Next Steps: Download

Abstract

The purpose of this research (1983-2010) was to examine the nutritional influences on the development of cervical neoplasia and thereby formulate a strategy for prevention. Articles retrieved from Ovid: Medline and Alt HealthWatch Databases were reviewed. The major topics of review include the role of micronutrients found in foods, herbs, and dietary supplements and their effects on cervical cancer. Results show that a significant body of research suggests that a diet rich in fruits and vegetables may protect against cervical cancer. In addition, protective effects have specifically been observed for dietary and plasma nutrients including but not limited to folate, B12, vitamin C, vitamin A, vitamin E (tocopherols), lycopene, and fiber. However, many women in the United States are not currently meeting the USDA recommendations for intake of some of these nutrients. Physician may suggest to patients at risk for cervical cancer that a diet rich in fruits and vegetables may reduce their risk of disease. In addition, for patients who find such a diet challenging, physicians may recommend dietary supplementation to ensure patients' nutritional needs are being met. Additional research into the role of herbs in the prevention of cervical cancer is warranted.

Corresponding Author(s)

Benjamin A. Cox, OMSIV, College of Medi- cine, OMSIV, c/o 2012, Bradenton, FL 34211.

E-mail address: Benjamin.cox@med.lecom.edu.

Read the article

The purpose of this research (1983-2010) was to examine the nutritional influences on the development of cervical neoplasia and thereby formulate a strategy for prevention. Articles retrieved from Ovid: Medline and Alt HealthWatch Databases were reviewed. The major topics of review include the role of micronutrients found in foods, herbs, and dietary supplements and their effects on cervical cancer. Results show that a significant body of research suggests that a diet rich in fruits and vegetables may protect against cervical cancer. In addition, protective effects have specifically been observed for dietary and plasma nutrients including but not limited to folate, B12, vitamin C, vitamin A, vitamin E (tocopherols), lycopene, and fiber. However, many women in the United States are not currently meeting the USDA recommendations for intake of some of these nutrients. Physician may suggest to patients at risk for cervical cancer that a diet rich in fruits and vegetables may reduce their risk of disease. In addition, for patients who find such a diet challenging, physicians may recommend dietary supplementation to ensure patients’ nutritional needs are being met. Additional research into the role of herbs in the prevention of cervical cancer is warranted.

© 2012 Elsevier Inc. All rights reserved.


 


‌Epidemiology of cervical cancer and significance of prevention


 

 

 

services is the key to reducing the rates of invasive cervical cancer.3


‌Etiology of cervical cancer


 


‌Table 1 USDA guidelines for recommended daily intake and upper limit for females >19 years old19,21

Nutrient

RDI

UL

Significant food source

Folate

400 µg/d

1000 ug/d

Deep green leaves, spinach, mustard greens, beans, oranges

B12

2.4 µg/d

Not Determined

Meat, eggs, milk

Vitamin C

75 mg/d

2000 mg/d

Peppers, citrus, broccoli, kiwi, papaya, mango, leafy greens

Vitamin A

700 µg/d

3000 ug/d

Carrots, pumpkin, squash, kale, sweet potato

Vitamin E (i.e., tocopherol)

15 mg/d

1000 mg/d

Nuts, seeds, avocado, turnip greens, tomato

Fiber

31 g/d

Not determined

Beans, mixed vegetables, berries, apples, pears

RDI = recommended daily intake; UL = upper limit.


nutritional factors have an impact, it is believed that nutri- tional status is a co-factor in this progression.6


‌Materials and methods

The databases searched were Ovid Medline and Alt Health- Watch. The search headers were: cervical cancer, cervical neoplasia, nutrition, vitamins, herbs, and folate. The articles obtained were cross-referenced and studies including mul- tiple search headers were reviewed (1983-2010).


‌Results

‌Diet and lifestyle


‌Folate

Folate has received much attention because epidemio- logic studies have supported its protective role and there are plausible explanatory mechanisms about how this occurs.8 In 1998, the FDA mandated the fortification of grain prod- ucts with folate to reduce the risk of neural tube defects. As a result, some subgroups of the population have had sus- tained levels exceeding the body’s physiologic need. Ob- servation of these groups produced no credible evidence of any adverse health effects. Interestingly, these studies have found that higher folate levels are associated with a signif- icantly lower risk of CIN, especially when vitamin B12 levels are sufficient. Women with supraphysiological plasma folate and sufficient B12 levels had 70% reduction of CIN II+ compared with those with low folate and insuffi- cient B12 levels.25



‌Antioxidants

and carotenoid status including beta-carotene.6,14


‌Retinoids

In clinical trials, topical application of all-trans-retinoic acid (tretinoin) has been shown to enhance the regression of cervical intraepithelial neoplasia. In cell culture studies, at physiologic concentrations, all-trans-retinoic acid has been found to inhibit the proliferation of cells harboring HPV.20


‌Phytotherapy


‌Conclusions


‌References‌

  1. Rogo KO: Cervical cancer can be controlled. East Afr Med J 78:53-4, 2001


  2. ‌Scarinci IC, Garcia FA, Kobetz E, et al: Cervical Cancer Prevention: New Tools and Old Barriers Cancer 116:2531-2542, 2010‌

  3. ‌Boyle P, Maisonneuve P, Autier P: Update on cancer control in women. Int J Gynaecol Obstet 70:263-303, 2000

  4. ‌Rampersaud GC, Bailey LB, Kauwell GP: Relationship of folate to colorectal and cervical cancer: review and recommendations for prac- titioners. J Am Diet Assoc 102:1273-1282, 2002

  5. ‌Peterson CE, Sedjo RL, Davis FG, et al: Combined antioxidant caro- tenoids and the risk of persistent human papillomavirus infection. Nutr Cancer 62:728-733, 2010

