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Plasma Tocopherol and Prevalence of Colorectal Adenomas in a Multiethnic Population¹

Department of Preventive Medicine, University of Southern California/Norris Cancer Center, Los Angeles, California 90033 [S. A. I., C. L. B., R. W. H.]; University of Alabama, Birmingham, Alabama 35213 [J. M. S.]; Division of Gastroenterology, Sunset Kaiser Permanente Medical Center, Los Angeles, California 90027 [H. D. F.]; and Division of Gastroenterology, Bellflower Kaiser Permanente Medical Center, Los Angeles, California 90706 [E. R. L.]

Although vitamin E can block mutagenesis and cell transformation in vitro and can reduce the number of chemically induced colonic adenomas in mice, previous clinical trials have found no protective effect of vitamin E supplements against colorectal adenomas, and epidemiological studies have found only weak protective effects of dietary or plasma -tocopherol against colorectal cancer. We previously examined first diagnosis of colorecta ladenomas in a sigmoidoscopy screening population and failed to find a protective effect of dietary vitamin E. Because measurements of dietary intake may not be a good proxy of vitamin E status, we assayed plasma - and -tocopherol concentration for 332 subjects with colorectal adenomas and 363 control subjects from this previous sigmoidoscopy-based study. Increasing -tocopherol and decreasing -tocopherol levels were associated with decreased occurrence of large (1 cm) but not of small (<1 cm) adenomas; however, after adjustment for potential confounding variables, these trends were not statistically significant. A strong trend (P = 0.02) was observed by using the -tocopherol: -tocopherol ratio, which may be a more sensitive indicator of -tocopherol intake. Subjects in the highest versus lowest quintile of -tocopherol: -tocopherol ratio had an odds ratio of 0.36 (95% confidence interval, 0.14–0.95) for large adenomas. The finding that a high -tocopherol: -tocopherol ratio is associated with decreased occurrence of large, but not of small, colorectal adenomas is consistent with previous findings that -tocopherol may be protective against colon cancer. A high plasma -tocopherol: -tocopherol ratio may be a better predictor of decreased cancer risk than high plasma -tocopherol alone.

¹ Supported by USPHS Grants CA51923 and CA42710 from the National Cancer Institute, NIH, Department of Health and Human Services.

² To whom requests for reprints should be addressed, at Department of Preventive Medicine, University of Southern California/Norris Cancer Center, 1441 Eastlake Avenue, MS#44, Room 5411, Los Angeles, CA 90033. Phone: (213) 764-0498; Fax: (213) 764-0140; E-mail: ingles@hsc.usc.edu.

Received 8/ 5/97. Accepted 12/12/97.

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