Effects of alpha-tocopherol and beta-carotene supplementation on gastric cancer incidence in male smokers (ATBC Study, Finland).
OBJECTIVE
This study investigated the effects of alpha-tocopherol and beta-carotene supplementation on the incidence of gastric cancer.


METHODS
A total of 29,133 male smokers, aged 50-69 years, participated in a placebo-controlled prevention trial, the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in southwestern Finland between 1985 and 1993. The men were randomly assigned to receive alpha-tocopherol (50 mg/day) or beta-carotene (20 mg/day) supplementation in a 2 x 2 factorial design. We identified 126 gastric cancer cases during the median follow-up of six years. Of these, 122 were adenocarcinomas: 75 of intestinal type, 30 of diffuse type, and 17 of mixed type.


RESULTS
There was no significant effect for either supplementation on the overall incidence of gastric cancer: relative risk (RR) 1.21, 95% confidence interval (CI) 0.85-1.74 for alpha-tocopherol, and RR 1.26, 95% Cl 0.88-1.80 for beta-carotene. Subgroup analyses by histologic type suggested an increased risk for beta-carotene on intestinal type cancers, RR 1.59, 95% CI 0.99-2.56. There were no differences across anatomic locations (cardia/noncardia) in the effects of alpha-tocopherol or beta-carotene supplementation.


CONCLUSIONS
Our study found no overall preventive effect of long-term supplementation with alpha-tocopherol or beta-carotene on gastric cancer in middle-aged male smokers.
Malila
Nea
N
National Public Health Institute, Helsinki, Finland. Nea.Malila@cancer.fi
Taylor
Philip R
PR
Virtanen
Mikko J
MJ
Korhonen
Pasi
P
Huttunen
Jussi K
JK
Albanes
Demetrius
D
Virtamo
Jarmo
J
D000284:Administration, Oral; D000368:Aged; D016001:Confidence Intervals; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012016:Reference Values; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage*
D019207:beta Carotene; D024502:alpha-Tocopherol