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Serum Vitamin A and Subsequent Development of Prostate Cancer in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study¹

Cancer Prevention Studies Branch, Division of Cancer Prevention and Control [M. E. R., A. S., P. R. T.], and Epidemiology and Biostatistics Program, Division of Cancer Etiology [R. B. H., R. G. Z., J. F. F.], National Cancer Institute, Bethesda, Maryland 20892; and Information Management Services, Silver Spring, Maryland 20910 [L. L. K.]

The relation between serum vitamin A measurements made at baseline examination (1971–1975) and subsequent development of prostate cancer was examined in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (1981–1984). The analytic cohort consisted of 2440 men 50 years of age or older who were followed for a median of 10 years. A total of 84 men developed prostate cancer. The mean level of serum vitamin A was significantly lower (P < 0.01) in prostate cancer cases than in noncases. Considered as a continuous variable or in quartiles, a statistically significant (P < 0.005 or P < 0.02, respectively) trend was observed for increased risk of prostate cancer with decreasing levels of serum vitamin A. Adjusted for age and race, men in the lowest quartile had a relative risk of 2.2 (95% confidence intervals, 1.1, 4.3) compared to those in the highest quartile. The elevated risk of prostate cancer associated with the lowest quartile of serum vitamin A levels did not attenuate with increasing time between blood drawing and diagnosis, suggesting that metabolic effects of early disease are an unlikely explanation of these results. The inverse association between serum vitamin A and prostate cancer incidence was independent of age at examination and several other possible confounding variables. This is the first prospective study of serum vitamin A and prostate cancer to include a large (84) number of cases.

¹ The NHANES I Epidemiologic Follow-up Study has been developed and funded by these agencies: National Institute on Aging; National Center for Health Statistics; National Cancer Institute; National Heart, Lung, and Blood Institute; National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases; National Institute of Mental Health; National Institute of Alcohol Abuse and Alcoholism; National Institute of Allergy and Infectious Disease; and National Institute of Neurological and Communicative Disorders and Stroke. The field work was conducted by Westat, Inc., under Contract 23380-2049.

² To whom requests for reprints should be addressed, at National Cancer Institute, NIH, 9000 Rockville Pike, EPN 211, Bethesda, MD 20892.

Received 9/28/89. Revised 1/ 9/90.

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