Vitamins may lower cancer risk - in men
The daily use of multivitamins may reduce the risk for cancer in men, according to the results of a very large randomized trial.
After about 11 years, multivitamin use resulted in a modest but statistically significant reduction — specifically, an 8% reduction in total cancer incidence. For some reason vitamins don't seem to help prostate cancer, so when you take it out of the picture the benefit is actually 12% reduction in all cancer ( except prostate )
The study has also been published early online in the Journal of the American Medical Association to coincide with the meeting.
The main message is that the main reason to take a multivitamin is for nutritional deficiencies but it certainly appears that there may be a modest benefit in preventing cancer in men over the age of 50," he said.
This study is considered extremely accurate because it was planned and executed over 17 years, had a placebo group and a control group , and all the control group took exactly the same vitamin supplement.
This is a confusing result , especially in view of several studies in women that show opposite findings. — one study found an increased risk while the other found that multivitamins decreased the risk. Another study showed no results at all multi-vitamin use had no influence on the risk for common cancers, cardiovascular disease, or overall mortality.
Reduction in Total Cancers
The data in the current study was drawn from the Physicians' Health Study II, a large-scale, randomized, double-blind, placebo-controlled trial that included 14, 641 male US physicians who were 50 years or older when the study began. The cohort included 1312 men with a history of cancer. The multivitamin study began in 1997, with treatment and follow-up that continued through June 1, 2011.
The cohort included a large proportion of former smokers (40.0%) and a very low proportion of current smokers (3.6%) with a high rate of current aspirin use (77.4%).
"This was a population of healthy physicians," Dr. Gaziano said. "Over two thirds of them exercised regularly and only 4% smoked."
Their results showed that men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer, as compared with placebo (17.0 and 18.3 events, respectively, per 1000 person-years; hazard ratio [HR], 0.92; P = .04).
However, when the cancers were considered separately, there was no significant effect. There was no effect of the daily multivitamin on prostate cancer (multivitamin and placebo groups, 9.1 and 9.2 events per 1000 person-years; HR, 0.98; P = .76), colorectal cancer (1.2 and 1.4 events per 1000 person years; HR, 0.89; P = .39), or any other site-specific cancers.
Dr. Gaziano and colleagues noted that the total cancer rates in this cohort were probably influenced by the increased surveillance for prostate-specific antigen (PSA) and subsequent diagnoses of prostate cancer during the last 1990s.
"We had included participants with a prior history of cancer and we had prespecified an analysis that we would do, and there is an appearance of a stronger effect in those with a prior cancer," he said.
"Given that more than 1.6 million new cancer cases are diagnosed in the U.S. each year, this translates into about 130,000 cancers prevented every year, and with it all the health care costs and human suffering," commented Dr. Frei, who was not involved in the study.
Dr. Frei also pointed out that the effect might be even higher in other population groups than seen in this study. "And it's worth noting that the research was done with 14,600 physicians," Dr. Frei said. "This highly-educated group has a better diet, knowledge base and health habits than the average person, so it's reasonable to believe that the impact of multivitamin use in the general population will be even greater."
11th Annual AACR International Conference on Frontiers in Cancer Prevention Research, Presented October 17, 2012. JAMA. 2012. Published online October 17, 2012.
After about 11 years, multivitamin use resulted in a modest but statistically significant reduction — specifically, an 8% reduction in total cancer incidence. For some reason vitamins don't seem to help prostate cancer, so when you take it out of the picture the benefit is actually 12% reduction in all cancer ( except prostate )
The study has also been published early online in the Journal of the American Medical Association to coincide with the meeting.
The main message is that the main reason to take a multivitamin is for nutritional deficiencies but it certainly appears that there may be a modest benefit in preventing cancer in men over the age of 50," he said.
This study is considered extremely accurate because it was planned and executed over 17 years, had a placebo group and a control group , and all the control group took exactly the same vitamin supplement.
This is a confusing result , especially in view of several studies in women that show opposite findings. — one study found an increased risk while the other found that multivitamins decreased the risk. Another study showed no results at all multi-vitamin use had no influence on the risk for common cancers, cardiovascular disease, or overall mortality.
Reduction in Total Cancers
The data in the current study was drawn from the Physicians' Health Study II, a large-scale, randomized, double-blind, placebo-controlled trial that included 14, 641 male US physicians who were 50 years or older when the study began. The cohort included 1312 men with a history of cancer. The multivitamin study began in 1997, with treatment and follow-up that continued through June 1, 2011.
The cohort included a large proportion of former smokers (40.0%) and a very low proportion of current smokers (3.6%) with a high rate of current aspirin use (77.4%).
