 0.004). Older age at menarche was associated with a decreased risk of endometrial and ovarian cancers. For these cancers, the decreased risk was detected with increasing parity number (endometrium, p for trend = 0.0001; ovary, p = 0.0002). There was no significant association between exogenous hormone use and gynecologic cancer risk. The results indicate that smoking is a major risk factor of cervical cancer. In addition, hormonal factors, which are related to early onset of menarche and low parity, are common risk factors for endometrial and ovarian cancers. The increase in female smokers and the decrease in fertility rate may contribute to the increase in gynecologic cancer incidence in Japan.
The Tohoku Journal of Experimental Medicine 01/2009; 216(4):297-307. · 1.24 Impact Factor
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ABSTRACT: Height and early-life environments have received attention as risk factors for prostate cancer. However, the evidence is sparse in Japan. To elucidate the associations of height and early-life factors with prostate cancer risk in Japanese men, we conducted a hospital-based case-control study. In addition, to investigate whether the associations vary between prostate cancer and other major cancers, we conducted a comparative study within the same case-control study.
Study subjects consisted of 282 prostate cancer cases, 584, 461, 231, and 156 male stomach, lung, colon and rectal cancer cases, respectively, and 1730 male hospital controls, aged 50 and over admitted to a single hospital in Miyagi Prefecture from 1997 to 2003. Information on height and early-life factors including birthplace and stature at 12 years was collected using a self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for each exposure variable.
A significant positive association was found between height and prostate cancer risk (OR, 1.52; 95% CI, 1.00-2.31, between the highest and lowest quartiles; P for trend = 0.03). A significant association of urban-born with prostate cancer risk was also found (OR, 1.48; 95% CI, 1.03-2.13). Analyses by stage revealed that height might be more strongly associated with the risk of advanced prostate cancer. For other major cancers, no significant association with height and early-life factors was observed.
Height and early-life factors were significantly associated with prostate cancer risk. Compared with other major cancers, these associations were specific to prostate cancer.
Japanese Journal of Clinical Oncology 04/2008; 38(3):205-13. · 1.78 Impact Factor
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Nippon rinsho. Japanese journal of clinical medicine 07/2007; 65 Suppl 6:22-6.
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ABSTRACT: It is hypothesized that breast cancer may consist of heterogeneous diseases with different hormonal environments classified by hormone receptor status. Epidemiologic studies evaluating risk factors for breast cancer by hormone receptor status have supported the hypothesis. However, there are inconsistencies in the risk factor profiles by estrogen receptor (ER) and progesterone receptor (PR) across the studies. To clarify the heterogeneity of the disease, it is necessary to understand not only risk factor profiles but also the biologic characteristics such as the relationships among endogenous sex hormone levels and hormone receptors.
We measured serum levels of estrone (E1), estradiol (E2), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) in 142 postmenopausal women aged 50 and over with primary breast cancer who had undergone surgical treatment, and investigated the heterogeneity in the relations of endogenous sex hormone levels to hormone receptor status, using the case-series study method. Subjects were categorized into 3 classes based on tertiles of each hormone level in receptor-negative subjects, and odds ratios (ORs) for receptor-positive status compared with receptor-negative status were computed, taking the lowest category as a reference category.
There were clear trends toward higher serum levels of E1, E2, and DHEAS in women with PR+ cancer. The case-series approach revealed that PR+ status might be strongly associated with serum sex hormone levels. In particular, the OR of PR+ was large for a high DHEAS level (OR for the highest category=4.28). No significant association between serum hormone levels and ER status was observed.
The association of serum sex hormone levels with hormone receptor status may differ by PR status, but not by ER status. This finding suggests that PR status may be related to the heterogeneity in hormonal environments associated with breast cancer risk.
Breast Cancer 02/2007; 14(3):269-76. · 1.36 Impact Factor
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ABSTRACT: During recent decades, colorectal cancer incidence rates have been rapidly increasing in Japan. To investigate trends in colorectal cancer incidence rates, we analyzed incidence data during 39 years between 1959 and 1997 in Miyagi Prefecture, Japan.
