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. 1999 Mar;79(9-10):1448–1453. doi: 10.1038/sj.bjc.6690231

Randomized double-blind trial of beta-carotene and vitamin C in women with minor cervical abnormalities

D Mackerras 1,2, L Irwig 1, J M Simpson 1, E Weisberg 3, M Cardona 1, F Webster 1, L Walton 1, D Ghersi 1
PMCID: PMC2362702  PMID: 10188889

Abstract

A double-blind, placebo-controlled, randomized, factorial study using a daily oral administration of 30 mg beta-carotene and/or 500 mg vitamin C was conducted in 141 women with colposcopically and histologically confirmed minor squamous atypia or cervical intra-epithelial neoplasia (CIN) I. Over approximately 2 years of follow-up, 43 lesions regressed to normal and 13 progressed to CIN II. The regression rate was slightly higher, but not significantly so, in those randomized to beta-carotene compared to no beta-carotene (hazard ratio = 1.58, 95% CI: 0.86–2.93, P = 0.14) and slightly lower, but not statistically significant, for those randomized to vitamin C compared to no vitamin C (hazard ratio = 0.65, 95% CI: 0.35–1.21, P = 0.17). In a model with no interaction, the progression rate was slightly higher in those randomized to beta-carotene (hazard ratio = 1.75, 95% CI: 0.57–5.36, P = 0.32) and also in those randomized to vitamin C (hazard ratio = 2.40, 95% CI: 0.74–7.80, P = 0.13). Neither of these were statistically significant. However, there was some evidence of an interaction effect of the two compounds on the progression rate (P = 0.052), with seven of the progressed lesions occurring in those randomized to both vitamins compared to a total of six in the three other groups. The currently available evidence from this and other trials suggests that high doses of these compounds are unlikely to increase the regression or decrease the progression of minor atypia and CIN I. © 1999 Cancer Research Campaign

Keywords: cervical dysplasia, neoplasm, beta-carotene, vitamin C, randomized controlled trial

