Correspondence

Lung Cancer and Vitamin Supplementation

N Engl J Med 1994; 331:614September 1, 1994

Article

To the Editor:

A randomized nutritional-intervention trial similar in scope and size to the Finnish alpha-tocopherol and beta carotene trial1 has been completed in Linxian, China, an area with one of the world's highest rates of esophageal and stomach cancer and habitually low intake of several nutrients2. We have previously reported3 that among the nearly 30,000 male and female participants, rates of mortality from cancer were significantly lower (relative risk, 0.87) among those who received daily supplementation from 1986 to 1991 with a combination of beta carotene (15 mg), alpha-tocopherol (30 mg), and selenium (50 μg). In this population, over 85 percent of the cancers arose in the esophagus or stomach, but 31 deaths were attributed to lung cancer. As shown in Table 1Table 1Relative Risk of Death from Lung Cancer among Subjects Taking Beta Carotene, Alpha-Tocopherol, and Selenium Supplements, 1986 to 1991., the risk of death from lung cancer was reduced by 45 percent (P = 0.11) among those receiving the beta carotene, alpha-tocopherol, and selenium supplements. Three nonfatal lung cancers were diagnosed, all among those in the group given supplements. Although the small numbers of events preclude detailed evaluation according to subgroup, the reduction in risk associated with supplementation was greater among the 30 percent (almost all men) of the participants who smoked cigarettes than among the 70 percent who were nonsmokers. Although clearly not definitive, these findings provide additional relevant data for the evaluation of the potential effect of vitamin supplementation on the risk of lung cancer.

William J. Blot, Ph.D.
National Cancer Institute, Bethesda, MD 20892

Jun-Yao Li, M.D.
Chinese Academy of Medical Sciences, Beijing 100021, China

Philip R. Taylor, M.D., Sc.D.
National Cancer Institute, Bethesda, MD 20892

Bing Li, M.D.
Chinese Academy of Medical Sciences, Beijing 100021, China

3 References

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Citing Articles (13)

Citing Articles

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   Kultida Klarod, Pranithi Hongsprabhas, Tueanjit Khampitak, Kosin Wirasorn, Sasisopin Kiertiburanakul, Roongpet Tangrassameeprasert, Jureerut Daduang, Puangrat Yongvanit, Patcharee Boonsiri. (2011) Serum antioxidant levels and nutritional status in early and advanced stage lung cancer patients. Nutrition 27:11-12, 1156-1160
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   S.-K. Myung, Y. Kim, W. Ju, H. J. Choi, W. K. Bae. (2010) Effects of antioxidant supplements on cancer prevention: meta-analysis of randomized controlled trials. Annals of Oncology 21:1, 166-179
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   David R. Jacobs, Linda C. Tapsell. (2007) Food, Not Nutrients, Is the Fundamental Unit in Nutrition. Nutrition Reviews 65:10, 439-450
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   C.-X. Qu, F. Kamangar, J.-H. Fan, B. Yu, X.-D. Sun, P. R. Taylor, B. E. Chen, C. C. Abnet, Y.-L. Qiao, S. D. Mark, S. M. Dawsey. (2007) Chemoprevention of Primary Liver Cancer: A Randomized, Double-Blind Trial in Linxian, China. JNCI Journal of the National Cancer Institute 99:16, 1240-1247
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   Gary M. Strauss. (2000) Randomized population trials and screening for lung cancer. Cancer 89:S11, 2399-2421
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    Gary M. Strauss. (2000) Randomized population trials and screening for lung cancer. Cancer 89:S11, 2399-2421
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