title: Multivitamin use and colon cancer mortality in the Cancer Prevention Study II cohort (United States).
abstract: OBJECTIVE
  Multivitamins contain several nutrients, including folic acid, which are hypothesized to reduce colon cancer risk. Previous epidemiologic studies have suggested that effects of multivitamins containing substantial amounts of folic acid (introduced in 1973) may not be evident until 15 or more years since first use.
  
  
  METHODS
  We examined the association between daily multivitamin use and colon cancer mortality among 806,397 US men and women in the Cancer Prevention Study II cohort who completed a questionnaire at enrollment in 1982 and were followed for mortality through 1998.
  
  
  RESULTS
  After multivariate adjustment, multivitamin use at enrollment showed little association with colon cancer mortality. After 15 years since first use of a multivitamin potentially containing folic acid, we observed slightly decreased risk of colon cancer mortality (rate ratio (RR) = 0.89, 95% confidence interval (CI) 0.80-0.99). Consistent with previous reports, this association was stronger among participants consuming two or more alcoholic drinks per day (RR = 0.71, 95% CI 0.56-0.91).
  
  
  CONCLUSIONS
  Our results are consistent with a modest reduction in colon cancer mortality associated with use of folic acid-containing multivitamins among moderate to heavy alcohol users.
authors.affiliation: Department of Epidemiology and Surveillance Research, American Cancer Society, National Home Office, Atlanta, GA 30329-4251, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Jacobs
authors.forename: C J
authors.initials: CJ
authors.lastname: Connell
authors.forename: A V
authors.initials: AV
authors.lastname: Patel
authors.forename: A
authors.initials: A
authors.lastname: Chao
authors.forename: C
authors.initials: C
authors.lastname: Rodriguez
authors.forename: J
authors.initials: J
authors.lastname: Seymour
authors.forename: M L
authors.initials: ML
authors.lastname: McCullough
authors.forename: E E
authors.initials: EE
authors.lastname: Calle
authors.forename: M J
authors.initials: MJ
authors.lastname: Thun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins