title: Serum alpha-tocopherol and subsequent risk of lung cancer among male smokers.
abstract: BACKGROUND
  Higher blood levels of alpha-tocopherol, the predominant form of vitamin E, have been associated in some studies with a reduced risk of lung cancer, but other studies have yielded conflicting results. To clarify this association, we examined the relationship between prospectively collected serum alpha-tocopherol and lung cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort.
  
  
  METHODS
  The ATBC Study was a randomized, clinical trial of 29 133 white male smokers from Finland who were 50-69 years old and who had received alpha-tocopherol (50 mg), beta-carotene (20 mg), both, or neither daily for 5-8 years. Data regarding medical histories, smoking, and dietary factors were obtained at study entry, as was a serum specimen for baseline alpha-tocopherol determination. alpha-Tocopherol measurements were available for 29 102 of the men, among whom 1144 incident cases of lung cancer were diagnosed during a median observation period of 7.7 years. The association between alpha-tocopherol and lung cancer was evaluated with the use of multivariate proportional hazards regression.
  
  
  RESULTS
  A 19% reduction in lung cancer incidence was observed in the highest versus lowest quintile of serum alpha-tocopherol (relative risk = 0.81; 95% confidence interval = 0. 67-0.97). There was a stronger inverse association among younger men (<60 years), among men with less cumulative tobacco exposure (<40 years of smoking), and possibly among men receiving alpha-tocopherol supplementation.
  
  
  CONCLUSIONS
  In the ATBC Study cohort, higher serum alpha-tocopherol status is associated with lower lung cancer risk; this relationship appears stronger among younger persons and among those with less cumulative smoke exposure. These findings suggest that high levels of alpha-tocopherol, if present during the early critical stages of tumorigenesis, may inhibit lung cancer development.
authors.affiliation: Cancer Prevention Studies Branch, Division of Clinical Sciences, National Cancer Institute, Bethesda, MD, USA.
authors.forename: K
authors.initials: K
authors.lastname: Woodson
authors.forename: J A
authors.initials: JA
authors.lastname: Tangrea
authors.forename: M J
authors.initials: MJ
authors.lastname: Barrett
authors.forename: J
authors.initials: J
authors.lastname: Virtamo
authors.forename: P R
authors.initials: PR
authors.lastname: Taylor
authors.forename: D
authors.initials: D
authors.lastname: Albanes
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000209:etiology; D000368:Aged; D002277:Carcinoma / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D018288:Carcinoma, Small Cell / Q000097:blood / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000209:etiology; D019587:Dietary Supplements; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016896:Treatment Outcome; D014810:Vitamin E / Q000008:administration & dosage / Q000097:blood*; D019207:beta Carotene / Q000008:administration & dosage / Q000097:blood*
chemical_list: D019207:beta Carotene; D014810:Vitamin E