THE ASSOCIATION OF PLASMA MICRONUTRIENTS WITH THE RISK OF CERVICAL DYSPLASIA IN HAWAII

Limited data from hematological studies suggest that certain nutrients , including carotenoids, tocopherols, and vitamin C, may protect again st malignant change in cervical tissue. Recognizing that human papillo mavirus (HPV) infection induces most neoplastic transformation of cerv ical tissue, the authors conducted a case-control study to examine the association of plasma micronutrient concentrations with the risk of c ervical dysplasia after careful adjustment for HPV infection, using a sensitive and reliable HPV detection method. The sample included 147 m ultiethnic women, between 18 and 65 years of age, with biopsy-confirme d squamous intraepithelial lesions (SILs) of the cervix and 191 clinic controls identified between 1992 and 1996. Cases were identified thro ugh cytology and pathology logs in three clinics on Oahu, Hawaii. Cont rols were selected randomly from admission logs of the participating c linics. In-person interviews were conducted in the subjects' homes, an d a fasting blood sample was drawn to measure plasma levels of lutein, lycopene, cryptoxanthin, total carotene, retinol, tocopherol, ascorbi c acid, and cholesterol. The presence and type of HPV was determined i n exfoliated cell samples using PCR dot blot hybridization. Mean plasm a lycopene, total cryptoxanthin, and alpha-cryptoxanthin levels were l ower among cases than controls. We found an inverse dose-response of a lpha-cryptoxanthin, total tocopherol, and alpha-tocopherol to the odds ratios for cervical SIL after adjustment for HPV and other confounder s. The odds ratio among women in the highest compared with the lowest quartile was 0.3 (95% confidence interval, 0.1-0.7) for alpha-cryptoxa nthin and 0.3 (95% confidence interval, 0.1-0.8) for alpha-tocopherol. Negative trends in the odds ratios were suggested for other carotenoi ds and vitamin C, but these were weak, and confidence intervals were w ide. Our results support existing evidence that high plasma levels of antioxidants may reduce the risk of cervical SILs independent of HPV i nfection. These findings are significant because diet is potentially m odifiable, and nutrition education and dietary intervention might be t argeted at specific highrisk groups.