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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Association between Dietary Tomato Intake and the Risk of Hepatocellular Carcinoma: The Singapore Chinese Health Study

Claire E. Thomas, Hung N. Luu, Renwei Wang, Jennifer Adams-Haduch, Aizhen Jin, Woon-Puay Koh and Jian-Min Yuan
Claire E. Thomas
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
2Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • ORCID record for Claire E. Thomas
Hung N. Luu
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
2Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • For correspondence: luuh@upmc.edu
Renwei Wang
2Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Jennifer Adams-Haduch
2Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Aizhen Jin
3Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.
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Woon-Puay Koh
3Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.
4Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Jian-Min Yuan
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
2Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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DOI: 10.1158/1055-9965.EPI-20-0051 Published July 2020
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Abstract

Background: Intake of tomato and/or lycopene has been associated with reduced risk of several cancers, but there is no report on the association with risk of hepatocellular carcinoma (HCC).

Methods: The associations of tomato and lycopene consumption with risk of HCC were examined in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese ages 45 to 74 years at enrollment. Diet was assessed using a validated semiquantitative food frequency questionnaire. Cox proportional hazard regression models were used to estimate HR and its 95% confidence interval (CI) of HCC with the consumption of tomato and lycopene among all cohort participants, and unconditional logistic regression was used to assess the association by hepatitis B surface antigen (HBsAg) positivity in a nested case–control study.

Results: After a mean follow-up of 17.6 years, 561 incident HCC cases were identified. Higher tomato intake was associated with lower risk of HCC after adjustment for potential confounders (Ptrend < 0.001). Compared with the lowest quartile, HRs (95% CIs) of HCC for the second, third, and fourth quartile of tomato intake were 0.70 (0.56–0.88), 0.73 (0.58–0.92), and 0.63 (0.49–0.81). Among HBsAg-negative individuals, the inverse association remained (Ptrend = 0.03). There was no association between lycopene intake and HCC risk (Ptrend = 0.54).

Conclusions: Tomato intake may offer protection against the development of HCC, particularly among individuals without chronic infection with hepatitis B virus.

Impact: Tomato intake is a low-cost preventative measure against HCC that may help reduce risk due to increasing rates of nonalcoholic fatty liver disease.

This article is featured in Highlights of This Issue, p. 1281

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2020;29:1430–5

  • Received January 13, 2020.
  • Revision received February 28, 2020.
  • Accepted April 8, 2020.
  • Published first April 13, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 29 (7)
July 2020
Volume 29, Issue 7
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Association between Dietary Tomato Intake and the Risk of Hepatocellular Carcinoma: The Singapore Chinese Health Study
Claire E. Thomas, Hung N. Luu, Renwei Wang, Jennifer Adams-Haduch, Aizhen Jin, Woon-Puay Koh and Jian-Min Yuan
Cancer Epidemiol Biomarkers Prev July 1 2020 (29) (7) 1430-1435; DOI: 10.1158/1055-9965.EPI-20-0051

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Association between Dietary Tomato Intake and the Risk of Hepatocellular Carcinoma: The Singapore Chinese Health Study
Claire E. Thomas, Hung N. Luu, Renwei Wang, Jennifer Adams-Haduch, Aizhen Jin, Woon-Puay Koh and Jian-Min Yuan
Cancer Epidemiol Biomarkers Prev July 1 2020 (29) (7) 1430-1435; DOI: 10.1158/1055-9965.EPI-20-0051
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