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Serum Carotenoids and Risk of Cervical Intraepithelial Neoplasia in Southwestern American Indian Women¹

University of Washington, Department of Epidemiology, Seattle, Washington 98115 [M. A. S.]; Fred Hutchinson Cancer Research Center, Cancer Prevention Research Program, Seattle, Washington 98109 [M. A. S., R. E. P.]; University of New Mexico School of Medicine, Department of Internal Medicine, Albuquerque, New Mexico 87131 [R. N. B.]; First Choice Community Health Clinic, Los Lunas, New Mexico 87031 [M. M.]; Rehoboth Medical Center, Gallup, New Mexico 87301 [L. v. A-K.]; University of New Mexico Health Sciences Center, Department of Molecular Genetics and Microbiology, Albuquerque, New Mexico 87131 [C. M. W.]; and Oregon Health Sciences University, Department of Public Health and Preventive Medicine, Portland, Oregon 97201 [T. M. B.]

The objective of this research was to evaluate the association between serum carotenoids and cervical intraepithelial neoplasia (CIN) among Southwestern American Indian women. Cases were American Indian women with biopsy-proven CIN II/III cervical lesions (n = 81) diagnosed between November 1994 and October 1997. Controls were American Indian women from the same clinics with normal cervical epithelium (n = 160). All of the subjects underwent interviews and laboratory evaluations. Interviews evaluated demographic information, sexual history, and cigarette smoking. Serum concentrations of -carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein/zeaxanthin were measured by high performance liquid chromatography. Cervical human papillomavirus infection was detected using a PCR-based test. Increasing levels of -carotene, ß-cryptoxanthin, and lutein/zeaxanthin were associated with decreasing risk of CIN II/III. In addition, the highest tertiles of ß-cryptoxanthin (odds ratio = 0.39, 95% confidence interval = 0.17–0.91) and lutein/zeaxanthin (odds ratio = 0.40, 95% confidence interval = 0.17–0.95) were associated with the lowest risk of CIN. In conclusion, specially targeted intervention efforts to increase consumption of fruits and vegetables may protect Southwestern American Indian women from developing CIN.

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