The effect of consumption of fruits, vegetables, and
antioxidants on the incidence of
gastric cancer is inconclusive. In this prospective cohort study, we report the association of dietary intake of fruits, vegetables,
antioxidants, and baseline serum levels of
antioxidants with subsequent incidence of gastric cardia
cancer (GCC) and gastric noncardia
cancer (GNCC). Participants of this study were 29,133 male smokers recruited into the
alpha-Tocopherol,
beta-Carotene Cancer Prevention study between 1985 and 1988. At baseline, a self-administered food use questionnaire with 276 food items was used to assess dietary intake. Baseline serum samples were stored at -70 degrees C. During a median follow-up of 12 years, 243 incident gastric
adenocarcinomas (64 GCC and 179 GNCC) were diagnosed in this cohort, of whom 220 (57 GCC and 163 GNCC) had complete dietary information. For GCC, high dietary intake of
retinol was protective [hazard ratio (HR), 0.46; 95% confidence interval (95% CI), 0.27-0.78], but high intake of
alpha-tocopherol (HR, 2.06; 95% CI, 1.20-3.54) and
gamma-tocopherol (HR, 1.94; 95% CI, 1.13-3.34) increased risk. For GNCC, higher intakes of fruits (HR, 0.51; 95% CI, 0.37-0.71),
vitamin C (HR, 0.60; 95% CI, 0.41-0.86),
alpha-tocopherol (HR, 0.78; 95% CI, 0.55-1.10),
gamma-tocopherol (HR, 0.69; 95% CI, 0.49-0.96), and
lycopene (HR, 0.67; 95% CI, 0.47-0.95) were protective. Our results suggest a difference in the effect of some of these exposures on GCC and GNCC.
Tocopherols were associated with higher risk of GCC, whereas dietary intake of fruits,
vitamin C,
tocopherols, and
lycopene seemed protective for GNCC.