Using age-period-cohort models, we evaluated the effects of time period and cohort on colon and rectal cancer incidence. Model fitting was based on eleven 5-year age groups (30-34 to 80-84), eight 5-year time periods, and 18 overlapping birth cohorts of 10 years each.
The analysis found a significant (p=0.04) and upward period effect on female colon cancer incidence, and a significant (p<0.01) and upward cohort effect on male colon cancer incidence. An upward period effect was also observed for male colon cancer incidence without significance. For rectal cancer incidence, a significant cohort effect was found among both males and females.
In light of known risk factors of colorectal cancer, the effects of period and cohort might be related to the change in the prevalence of risk factors such as high intake of meat and animal fat, and obesity. The improved diagnostic procedures including the spread of cancer screening might be responsible for the period effect. Although the significant cohort effects may give a caution for a continuous increase of colorectal cancer incidence, the future trend may be influenced by the period-related factors. Successive monitoring of cancer incidence and prevalence of risk factors is required.
Journal of Epidemiology 12/2006; 16(6):240-8. · 1.86 Impact Factor
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ABSTRACT: During recent decades, breast cancer incidence has been increasing in Japan. According to the latest reports from several cancer registries in Japan, the breast has become the leading cancer site in female cancer incidence. To analyze the trend of breast cancer incidence in detail, we summarized female breast cancer incidence in Miyagi Prefecture, Japan during 1959-1997, and evaluated the period and cohort effect on breast cancer incidence using the age-period-cohort model. Age-specific and age-standardized rates have increased over successive calendar periods. Around 1980, an accelerated increase in these incidence rates took place. A full model including age, period and cohort was best fitted to the trend of incidence. In the model, the effects of period and cohort were statistically significant. The nonlinear effect for cohort indicates an increasing trend, beginning with the cohort in 1888-1897, and the nonlinear effect for period showed a clear increase in risk with calendar period. Furthermore, the full model including a linear component showed a steadily upward trend in the cohort effect. Based on our own epidemiologic studies previously conducted in Miyagi Prefecture, and other published reports, the cohort effect is likely to be related to the change in prevalence of women with risk factors such as low parity and insufficient breastfeeding. We believe that the emergence of the cohort effect is an important finding, although the period effect may also persist. The significant cohort effect may give a caution for continuous increase of breast cancer incidence in Japan.
International Journal of Cancer 04/2004; 108(6):901-6. · 5.44 Impact Factor
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ABSTRACT: Although cigarette smoking is a well-known risk factor of lung cancer, associations of cigarette smoking with the risk of other sites have not been fully elucidated in Japan. To simultaneously evaluate the associations of cigarette smoking with the risks of cancers of the stomach, lung, colon, and rectum, which have been the leading cancer sites in recent years in Miyagi Prefecture, Japan, we conducted a hospital-based case-control study. Study subjects consisted of 614 stomach, 515 lung, 324 colon, and 164 rectal cancer cases and 2444 hospital controls admitted to a single hospital in Miyagi Prefecture from 1997 to 2001. Information on smoking habit and other lifestyle factors was collected using a self-administered questionnaire. Distributions of referral base among cases and controls were also investigated. For each site, odds ratios (ORs) and 95% confidence intervals (95% CIs) for smoking habit were estimated with adjustment for age, year of survey, history of alcohol drinking, family history of index cancer, and occupational history, respectively, using an unconditional logistic regression model. Cigarette smoking (ever vs. never) was associated with an increased risk of stomach (OR = 1.62; 95% CI 1.20-2.19) and lung (OR = 3.82; 95% CI 2.49-5.86) cancer among males and lung cancer among females (OR = 2.02; 95% CI 1.28-3.18). For female stomach cancer, the association with cigarette smoking was uncertain (OR = 0.65, P = 0.1533). For rectal cancer, a significant increased risk was observed in both-sex-combined analysis. There was no association between cigarette smoking and the risk of colon cancer. Detailed analysis showed that the association of cigarette smoking with cancer risk might be modified by the patient referral pattern, i.e., screened or not screened. The present results indicate that the association of cigarette smoking with cancer risk may differ among sites and sexes. In terms of the population attributable risk, a large proportion of leading cancers in males appears to be related to cigarette smoking.
