title: Dietary supplement use in individuals living with cancer and other chronic conditions: a population-based study.
abstract: OBJECTIVE
  Cancer survivors are increasingly turning to complementary and alternative medicine (CAM) to manage short- and long-term treatment sequelae. Population-based data on relative use of dietary supplements among cancer survivors compared to those without a cancer history is lacking. Our objective was to compare supplement use among those with and without cancer and among those with and without other chronic conditions, and to identify correlates of supplement use by cancer status.
  
  
  METHODS
  Cross-sectional, population-based survey of participants in the 2003 CAM supplement to the 2001 California Health Interview Survey.
  
  
  METHODS
  Participants reporting a cancer diagnosis on the 2001 California Health Interview Survey or newly reported diagnosis on the 2003 survey (n=1,844) plus a random oversampling of racial/ethnic minorities (n=7,343).
  
  
  METHODS
  Self-reported use of a multivitamin and 27 vitamins, minerals, herbs, and other natural products during the preceding 12 months.
  
  
  METHODS
  Logistic regression analyses were performed with control for potential confounders.
  
  
  RESULTS
  Adults with cancer or other chronic conditions had higher prevalence of supplement use than those reporting no illness. The independent effect of cancer was associated with vitamin use, whereas living with other chronic conditions was associated with all types of supplement use, except multivitamins. Correlates of supplement use were similar between cancer survivors and cancer-free individuals-being a woman, advancing age, and greater physical activity, fruit and vegetable intake, and other CAM use. Among cancer survivors, non-Hispanic whites had the lowest prevalence of herbal supplement use.
  
  
  CONCLUSIONS
  These results indicate that having a chronic medical condition is the major factor associated with supplement use. A diagnosis of cancer, by itself, does not have an independent effect on supplement use. This suggests that most supplement use among cancer survivors is directed at dealing with or preventing the exacerbation of a comorbid condition. Consumers and health professionals should be aware that there is limited information on the effects of dietary supplements taken concurrently with prescription and other over-the-counter medications.
authors.affiliation: Cancer Prevention Fellowship Program, National Cancer Institute, 6116 Executive Blvd, Ste 404, MSC 8336, Bethesda, MD 20892, USA. millermeli@mail.nih.gov
authors.forename: Melissa Farmer
authors.initials: MF
authors.lastname: Miller
authors.forename: Keith M
authors.initials: KM
authors.lastname: Bellizzi
authors.forename: Meryl
authors.initials: M
authors.lastname: Sufian
authors.forename: Anita H
authors.initials: AH
authors.lastname: Ambs
authors.forename: Michael S
authors.initials: MS
authors.lastname: Goldstein
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002140:California; D002908:Chronic Disease / Q000517:prevention & control; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D004347:Drug Interactions; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000517:prevention & control / Q000628:therapy; D011159:Population Surveillance / Q000379:methods; D017678:Sex Distribution