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Intake of Lycopene and other Carotenoids and Incidence of Uterine Leiomyomata: A Prospective Ultrasound Study

Published:October 21, 2020DOI:



      Uterine leiomyomata (UL) are the leading indication for hysterectomy in the United States. Dietary supplementation with lycopene was associated with reduced size and incidence of oviduct leiomyoma in the Japanese quail. Two US prospective cohort studies of women reported little association between intake of lycopene, or other carotenoids, and UL incidence. However, these studies relied on self-reported physician-diagnosed UL, which is prone to misclassification.


      This study examines the association between dietary intake of carotenoids and UL incidence.


      Data were derived from the Study of the Environment, Lifestyle, and Fibroids, a prospective cohort study. Women completed self-administered baseline questionnaires on demographic characteristics, reproductive history, and lifestyle, including a 110-item validated food frequency questionnaire, from which dietary intakes of carotenoids—including alpha carotene, beta carotene, cryptoxanthin, lutein-zeaxanthin, and lycopene—and vitamin A were estimated.


      One thousand two hundred thirty Black women aged 23 to 35 years who did not have a previous diagnosis of UL, cancer, or autoimmune disease were eligible for enrollment (2010-2012). Participants were residents of the Detroit, MI, metropolitan area.

      Main outcome measures

      Transvaginal ultrasound was used to assess UL at baseline and 20, 40, and 60 months of follow-up.

      Statistical analyses performed

      Cox regression was used to estimate hazard ratios and 95% CIs, adjusted for energy intake, age at menarche, education, body mass index, parity, age at first birth, years since last birth, current use of oral contraceptives or progestin-only injectables, alcohol intake, and cigarette smoking.


      Among 1,230 women without prevalent UL at baseline, 301 incident UL cases during follow-up were identified. Intakes of lycopene, other carotenoids, and vitamin A were not appreciably associated with UL incidence. Hazard ratios comparing quartiles 2 (2,376 to 3,397 μg/day), 3 (3,398 to 4,817 μg/day), and 4 (≥4,818 μg/day) with quartile 1 (<2,376 μg/day) of lycopene intake were 1.03 (95% CI 0.72 to 1.47), 1.22 (95% CI 0.86 to 1.72), and 0.95 (95% CI 0.67 to 1.36), respectively.


      Study findings do not support the hypothesis that greater carotenoid intake is associated with reduced UL incidence.


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      L. A. Wise is a professor, Department of Epidemiology, Boston University School of Public Health, Boston, MA.


      A. K. Wesselink is a research assistant professor, Department of Epidemiology, Boston University School of Public Health, Boston, MA.


      T. N. Bethea is an assistant professor, Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.


      T. M. Brasky is a research assistant professor, Division of Medical Oncology, The Ohio State University College of Medicine; Columbus.


      G. Wegienka is a senior scientist, Department of Public Health Sciences, Henry Ford Health System; Detroit, MI.


      Q. Harmon is staff scientist, Epidemiology Branch, Women’s Health Group, National Institute for Environmental Health Sciences, Research Triangle, NC.


      D. D. Baird is staff scientist, Epidemiology Branch, Women’s Health Group, National Institute for Environmental Health Sciences, Research Triangle, NC.


      T. Block is a nutrition consultant, NutritionQuest, Berkeley, CA.