"This was a population of healthy physicians," Dr. Gaziano said. "Over two thirds of them exercised regularly and only 4% smoked."
Their results showed that men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer, as compared with placebo (17.0 and 18.3 events, respectively, per 1000 person-years; hazard ratio [HR], 0.92; P = .04).
However, when the cancers were considered separately, there was no significant effect. There was no effect of the daily multivitamin on prostate cancer (multivitamin and placebo groups, 9.1 and 9.2 events per 1000 person-years; HR, 0.98; P = .76), colorectal cancer (1.2 and 1.4 events per 1000 person years; HR, 0.89; P = .39), or any other site-specific cancers.
Dr. Gaziano and colleagues noted that the total cancer rates in this cohort were probably influenced by the increased surveillance for prostate-specific antigen (PSA) and subsequent diagnoses of prostate cancer during the last 1990s.
"We had included participants with a prior history of cancer and we had prespecified an analysis that we would do, and there is an appearance of a stronger effect in those with a prior cancer," he said.
"Given that more than 1.6 million new cancer cases are diagnosed in the U.S. each year, this translates into about 130,000 cancers prevented every year, and with it all the health care costs and human suffering," commented Dr. Frei, who was not involved in the study.
Dr. Frei also pointed out that the effect might be even higher in other population groups than seen in this study. "And it's worth noting that the research was done with 14,600 physicians," Dr. Frei said. "This highly-educated group has a better diet, knowledge base and health habits than the average person, so it's reasonable to believe that the impact of multivitamin use in the general population will be even greater."
11th Annual AACR International Conference on Frontiers in Cancer Prevention Research, Presented October 17, 2012. JAMA. 2012. Published online October 17, 2012.
Vitamin D makes old Englishmen live longer
Abstract and IntroductionAbstractAims To examine the independent relevance of plasma concentrations of 25-hydroxyvitamin D [25(OH)D] for vascular and non-vascular mortality.
Methods and results We examined associations of plasma concentrations of 25(OH)D and cause-specific mortality in a prospective study of older men living in the UK and included findings in meta-analyses of similar studies identified by a systematic search reporting on vascular and all-cause mortality. In a 13-year follow-up of 5409 men (mean baseline age 77 years), 1358 died from vascular and 1857 from non-vascular causes. Median season-adjusted baseline 25(OH)D concentration was 56 (interquartile range: 45–67) nmol/L. After adjustment for age and seasonality, higher concentrations of 25(OH)D were inversely and approximately linearly (log–log scale) associated with vascular and non-vascular mortality throughout the range 40–90 nmol/L. After additional adjustment for prior disease and cardiovascular risk factors, a doubling in 25(OH)D concentration was associated with 20% [95% confidence interval (CI): 9–30%] lower vascular and 23% (95% CI: 14–31%) lower non-vascular mortality. In meta-analyses of prospective studies, individuals in the top vs. bottom quarter of 25(OH)D concentrations had 21% (95% CI: 13–28%) lower vascular and 28% (95% CI: 24–32%) lower all-cause mortality.
Conclusions Despite strong inverse and apparently independent associations of 25(OH)D with vascular and non-vascular mortality, causality remains uncertain. Large-scale randomized trials, using high doses of vitamin D, are required to assess the clinical relevance of these associations.
Methods and results We examined associations of plasma concentrations of 25(OH)D and cause-specific mortality in a prospective study of older men living in the UK and included findings in meta-analyses of similar studies identified by a systematic search reporting on vascular and all-cause mortality. In a 13-year follow-up of 5409 men (mean baseline age 77 years), 1358 died from vascular and 1857 from non-vascular causes. Median season-adjusted baseline 25(OH)D concentration was 56 (interquartile range: 45–67) nmol/L. After adjustment for age and seasonality, higher concentrations of 25(OH)D were inversely and approximately linearly (log–log scale) associated with vascular and non-vascular mortality throughout the range 40–90 nmol/L. After additional adjustment for prior disease and cardiovascular risk factors, a doubling in 25(OH)D concentration was associated with 20% [95% confidence interval (CI): 9–30%] lower vascular and 23% (95% CI: 14–31%) lower non-vascular mortality. In meta-analyses of prospective studies, individuals in the top vs. bottom quarter of 25(OH)D concentrations had 21% (95% CI: 13–28%) lower vascular and 28% (95% CI: 24–32%) lower all-cause mortality.
Conclusions Despite strong inverse and apparently independent associations of 25(OH)D with vascular and non-vascular mortality, causality remains uncertain. Large-scale randomized trials, using high doses of vitamin D, are required to assess the clinical relevance of these associations.