Effects of supplemental alpha-tocopherol and beta-carotene on urinary tract cancer: incidence and mortality in a controlled trial (Finland).
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.
Virtamo
J
J
National Public Health Institute, Helsinki, Finland.
Edwards
B K
BK
Virtanen
M
M
Taylor
P R
PR
Malila
N
N
Albanes
D
D
Huttunen
J K
JK
Hartman
A M
AM
Hietanen
P
P
Mäenpää
H
H
Koss
L
L
Nordling
S
S
Heinonen
O P
OP
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*
D000975:Antioxidants; D019207:beta Carotene; D014810:Vitamin E