title: Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer.
abstract: OBJECTIVE
  To evaluate the evidence of the supplements vitamin C and vitamin E for treatment and prevention of cancer.
  
  
  METHODS
  Systematic review of trials and meta-analysis. DATA SOURCES AND MAIN RESULTS: Thirty-eight studies showed scant evidence that vitamin C or vitamin E beneficially affects survival. In the ATBC Cancer Prevention Study Group, no statistically significant effect of treatment was seen for any cancer individually, and our pooled relative risk (regardless of tumor type) for alpha-tocopherol alone was 0.91 (95% confidence interval [CI]: 0.74, 1.12). All cause mortality was not significant. In the Linxian General Population Trial, the relative risks for cancer death for vitamin C (combined with molybdenum) was 1.06 (95% CI: 0.92, 1.21) and for vitamin E (combined with beta-carotene and selenium) was 0.87 (95% CI: 0.76, 1.00). We identified only 3 studies that reported statistically significant beneficial results: vitamin C (in combination with BCG) was found to be beneficial in a single trial of bladder cancer and vitamin E (in combination with omega-3 fatty acid) increased survival in patients with advanced cancer. In the ATBC trial, in analyses of 6 individual cancers, the prevention of prostate cancer in subjects treated with alpha-tocopherol was statistically significant (RR=0.64, 95% CI: 0.44, 0.94).
  
  
  CONCLUSIONS
  The systematic review of the literature does not support the hypothesis that the use of supplements of vitamin C or vitamin E in the doses tested helps prevent and/or treat cancer in the populations tested. There were isolated findings of benefit, which require confirmation.
authors.affiliation: RAND, Southern California Evidence-based Practice Center, Santa Monica, CA, USA. coulter@rand.org
authors.forename: Ian D
authors.initials: ID
authors.lastname: Coulter
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hardy
authors.forename: Sally C
authors.initials: SC
authors.lastname: Morton
authors.forename: Lara G
authors.initials: LG
authors.lastname: Hilton
authors.forename: Wenli
authors.initials: W
authors.lastname: Tu
authors.forename: Di
authors.initials: D
authors.lastname: Valentine
authors.forename: Paul G
authors.initials: PG
authors.lastname: Shekelle
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D012306:Risk; D016019:Survival Analysis; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D014810:Vitamin E; D001205:Ascorbic Acid