Effects of α‐tocopherol and β‐carotene supplementation on cancer incidence and mortality: 18‐Year postintervention follow‐up of the Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention Study. Issue 1 (12th December 2013)

• Record Type: Journal Article
• Authors: Virtamo, Jarmo; Taylor, Phil R.; Kontto, Jukka; Männistö, Satu; Utriainen, Meri; Weinstein, Stephanie J.; Huttunen, Jussi; Albanes, Demetrius
• Is Part Of: International journal of cancer. Volume 135:Issue 1(2014:Jul. 01)
• Page Start: 178
• Page End: 185
• Publication Date: 2013-12-12
• Subjects: α‐tocopherol -- β‐carotene -- cancer -- mortality -- post‐trial; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.28641
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : In the Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention Study among 29, 133 Finnish male smokers aged 50–69 years, daily α‐tocopherol (50 mg) for a median of 6.1 years decreased the risk of prostate cancer, whereas β‐carotene (20 mg) increased risk of lung cancer and overall mortality. To determine the postintervention effects of α‐tocopherol and β‐carotene, 25, 563 men were followed 18 years for cancer incidence and all causes of mortality through national registers. Neither supplement had significant effects on post‐trial cancer incidence. Relative risk (RR) for lung cancer ( n = 2, 881) was 1.04 (95% confidence interval [CI], 0.96–1.11) among β‐carotene recipients compared with nonrecipients. For prostate cancer ( n = 2, 321), RR was 0.97 (95% CI, 0.89–1.05) among α‐tocopherol recipients compared with nonrecipients with the preventive effect of α‐tocopherol continuing ∼8 years postintervention. Body mass index significantly modified the effect of α‐tocopherol on prostate cancer ( p for interaction = 0.01) RR 1.00 (95% CI, 0.88–1.14) in normal‐weight men, 0.87 (95% CI, 0.77–0.98) in overweight men, and 1.25 (95% CI, 1.01–1.55) in obese men. The post‐trial relative mortality (based on 16, 686 deaths) was 1.02 (95% CI, 0.98–1.05) for α‐tocopherol recipients compared with nonrecipients and 1.02 (95% CI, 0.99–1.05) for β‐carotene recipients compared with nonrecipients. α‐Tocopherol decreased post‐trial prostate cancer mortality (RR, 0.84; 95% CI, 0.70–0.99), whereas β‐carotene increased it (RR, 1.20; 95% CI, 1.01–1.42). In conclusion, supplementation with α‐tocopherol and β‐carotene appeared to have no late effects on cancer incidence. The preventive effect of moderate‐dose α‐tocopherol on prostate cancer continued several years post‐trial and resulted in lower prostate cancer mortality. Abstract : What's new? The Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention (ATBC) Study, begun in the mid‐1980s, found that daily α‐tocopherol supplementation decreased the risk of prostate cancer, whereas β‐carotene increased the risk of lung cancer in Finnish male smokers. In the present study, a post‐trial follow‐up, neither α‐tocopherol nor β‐carotene were found to have significant effects on cancer incidence. The reduced risk of prostate cancer lasted about 8 years post‐trial and was accompanied by decreased 18‐year post‐trial mortality from prostate cancer. BMI may modify the effect of α‐tocopherol on prostate cancer, such that risk is decreased in overweight men but increased in obese men.