title: Effects of supplemental alpha-tocopherol and beta-carotene on urinary tract cancer: incidence and mortality in a controlled trial (Finland).
abstract: OBJECTIVE
  Epidemiological studies have suggested a protective effect of vegetables and fruits on urinary tract cancer but the possible protective nutrients are unknown. We studied the effect of alpha-tocopherol (a form of vitamin E) and beta-carotene supplementation on urinary tract cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study.
  
  
  METHODS
  A total of 29,133 male smokers aged 50-69 years from southwestern Finland were randomly assigned to receive alpha-tocopherol (50 mg), beta-carotene (20 mg), both agents, or a placebo daily for 5-8 years (median 6.1 years). Incident urothelial cancers (bladder, ureter, and renal pelvis; n = 169) and renal cell cancers (n = 102) were identified through the nationwide cancer registry. The diagnoses were centrally confirmed by review of medical records and pathology specimens. The supplementation effects were estimated using a proportional hazards model.
  
  
  RESULTS
  Neither alpha-tocopherol nor beta-carotene affected the incidence of urothelial cancer, relative risk 1.1 (95% confidence interval (CI) 0.8-1.5) and 1.0 (95% CI 0.7-1.3), respectively, or the incidence of renal cell cancer, relative risk 1.1 (95% CI 0.7-1.6) and 0.8 (95% CI 0.6-1.3), respectively.
  
  
  CONCLUSIONS
  Long-term supplementation with alpha-tocopherol and beta-carotene has no preventive effect on urinary tract cancers in middle-aged male smokers.
authors.affiliation: National Public Health Institute, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Virtamo
authors.forename: B K
authors.initials: BK
authors.lastname: Edwards
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.forename: P R
authors.initials: PR
authors.lastname: Taylor
authors.forename: N
authors.initials: N
authors.lastname: Malila
authors.forename: D
authors.initials: D
authors.lastname: Albanes
authors.forename: J K
authors.initials: JK
authors.lastname: Huttunen
authors.forename: A M
authors.initials: AM
authors.lastname: Hartman
authors.forename: P
authors.initials: P
authors.lastname: Hietanen
authors.forename: H
authors.initials: H
authors.lastname: Mäenpää
authors.forename: L
authors.initials: L
authors.lastname: Koss
authors.forename: S
authors.initials: S
authors.lastname: Nordling
authors.forename: O P
authors.initials: OP
authors.lastname: Heinonen
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000494:pharmacology*; D019587:Dietary Supplements; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D014571:Urologic Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D014810:Vitamin E / Q000008:administration & dosage / Q000494:pharmacology*; D019207:beta Carotene / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D000975:Antioxidants; D019207:beta Carotene; D014810:Vitamin E