Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant
micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of
seven common carotenoids, their total plasma concentration, retinol and a- and g-tocopherol, with the risk of gastric adenocarcinoma in
a case–control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10
countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and a-tocopherol on GCs by
anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid
chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood
donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori
infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk
was observed in the highest vs the lowest quartiles of plasma b-cryptoxanthin (odds ratio (OR)¼ 0.53, 95% confidence intervals
(CI)¼ 0.30–0.94, Ptrend¼ 0.006), zeaxanthin (OR¼ 0.39, 95% CI ¼ 0.22–0.69, Ptrend¼ 0.005), retinol (OR¼ 0.55, 95% CI¼ 0.33–0.93,
Ptrend¼ 0.005) and lipid-unadjusted a-tocopherol (OR¼ 0.59, 95% CI ¼ 0.37–0.94, Ptrend¼ 0.022). For all analytes, no heterogeneity of
risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was
observed with the highest vs lowest quartile of lipid-unadjusted a-tocopherol (OR ¼ 0.26, 95% CI ¼ 0.11–0.65, Ptrend¼ 0.003). These
results show that higher plasma concentrations of some carotenoids, retinol and a-tocopherol are associated with reduced risk of GC.