Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial.
Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial.
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DOI：
10.1001/jama.2008.862
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发表时间：
2009-01-07
影响因子：
120.7
通讯作者：
Buring, Julie E.
中科院分区：
文献类型：
--
作者：
Gaziano, J. Michael;Glynn, Robert J.;Christen, William G.;Kurth, Tobias;Belanger, Charlene;MacFadyen, Jean;Bubes, Vadim;Manson, Joann E.;Sesso, Howard D.;Buring, Julie E.
许多美国人服用维生素是为了预防癌症等慢性疾病，而维生素E和C是最常见的个人补充剂。一项大规模的随机试验表明，维生素E可能会降低前列腺癌的风险；然而，很少有试验能够解决这种关系。此前，没有一项针对普通高危男性的试验单独检查了维生素C对癌症的预防作用。评估长期补充维生素E或C是否可以降低男性患前列腺癌和总癌症的风险。医生健康研究II是一项关于维生素E和C的随机、双盲、安慰剂对照因素试验，从1997年开始，一直持续到2007年8月31日完成。美国共有14,641名男性医生参加了研究，他们最初的年龄为≥50岁，其中包括1,307名随机调查时有癌症病史的男性。每隔一天补充400国际单位的维生素E，每天补充500毫克的维生素C。前列腺癌和完全癌症。在平均8.0年的随访中，有1,008例前列腺癌确诊病例，总共1,943例癌症。与安慰剂相比，维生素E对前列腺癌的发病率没有影响(活性维生素E组和安慰剂维生素E组，每1000人年发生9.1和9.5事件；风险比[HR]，0.97；95%可信区间[CI]，0.85-1.09；P=0.58)或总癌症(活性维生素E组和安慰剂维生素E组，每1000人年17.8和17.3例；HR，1.04；95%CI，0.95-1.13；P=0.41)。维生素C对总癌症(活性维生素C组和安慰剂维生素C组，每千人年17.6和17.5次；HR，1.01；95%CI，0.92-1.10；P=0.86)或前列腺癌(活性维生素C组和安慰剂维生素C组，每千人年9.4和9.2例；HR，1.02；95%CI，0.90-1.15；P=0.80)也没有显著影响。维生素E和维生素C对结直肠癌、肺癌或其他特定部位的癌症都没有显著影响。对遵从性的调整和排除头四年或六年的后续行动并没有改变结果。按不同癌症风险因素分层显示，维生素E对前列腺癌风险的影响或任何一种因素对总癌症风险的影响都没有显着改变。在这项对男性医生进行的大型长期试验中，补充维生素E或C都不能降低患前列腺癌或全身癌症的风险。这些数据不支持在中老年男性中使用这些补充剂来预防癌症。Http://www.clinicaltrials.gov标识：NCT00270647
Many Americans take vitamins in the hopes of preventing chronic diseases such as cancer, and vitamins E and C are among the most common individual supplements. A large-scale randomized trial suggested that vitamin E may reduce risk of prostate cancer; however, few trials have been powered to address this relationship. No previous trial in men at usual risk has examined vitamin C alone in the prevention of cancer. To evaluate whether long-term vitamin E or C supplementation decreases risk of prostate and total cancer events among men. The Physicians’ Health Study II is a randomized, double-blind, placebo-controlled factorial trial of vitamins E and C that began in 1997 and continued until its scheduled completion on August 31, 2007. A total of 14,641 male physicians in the U.S. initially aged ≥50 years, including 1,307 men with a history of prior cancer at randomization, were enrolled. Individual supplements of 400 IU of vitamin E every other day and 500 mg vitamin C daily. Prostate and total cancer. During a mean follow-up of 8.0 years, there were 1,008 confirmed incident cases of prostate cancer and 1,943 total cancers. Compared with placebo, vitamin E had no effect on the incidence of prostate cancer (active and placebo vitamin E groups, 9.1 and 9.5 events per 1,000 person-years; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.85–1.09; P=0.58) or total cancer (active and placebo vitamin E groups, 17.8 and 17.3 cases per 1,000 person-years; HR, 1.04; 95% CI, 0.95–1.13; P=0.41). There was also no significant effect of vitamin C on total cancer (active and placebo vitamin C groups, 17.6 and 17.5 events per 1,000 person-years; HR, 1.01; 95% CI, 0.92–1.10; P=0.86), or prostate cancer (active and placebo vitamin C groups, 9.4 and 9.2 cases per 1,000 person-years; HR, 1.02; 95% CI, 0.90–1.15; P=0.80). Neither vitamin E nor vitamin C had a significant effect on colorectal, lung, or other site-specific cancers. Adjustment for compliance and exclusion of the first four or six years of follow-up did not alter the results. Stratification by various cancer risk factors demonstrated no significant modification of the effect of vitamin E on prostate cancer risk or either agent on total cancer risk. In this large long-term trial of male physicians, neither vitamin E nor C supplementation reduced the risk of prostate or total cancer. These data provide no support for the use of these supplements for the prevention of cancer in middle-aged and older men. http://www.clinicaltrials.gov identifier: NCT00270647
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