Cancer Science 07/2003; 94(6):540-7. · 3.33 Impact Factor
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ABSTRACT: To investigate the associations of dietary factors with the occurrences of active disease and vascular damage in female patients with systemic lupus erythematosus (SLE).
Clinical and questionnaire data were collected from 279 female patients with SLE in a 1995 baseline survey. Dietary nutrients were estimated by a semiquantitative food frequency questionnaire and disease activity was evaluated based on the Lupus Activity Criteria Count. Patients were followed over 4 years (1995-99) and changes in disease activity and occurrences of major organ damage were determined. Using data from 216 patients with inactive disease whose dietary data were complete at baseline, the association of each nutrient intake with occurrence of active disease was evaluated. The relation of diet with the development of 3 types of vascular injury (ischemic heart disease, cerebrovascular accident, thrombotic events) was examined in 196 patients who had been inactive with no history of these injuries. Patients who developed these vascular events were put in one category and nutrient intakes at baseline were compared between patients who did or did not develop vascular events.
A total of 9966 person-months were accumulated from the 216 inactive patients, among whom 43 patients developed active disease. The proportional hazard model including indicator variables for tertiles of each nutrient, total energy, and confounding variables revealed an inverse association of intake of vitamin C (p for trend = 0.005) and crude fiber (p for trend = 0.06) with the risk of active disease. The inverse association with vitamin C intake was also significant after Bonferroni adjustment. Patients who developed vascular events (n = 7) consumed a greater amount of vegetable fat at baseline than patients who did not (p = 0.04).
Our findings suggest that dietary nutrients may modify clinical course of disease in female patients with SLE. Vitamin C intake is inversely associated with the risk of active disease, suggesting that vitamin C intake may prevent the occurrence of active SLE disease.
The Journal of Rheumatology 05/2003; 30(4):747-54. · 3.69 Impact Factor
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ABSTRACT: Psychological factors have been suspected to be associated with the development of systemic lupus erythematosus (SLE) and patient's health status. However, psychological profiles among Japanese patients with SLE have been poorly understood. We started a prospective study of female patients with SLE in 1995. Using the baseline data from 279 patients in this prospective study, we cross-sectionally analyzed the relations of clinical factors and social factors to psychological factors, and the association between psychological factors and mental and physical health status. We used the Japanese notion ikigai as an indicator of mental health, and ambulatory activity as an indicator of their physical health, respectively. To measure psychological factors, the short-form of the Eysenck Personality Questionnaire-Revised (short EPQ-R) and the Multidimensional Health Locus of Control (HLOC) scale were used. Active phase of the disease was significantly related to the neuroticism score in the short EPQ-R. Educational level was inversely related to the scores of powerful others and chance HLOC belief. As for health status, the internal HLOC belief was significantly associated with ikigai, and the chance HLOC belief was inversely associated with ambulatory activity. The scores on the short EPQ-R (Extraversion/Introversion and Neuroticism) were exclusively related to ikigai. This study suggests that psychological factors may have effects on both the development of SLE and patient's health status.
Journal of Epidemiology 04/2002; 12(2):55-63. · 1.86 Impact Factor
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ABSTRACT: Background Previous studies indicated that serum β-carotene levels were low among smokers and drinkers. However these findings may result from the strong relationship between smoking and drinking. Methods Data were collected from 1902 males randomly selected from participants of a cohort study. The effects of smoking on serum β-carotene levels were assessed according to drinking status (non-drinker, ex-drinker and current drinker), and those of drinking were assessed according to smoking status (non-smoker, ex-smoker and current smoker) using general linear model including other factors (age, intake of green-yellow vegetables, intake of carrot or pumpkin, body mass index, serum cholesterol levels). Results An inverse dose-response relationship between daily consumption of alcohol and β-carotene levels was observed regardless of smoking status, and also between number of cigarettes smoked per day and β-carotene levels regardless of drinking status. Conclusions These results suggest that cigarette smoking and alcohol drinking reduce β-carotene levels independently.