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Selected References

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  1. Block G., Patterson B., Subar A. Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr Cancer. 1992;18(1):1–29. doi: 10.1080/01635589209514201. [DOI] [PubMed] [Google Scholar]
  2. Block G. Vitamin C and cancer prevention: the epidemiologic evidence. Am J Clin Nutr. 1991 Jan;53(1 Suppl):270S–282S. doi: 10.1093/ajcn/53.1.270S. [DOI] [PubMed] [Google Scholar]
  3. Brown E. D., Micozzi M. S., Craft N. E., Bieri J. G., Beecher G., Edwards B. K., Rose A., Taylor P. R., Smith J. C., Jr Plasma carotenoids in normal men after a single ingestion of vegetables or purified beta-carotene. Am J Clin Nutr. 1989 Jun;49(6):1258–1265. doi: 10.1093/ajcn/49.6.1258. [DOI] [PubMed] [Google Scholar]
  4. Butterworth C. E., Jr, Hatch K. D., Gore H., Mueller H., Krumdieck C. L. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr. 1982 Jan;35(1):73–82. doi: 10.1093/ajcn/35.1.73. [DOI] [PubMed] [Google Scholar]
  5. Campion M. J., McCance D. J., Cuzick J., Singer A. Progressive potential of mild cervical atypia: prospective cytological, colposcopic, and virological study. Lancet. 1986 Aug 2;2(8501):237–240. doi: 10.1016/s0140-6736(86)92067-2. [DOI] [PubMed] [Google Scholar]
  6. DeCosse J. J., Miller H. H., Lesser M. L. Effect of wheat fiber and vitamins C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst. 1989 Sep 6;81(17):1290–1297. doi: 10.1093/jnci/81.17.1290. [DOI] [PubMed] [Google Scholar]
  7. Garewal H., Meyskens F., Jr, Friedman S., Alberts D., Ramsey L. Oral cancer prevention: the case for carotenoids and anti-oxidant nutrients. Prev Med. 1993 Sep;22(5):701–711. doi: 10.1006/pmed.1993.1064. [DOI] [PubMed] [Google Scholar]
  8. Gerster H. Beta-carotene, vitamin E and vitamin C in different stages of experimental carcinogenesis. Eur J Clin Nutr. 1995 Mar;49(3):155–168. [PubMed] [Google Scholar]
  9. Greenberg E. R., Baron J. A., Karagas M. R., Stukel T. A., Nierenberg D. W., Stevens M. M., Mandel J. S., Haile R. W. Mortality associated with low plasma concentration of beta carotene and the effect of oral supplementation. JAMA. 1996 Mar 6;275(9):699–703. doi: 10.1001/jama.1996.03530330043027. [DOI] [PubMed] [Google Scholar]
  10. Greenberg E. R., Baron J. A., Tosteson T. D., Freeman D. H., Jr, Beck G. J., Bond J. H., Colacchio T. A., Coller J. A., Frankl H. D., Haile R. W. A clinical trial of antioxidant vitamins to prevent colorectal adenoma. Polyp Prevention Study Group. N Engl J Med. 1994 Jul 21;331(3):141–147. doi: 10.1056/NEJM199407213310301. [DOI] [PubMed] [Google Scholar]
  11. Hennekens C. H., Buring J. E., Manson J. E., Stampfer M., Rosner B., Cook N. R., Belanger C., LaMotte F., Gaziano J. M., Ridker P. M. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med. 1996 May 2;334(18):1145–1149. doi: 10.1056/NEJM199605023341801. [DOI] [PubMed] [Google Scholar]
  12. MacLennan R., Macrae F., Bain C., Battistutta D., Chapuis P., Gratten H., Lambert J., Newland R. C., Ngu M., Russell A. Randomized trial of intake of fat, fiber, and beta carotene to prevent colorectal adenomas. J Natl Cancer Inst. 1995 Dec 6;87(23):1760–1766. doi: 10.1093/jnci/87.23.1760. [DOI] [PubMed] [Google Scholar]
  13. Manetta A., Schubbert T., Chapman J., Schell M. J., Peng Y. M., Liao S. Y., Meyskens F. J., Jr beta-Carotene treatment of cervical intraepithelial neoplasia: a phase II study. Cancer Epidemiol Biomarkers Prev. 1996 Nov;5(11):929–932. [PubMed] [Google Scholar]
  14. McKeown-Eyssen G., Holloway C., Jazmaji V., Bright-See E., Dion P., Bruce W. R. A randomized trial of vitamins C and E in the prevention of recurrence of colorectal polyps. Cancer Res. 1988 Aug 15;48(16):4701–4705. [PubMed] [Google Scholar]
  15. McLarty J. W., Holiday D. B., Girard W. M., Yanagihara R. H., Kummet T. D., Greenberg S. D. Beta-Carotene, vitamin A, and lung cancer chemoprevention: results of an intermediate endpoint study. Am J Clin Nutr. 1995 Dec;62(6 Suppl):1431S–1438S. doi: 10.1093/ajcn/62.6.1431S. [DOI] [PubMed] [Google Scholar]
  16. Morrison B. W., Erickson E. R., Doshi N., Russo J. F. The significance of atypical cervical smears. J Reprod Med. 1988 Oct;33(10):809–812. [PubMed] [Google Scholar]
  17. Niki E., Noguchi N., Tsuchihashi H., Gotoh N. Interaction among vitamin C, vitamin E, and beta-carotene. Am J Clin Nutr. 1995 Dec;62(6 Suppl):1322S–1326S. doi: 10.1093/ajcn/62.6.1322S. [DOI] [PubMed] [Google Scholar]
  18. Omenn G. S., Goodman G. E., Thornquist M. D., Balmes J., Cullen M. R., Glass A., Keogh J. P., Meyskens F. L., Valanis B., Williams J. H. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996 May 2;334(18):1150–1155. doi: 10.1056/NEJM199605023341802. [DOI] [PubMed] [Google Scholar]
  19. Pepe M. S., Mori M. Kaplan-Meier, marginal or conditional probability curves in summarizing competing risks failure time data? Stat Med. 1993 Apr 30;12(8):737–751. doi: 10.1002/sim.4780120803. [DOI] [PubMed] [Google Scholar]
  20. Potischman N. Nutritional epidemiology of cervical neoplasia. J Nutr. 1993 Feb;123(2 Suppl):424–429. doi: 10.1093/jn/123.suppl_2.424. [DOI] [PubMed] [Google Scholar]
  21. Romney S. L., Ho G. Y., Palan P. R., Basu J., Kadish A. S., Klein S., Mikhail M., Hagan R. J., Chang C. J., Burk R. D. Effects of beta-carotene and other factors on outcome of cervical dysplasia and human papillomavirus infection. Gynecol Oncol. 1997 Jun;65(3):483–492. doi: 10.1006/gyno.1997.4697. [DOI] [PubMed] [Google Scholar]
  22. Roncucci L., Di Donato P., Carati L., Ferrari A., Perini M., Bertoni G., Bedogni G., Paris B., Svanoni F., Girola M. Antioxidant vitamins or lactulose for the prevention of the recurrence of colorectal adenomas. Colorectal Cancer Study Group of the University of Modena and the Health Care District 16. Dis Colon Rectum. 1993 Mar;36(3):227–234. doi: 10.1007/BF02053502. [DOI] [PubMed] [Google Scholar]
  23. Steinmetz K. A., Potter J. D. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control. 1991 Sep;2(5):325–357. doi: 10.1007/BF00051672. [DOI] [PubMed] [Google Scholar]
  24. de Vet H. C., Knipschild P. G., Willebrand D., Schouten H. J., Sturmans F. The effect of beta-carotene on the regression and progression of cervical dysplasia: a clinical experiment. J Clin Epidemiol. 1991;44(3):273–283. doi: 10.1016/0895-4356(91)90039-c. [DOI] [PubMed] [Google Scholar]

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