J Cancer 2021; 12(1):111-123. doi:10.7150/jca.39806

Research Paper

Lower dietary mineral intake is significantly associated with cervical cancer risk in a population-based cross-sectional study

Zhe Wang1*, Wenhao Wang1*, Aimin Yang2, Weihong Zhao1, Jing Yang1, Zhilian Wang1, Wei Wang1, Xiaoqiang Su1, Jintao Wang3, Jinghui Song4, Li Li5, Weiguo Lv6, Dongyan Li1, Huiqiang Liu1, Chen Wang7, Min Hao1✉

1. Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
2. Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR.
3. Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
4. Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China.
5. Department of Obstetrics and Gynecology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
6. Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
7. Department of pathology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
* The first two authors contributed equally to this work.

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Citation:
Wang Z, Wang W, Yang A, Zhao W, Yang J, Wang Z, Wang W, Su X, Wang J, Song J, Li L, Lv W, Li D, Liu H, Wang C, Hao M. Lower dietary mineral intake is significantly associated with cervical cancer risk in a population-based cross-sectional study. J Cancer 2021; 12(1):111-123. doi:10.7150/jca.39806. Available from https://www.jcancer.org/v12p0111.htm

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Abstract

Population-based studies investigating the association between dietary mineral intake and risk of cervical intraepithelial neoplasia (CIN) or cervical cancer in Chinese women are few. We performed a cross-sectional analysis of screening data obtained from 2,304 women in 2014 within an ongoing cohort study comprising 40,000 women in China. Dietary intake was assessed using a semiquantitative food frequency questionnaire. Nutrition intake was calculated using a 26-item list of food sources drawn from a validated, comprehensive database. All participants were surveyed through in-person interviews, physical examinations, and laboratory tests. The Pearson chi-square test was used for categorical variables. Multivariable logistic regression models were used to evaluate the relationship between dietary mineral intake and CIN+ risk. The food frequency questionnaire exhibited acceptable reproducibility and reasonable validity in assessing nutrient intakes among these women. After adjusting for multiple potential confounders, low dietary calcium intake was associated with CIN2+ risk (first versus fourth quartile: odds ratio [OR]=1.52, 95% confidence interval [CI]: 1.01-2.32). Similar for magnesium (OR=1.80, 95% CI: 1.20-2.68), phosphorus (OR=1.69, 95% CI: 1.12-2.55), zinc (OR=1.55, 95% CI: 1.03-2.34), and potassium (OR=1.92, 95% CI: 1.28-2.88). Low dietary intakes of calcium and potassium were significantly associated with CIN1 risk. Increased CIN2+ risk correlated with rates of no oral contraceptives and lower levels of dietary Potassium. These results thus proposed that low dietary mineral intake was an independent risk factor, potential synergy may exist between low dietary mineral levels and oral contraceptives contribute to the development of higher-grade CIN and cervical cancer.

Keywords: dietary mineral intake, cervical intraepithelial neoplasia, cervical cancer, China, cross-sectional study