  6. ‌Potischman N: Nutritional epidemiology of cervical neoplasia. J Nutr 123(2 Suppl):424-429, 1993

  7. ‌Sedjo RL, Roe DJ, Abrahamsen M, et al: Vitamin A, carotenoids, and risk of persistent oncogenic human papillomavirus infection. Cancer Epidemiol Biomarkers Prev 11:876-884, 2002

  8. ‌Powers HJ: Interaction among folate, riboflavin, genotype, and cancer, with reference to colorectal and cervical cancer. J Nutr 135(12 Suppl): 2960S-2966S, 2005

  9. ‌Shannon J, Thomas DB, Ray RM, et al: Dietary risk factors for invasive and in-situ cervical carcinomas in Bangkok, Thailand. Cancer Cause Control 13:691-699, 2002

  10. ‌Glade M: Antioxidant vitamins reduce the risk for cancer: part two. J Orthomol Med 24:65-87, 2009

  11. Ghosh C, Baker JA, Moysich KB, et al: Dietary intakes of selected nutrients and food groups and risk of cervical cancer. Nutr Cancer 60:331-341, 2008

  12. Choi SW, Mason JB: Folate and carcinogenesis: an integrated scheme.

    ‌J Nutr 130:129-132, 2000

  13. ‌Hernandez BY, McDuffie K, Wilkens LR, et al: Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12. Cancer Cause Control 14:859-870, 2003

  14. Palan PR, Mikhail MS, Goldberg GL, et al: Plasma levels of beta- carotene, lycopene, canthaxanthin, retinol, and alpha- and tau-tocoph- erol in cervical intraepithelial neoplasia and cancer. Clin Cancer Res 2:181-185, 1996

  15. ‌Schiff MA, Patterson RE, Baumgartner RN, et al: Serum carotenoids and risk of cervical intraepithelial neoplasia in Southwestern American Indian women. Cancer Epidemiol Biomarkers Prev 10:1219-1222, 2001

  16. ‌Mason JB, Levesque T: Folate: effects on carcinogenesis and the potential for cancer chemoprevention. Oncology (Williston Park) 10: 1727-1736, 1742-1743; discussion 1743-1744, 1996

  17. Meyskens FL Jr, Manetta A: Prevention of cervical intraepithelial neoplasia and cervical cancer. Am J Clin Nutr 62(6 Suppl):1417S- 1419S, 1995

  18. ‌Giuliano AR, Gapstur S: Can cervical dysplasia and cancer be pre- vented with nutrients? Nutr Rev 56(1 Pt 1):9-16, 1998

  19. ‌Hirose K, Tajima K, Hamajima N, et al: Subsite (cervix/endometri- um)-specific risk and protective factors in uterus cancer. Jpn J Cancer Res 87:1001-1009, 1996

  20. Rock CL, Michael CW, Reynolds RK, et al: Prevention of cervix cancer. Crit Rev Oncol Hematol 33:169-185, 2000

  21. U.S. Department of Health and Human Services; U.S. Department of Agriculture. Dietary Guidelines for Americans 2005. Available at: http://health.gov/dietaryguidelines/.

  22. ‌Goodman MT, McDuffie K, Hernandez B, et al: Association of meth- ylenetetrahydrofolate reductase polymorphism C677T and dietary fo- late with the risk of cervical dysplasia. Cancer Epidemiol Biomarkers Prev 10:1275-1280, 2001

  23. ‌Kanetsky PA, Gammon MD, Mandelblatt J, et al: Dietary intake and blood levels of lycopene: association with cervical dysplasia among non-Hispanic, black women. Nutr Cancer 31:31-40, 1998

  24. ‌Shikany JM, Heimburger DC, Piyathilake CJ, et al: Effect of folic acid fortification of foods on folate intake in female smokers with cervical dysplasia. Nutrition 20:409-414, 2004

  25. ‌Piyathilake CJ, Macaluso M, Alvarez RD, et al: Lower risk of cervical intraepithelial neoplasia in women with high plasma folate and suffi- cient vitamin B12 in the post-folic acid fortification era. Cancer Prev Res (Phila) 2:658-664, 2009

  26. ‌Palan PR, Mikhail MS, Shaban DW, et al: Plasma concentrations of coenzyme Q10 and tocopherols in cervical intraepithelial neoplasia and cervical cancer. Eur J Cancer Prev 12:321-326, 2003

  27. ‌Doll R: Prospects for the prevention of cancer. Clin Radiol 34:609- 623, 1983

  28. Lehtinen M, Luostarinen T, Youngman LD, et al: Low levels of serum vitamins A and E in blood and subsequent risk for cervical cancer: interaction with HPV seropositivity. Nutr Cancer 34:229-234, 1999

  29. ‌Romney SL, Dwyer A, Slagle S, et al: Chemoprevention of cervix cancer. Phase I-II: a feasibility study involving the topical vaginal administration of retinyl acetate gel. Gynecol Oncol 20:109-119, 1985

  30. ‌Agarwal C, Rorke EA, Irwin JC, et al: Immortalization by human papillomavirus type 16 alters retinoid regulation of human ectocervical epithelial cell differentiation. Cancer Res 51:3982-3989, 1991

  31. ‌Xu M, Deng PX, Qi C, et al: Adjuvant phytotherapy in the treatment of cervical cancer: a systematic review and meta-analysis. J Altern Complement Med 15:1347-1353, 2009

  32. ‌Susidarti RA, Rahmani M, Ismail HBM, et al: Cytotoxic activity of coumarins from Micromelum minutum. Pharm Biol 47:182-185, 2009

  33. Paisley J, Brown CM, Greenberg M: Information needs of women at risk of breast cancer. Can J Diet Pract Res 69:59-64, 2008