Carotenoid intake and risk of non-Hodgkin lymphoma: a systematic review and dose-response meta-analysis of observational studies

Ann Hematol. 2017 Jun;96(6):957-965. doi: 10.1007/s00277-016-2898-1. Epub 2016 Dec 24.


Carotenoids may play a protective role in the development of non-Hodgkin lymphoma (NHL), but findings from epidemiological studies on the associations between carotenoid intake and NHL risk are inconsistent. We therefore performed a meta-analysis to systemically evaluate the associations. Eligible studies were identified by a search of PubMed, Web of Science, Embase, and article reference lists. We pooled risk estimates from individual studies using a random-effect model to quantify the associations between intakes of specific carotenoids and NHL risk. A total of 10 (7 case-control and 3 cohort) studies met our inclusion criteria. In the highest versus lowest analyses, intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin, but not lycopene or beta-cryptoxanthin, were associated with a significant reduced risk of NHL. The estimated summary relative risks (95% confidence intervals) for alpha-carotene, beta-carotene, and lutein/zeaxanthin were 0.87 (0.78-0.97), 0.80 (0.68-0.94), and 0.82 (0.69-0.97), respectively. Subgroup analyses showed that evidence supporting these protective associations was mostly based on studies with a case-control design. In addition, intakes of alpha-carotene and beta-carotene were associated with a significant decreased risk of diffuse large B-cell lymphoma, but not follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. There was a significant inverse dose-response relationship between alpha-carotene intake and NHL risk (13% lower risk per 1000 μg/day increment of intake). In conclusion, our findings suggest that higher intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin might protect against NHL development. Further cohort studies with a control of plausible confounding are needed to confirm these associations.

Keywords: Carotenoids; Dose-response; Meta-analysis; Non-Hodgkin lymphoma; Risk.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carotenoids / administration & dosage*
  • Case-Control Studies
  • Cohort Studies
  • Humans
  • Lutein / administration & dosage*
  • Lymphoma, Non-Hodgkin / prevention & control*
  • Observational Studies as Topic
  • Prognosis
  • Risk Factors
  • Zeaxanthins / administration & dosage*
  • beta Carotene / administration & dosage*


  • Zeaxanthins
  • beta Carotene
  • Carotenoids
  • alpha-carotene
  • Lutein