Efficacy of antioxidant supplementation in reducing primary cancer incidence and mortality: Systematic review and meta-analysis

被引:112
作者
Bardia, Aditya [1 ]
Tleyjeh, Imad M. [1 ]
Cerhan, James R. [1 ]
Sood, Amit K. [1 ]
Limburg, Paul J. [1 ]
Erwin, Patricia J. [1 ]
Montori, Victor M. [1 ]
机构
[1] Mayo Clin, Dept Med, Knowledge & Encounter Res Unit, Rochester, MN 55905 USA
关键词
D O I
10.4065/83.1.23
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE: To estimate the association between antioxidant use and primary cancer incidence and mortality and to evaluate these effects across specific antioxidant compounds, target organs, and participant subgroups. METHODS: Multiple electronic databases (MEDLINE, Cochrane Controlled Clinical Trials Register, EMBASE, Science Citation Index) were searched from their dates of inception until August 2005 to identify eligible randomized clinical trials. Random effects meta-analyses estimated pooled relative risks (RRs) and 95% confidence intervals (CIs) that described the effect of antioxidants vs placebo on cancer incidence and cancer mortality. RESULTS: Twelve eligible trials, 9 of high methodological quality, were identified (total subject population, 104,196). Antioxidant supplementation did not significantly reduce total cancer incidence (IRR, 0.99; 95% CI, 0.94-1.04) or mortality (RR, 1.03; 95% CI, 0.92-1.15) or any site-specific cancer incidence. Beta carotene supplementation was associated with an increase in the incidence of cancer among smokers (RR, 1.10; 95% CI, 1.03-1.10) and with a trend toward increased cancer mortality (RR, 1.16; 95% CI, 0.98-1.37). Selenium supplementation was associated with reduced cancer incidence in men (RR, 0.77; 95% CI, 0.64-0.92) but not in women (IRR, 1.00; 95% CI, 0.89-1.13, value for interaction, P<.001) and with reduced cancer mortality (RR, 0.78; 95% CI, 0.65-0.94). Vitamin E supplementation had no apparent effect on overall cancer incidence (RR, 0.99; 95% CI, 0.941.04) or cancer mortality (RR, 1.04; 95% CI, 0.97-1.12). CONCLUSION: Beta carotene supplementation appeared to increase cancer incidence and cancer mortality among smokers, whereas vitamin E supplementation had no effect. Selenium supplementation might have anticarcinogenic effects in men and thus requires further research.
引用
收藏
页码:23 / 34
页数:12
相关论文
共 76 条
[11]   OXYRADICALS AND CANCER [J].
CERUTTI, PA .
LANCET, 1994, 344 (8926) :862-863
[12]   Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin a randomized controlled trial - A randomized controlled trial [J].
Clark, LC ;
Combs, GF ;
Turnbull, BW ;
Slate, EH ;
Chalker, DK ;
Chow, J ;
Davis, LS ;
Glover, RA ;
Graham, GF ;
Gross, EG ;
Krongrad, A ;
Lesher, JL ;
Park, HK ;
Sanders, BB ;
Smith, CL ;
Taylor, JR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1996, 276 (24) :1957-1963
[13]   Randomized, controlled chemoprevention trials in populations at very high risk for prostate cancer: Elevated prostate-specific antigen and high-grade prostatic intraepithelial neoplasia [J].
Clark, LC ;
Marshall, JR .
UROLOGY, 2001, 57 (4A) :185-187
[14]   INCREASED GREEN AND YELLOW VEGETABLE INTAKE AND LOWERED CANCER DEATHS IN AN ELDERLY POPULATION [J].
COLDITZ, GA ;
BRANCH, LG ;
LIPNICK, RJ ;
WILLETT, WC ;
ROSNER, B ;
POSNER, BM ;
HENNEKENS, CH .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1985, 41 (01) :32-36
[15]  
Collins R, 2002, LANCET, V360, P23, DOI 10.1016/S0140-6736(02)09328-5
[16]   SERUM RETINOL, BETA-CAROTENE, VITAMIN-E, AND SELENIUM AS RELATED TO SUBSEQUENT CANCER OF SPECIFIC SITES [J].
COMSTOCK, GW ;
BUSH, TL ;
HELZLSOUER, K .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1992, 135 (02) :115-121
[17]   Effects of beta-carotene supplementation on cancer incidence by baseline characteristics in the Physicians' Health Study (United States) [J].
Cook, NR ;
Lee, IM ;
Manson, JE ;
Buring, JE ;
Hennekens, CH .
CANCER CAUSES & CONTROL, 2000, 11 (07) :617-626
[18]   Antioxidants vitamin C and vitamin E for the prevention and treatment of cancer [J].
Coulter, Ian D. ;
Hardy, Mary L. ;
Morton, Sally C. ;
Hilton, Lara G. ;
Tu, Wenli ;
Valentine, Di ;
Shekelle, Paul G. .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2006, 21 (07) :735-744
[19]  
de Klerk NH, 1998, INT J CANCER, V75, P362, DOI 10.1002/(SICI)1097-0215(19980130)75:3&lt
[20]  
362::AID-IJC6&gt