Prediagnostic circulating carotenoid levels and the risk of non-Hodgkin lymphoma: the Multiethnic Cohort

This analysis examined the association of non-Hodgkin lymphoma (NHL) with pre-diagnostic carotenoid levels, a marker for a diet rich in fruits and vegetables. We conducted a nested case-control study within the Multiethnic Cohort with 271 NHL cases and 538 controls matched on sex, ethnicity, location (Hawaii or Los Angeles), birth year, date and time of blood draw, and hours fasting before blood draw. Serum carotenoid levels were obtained by high-pressure liquid chromatography with photodiode array detection. Conditional logistic regression was used to calculate odds ratios (ORs) according to tertiles of serum carotenoids and trend tests using continuous variables. Higher total serum carotenoids (ORT3 vs T1 = 0.66 [0.46-0.96]; P-trend = .02), lycopene (OR = 0.54 [0.38-0.78]; P-trend = .003), and alpha-cryptoxanthin (OR = 0.53 [0.36-0.78]; P-trend = .003) were associated with a lower risk of NHL. For retinol (OR = 0.90 [0.61-1.33]; P-trend = .04), a statistically significant inverse linear trend was detected. Risk estimates remained unchanged with adjustment for NHL risk factors and were similar in analyses stratified by sex and ethnicity; heterogeneity with NHL subtype was detected only for beta-carotene. Other carotenoids, including alpha-carotene, beta-carotene, lutein, beta-cryptoxanthin, and zeaxanthin, showed no association with risk. These data provide support for a protective role of carotenoid-rich fruits and vegetables in the etiology of NHL. (Blood. 2012; 119(24):5817-5823)