Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not reduce the risk of lung cancer

Christopher G. Slatore, Alyson J. Littman, David H. Au, Jessie A. Satia, Emily White

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk. Objectives: Toexplore the associationof supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer. Methods: Prospective cohort of 77,721 men and women aged 50-76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle-Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry. Measurements and Main Results: Hazard ratios (HRs) for incident lung cancer according to 10-year average daily use of supplemental multivitamins, vitamin C, vitamin E, and folate. A total of 521 cases of lung cancer were identified. Adjusting for smoking, age, and sex, there was no inverse association with any supplement. Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose; 95% confidence interval [CI], 1.00-1.09; P = 0.033). This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase; 95% CI, 1.03-1.19; P <0.01) and was greatest for non-small cell lung cancer (HR, 1.07 for every 100-mg/d increase; 95% CI, 1.02-1.12; P = 0.004). Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk. Patients should be counseled against using these supplements to prevent lung cancer.

Original languageEnglish (US)
Pages (from-to)524-530
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume177
Issue number5
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Fingerprint

Vitamin E
Folic Acid
Ascorbic Acid
Lung Neoplasms
Confidence Intervals
Vitamins
Non-Small Cell Lung Carcinoma
Registries
Life Style
Neoplasms
Epidemiology
Smoking
Mortality
Population

Keywords

  • Bronchial neoplasm
  • Diet
  • Dietary supplements
  • Public health

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not reduce the risk of lung cancer. / Slatore, Christopher G.; Littman, Alyson J.; Au, David H.; Satia, Jessie A.; White, Emily.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 177, No. 5, 01.03.2008, p. 524-530.

Research output: Contribution to journalArticle

@article{e96d87029e6d4c67aa952bd4424b0d0d,
title = "Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not reduce the risk of lung cancer",
abstract = "Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk. Objectives: Toexplore the associationof supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer. Methods: Prospective cohort of 77,721 men and women aged 50-76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle-Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry. Measurements and Main Results: Hazard ratios (HRs) for incident lung cancer according to 10-year average daily use of supplemental multivitamins, vitamin C, vitamin E, and folate. A total of 521 cases of lung cancer were identified. Adjusting for smoking, age, and sex, there was no inverse association with any supplement. Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose; 95{\%} confidence interval [CI], 1.00-1.09; P = 0.033). This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase; 95{\%} CI, 1.03-1.19; P <0.01) and was greatest for non-small cell lung cancer (HR, 1.07 for every 100-mg/d increase; 95{\%} CI, 1.02-1.12; P = 0.004). Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk. Patients should be counseled against using these supplements to prevent lung cancer.",
keywords = "Bronchial neoplasm, Diet, Dietary supplements, Public health",
author = "Slatore, {Christopher G.} and Littman, {Alyson J.} and Au, {David H.} and Satia, {Jessie A.} and Emily White",
year = "2008",
month = "3",
day = "1",
doi = "10.1164/rccm.200709-1398OC",
language = "English (US)",
volume = "177",
pages = "524--530",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "5",

}

TY - JOUR

T1 - Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not reduce the risk of lung cancer

AU - Slatore, Christopher G.

AU - Littman, Alyson J.

AU - Au, David H.

AU - Satia, Jessie A.

AU - White, Emily

PY - 2008/3/1

Y1 - 2008/3/1

N2 - Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk. Objectives: Toexplore the associationof supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer. Methods: Prospective cohort of 77,721 men and women aged 50-76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle-Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry. Measurements and Main Results: Hazard ratios (HRs) for incident lung cancer according to 10-year average daily use of supplemental multivitamins, vitamin C, vitamin E, and folate. A total of 521 cases of lung cancer were identified. Adjusting for smoking, age, and sex, there was no inverse association with any supplement. Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose; 95% confidence interval [CI], 1.00-1.09; P = 0.033). This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase; 95% CI, 1.03-1.19; P <0.01) and was greatest for non-small cell lung cancer (HR, 1.07 for every 100-mg/d increase; 95% CI, 1.02-1.12; P = 0.004). Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk. Patients should be counseled against using these supplements to prevent lung cancer.

AB - Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk. Objectives: Toexplore the associationof supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer. Methods: Prospective cohort of 77,721 men and women aged 50-76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle-Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry. Measurements and Main Results: Hazard ratios (HRs) for incident lung cancer according to 10-year average daily use of supplemental multivitamins, vitamin C, vitamin E, and folate. A total of 521 cases of lung cancer were identified. Adjusting for smoking, age, and sex, there was no inverse association with any supplement. Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose; 95% confidence interval [CI], 1.00-1.09; P = 0.033). This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase; 95% CI, 1.03-1.19; P <0.01) and was greatest for non-small cell lung cancer (HR, 1.07 for every 100-mg/d increase; 95% CI, 1.02-1.12; P = 0.004). Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk. Patients should be counseled against using these supplements to prevent lung cancer.

KW - Bronchial neoplasm

KW - Diet

KW - Dietary supplements

KW - Public health

UR - http://www.scopus.com/inward/record.url?scp=40649103670&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=40649103670&partnerID=8YFLogxK

U2 - 10.1164/rccm.200709-1398OC

DO - 10.1164/rccm.200709-1398OC

M3 - Article

C2 - 17989343

AN - SCOPUS:40649103670

VL - 177

SP - 524

EP - 530

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 5

ER -