American Journal of Epidemiology Advance Access originally published online on February 10, 2009
American Journal of Epidemiology 2009 169(7):815-828; doi:10.1093/aje/kwn409
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ORIGINAL CONTRIBUTIONS |
Long-term Use of β-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study
Correspondence to Dr. Jessie A. Satia, Departments of Nutrition and Epidemiology, 2209 McGavran-Greenberg Hall, CB 7461, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 (e-mail: jsatia{at}unc.edu).
Received for publication August 20, 2008. Accepted for publication December 11, 2008.
High-dose β-carotene supplementation in high-risk persons has been linked to increased lung cancer risk in clinical trials; whether effects are similar in the general population is unclear. The authors examined associations of supplemental β-carotene, retinol, vitamin A, lutein, and lycopene with lung cancer risk among participants, aged 50–76 years, in the VITamins And Lifestyle (VITAL) cohort Study in Washington State. In 2000–2002, eligible persons (n = 77,126) completed a 24-page baseline questionnaire, including detailed questions about supplement use (duration, frequency, dose) during the previous 10 years from multivitamins and individual supplements/mixtures. Incident lung cancers (n = 521) through December 2005 were identified by linkage to the Surveillance, Epidemiology, and End Results cancer registry. Longer duration of use of individual β-carotene, retinol, and lutein supplements (but not total 10-year average dose) was associated with statistically significantly elevated risk of total lung cancer and histologic cell types; for example, hazard ratio = 2.02, 95% confidence interval: 1.28, 3.17 for individual supplemental lutein with total lung cancer and hazard ratio = 3.22, 95% confidence interval: 1.29, 8.07 for individual β-carotene with small-cell lung cancer for >4 years versus no use. There was little evidence for effect modification by gender or smoking status. Long-term use of individual β-carotene, retinol, and lutein supplements should not be recommended for lung cancer prevention, particularly among smokers.
beta carotene; carotenoids; cohort studies; dietary supplements; lung neoplasms; randomized controlled trials as topic; vitamins
Abbreviations: ATBC, Alpha-Tocopherol, Beta-Carotene Cancer Prevention; CARET, Beta-Carotene and Retinol Efficacy Trial; COPD, chronic obstructive pulmonary disease; SEER, Surveillance, Epidemiology, and End Results; VITAL, VITamins And Lifestyle
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 K. Svennevig RE: "LONG-TERM USE OF {beta}-CAROTENE, RETINOL, LYCOPENE, AND LUTEIN SUPPLEMENTS AND LUNG CANCER RISK: RESULTS FROM THE VITAMINS AND LIFESTYLE (VITAL) STUDY" Am. J. Epidemiol., August 1, 2009; 170(3): 401 - 402. [Full Text] [PDF]
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RE: "LONG-TERM USE OF {beta}-CAROTENE, RETINOL, LYCOPENE, AND LUTEIN SUPPLEMENTS AND LUNG CANCER RISK: RESULTS FROM THE VITAMINS AND LIFESTYLE (VITAL) STUDY" Am. J. Epidemiol., June 1, 2009; 169(11): 1409 - 1409. [Full Text] [PDF]
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