Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population

source extracted confidence: high 2026-04-09
#ascorbic-acid #asian-people #carcinoma-squamous-cell #china #esophageal-neoplasms

Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population

Lam et al., 2013 | Am J Clin Nutr | Meta Analysis

Citation

Lam Tram Kim, Freedman Neal D, ... Abnet Christian C. Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population. Am J Clin Nutr. 2013-Nov;98(5):1289-97. doi:10.3945/ajcn.113.061267

Abstract

BACKGROUND: China has some of the highest incidence rates for gastric adenocarcinoma (GA) and esophageal squamous cell carcinoma (ESCC) in the world. Prospective studies suggested that vitamin C may reduce risks; however, associations are unclear because of limited sample size. OBJECTIVE: The objective was to examine the relation between prediagnostic plasma vitamin C and the risk of GA and ESCC. DESIGN: A case-cohort study was used to assess the association between prediagnostic plasma vitamin C and incidence of GA (n = 467) and ESCC (n = 618) in the General Population Nutrition Intervention Trial. With the use of multivariate Cox proportional hazards models, we estimated the HRs and 95% CIs. We also conducted a meta-analysis of the literature up to 1 October 2012 on the relation between circulating vitamin C and gastric cancer incidence. Two cohort studies and the current study were included to assess the body of evidence. RESULTS: For GA, each 20-μmol/L increase in plasma vitamin C was associated with a 14% decrease in risk (HR: 0.86; 95% CI: 0.76, 0.96). Compared with individuals with low plasma vitamin C concentrations (≤28 μmol/L), those with normal concentrations (>28 μmol/L) had a 27% reduced risk of GA (HR: 0.73; 95% CI: 0.56, 0.94). No association between vitamin C concentrations and ESCC was seen. Meta-analysis showed that the risk of incident GA among those with the highest concentration of plasma vitamin C was 31% lower (random-effects-pooled-odds ratio 0.69; 95% CI: 0.54, 0.89) than those in the lowest category. CONCLUSION: Our data provide evidence that higher circulating vitamin C was associated with a reduced risk of incident GA, but no association was seen for ESCC.

Key Findings

For GA, each 20-μmol/L increase in plasma vitamin C was associated with a 14% decrease in risk (HR: 0.86; 95% CI: 0.76, 0.96). Compared with individuals with low plasma vitamin C concentrations (≤28 μmol/L), those with normal concentrations (>28 μmol/L) had a 27% reduced risk of GA (HR: 0.73; 95% CI: 0.56, 0.94). No association between vitamin C concentrations and ESCC was seen. Meta-analysis showed that the risk of incident GA among those with the highest concentration of plasma vitamin C was 3

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population low plasma vitamin c
Sample Size 467
Age Range See abstract
Condition See abstract

MeSH Terms

  • Ascorbic Acid
  • Asian People
  • Carcinoma, Squamous Cell
  • China
  • Esophageal Neoplasms
  • Esophageal Squamous Cell Carcinoma
  • Humans
  • Incidence
  • Odds Ratio
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Stomach Neoplasms

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, N.I.H., Intramural
  • Vertical: vitamin-c-cancer

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09