Long-term use of beta-carotene, retinol, lycopene, and lutein supplements and lung cancer risk: results from the VITamins And Lifestyle (VITAL) study.
High-dose beta-carotene supplementation in high-risk persons has been linked to increased lung cancer risk in clinical trials; whether effects are similar in the general population is unclear. The authors examined associations of supplemental beta-carotene, retinol, vitamin A, lutein, and lycopene with lung cancer risk among participants, aged 50-76 years, in the VITamins And Lifestyle (VITAL) cohort Study in Washington State. In 2000-2002, eligible persons (n = 77,126) completed a 24-page baseline questionnaire, including detailed questions about supplement use (duration, frequency, dose) during the previous 10 years from multivitamins and individual supplements/mixtures. Incident lung cancers (n = 521) through December 2005 were identified by linkage to the Surveillance, Epidemiology, and End Results cancer registry. Longer duration of use of individual beta-carotene, retinol, and lutein supplements (but not total 10-year average dose) was associated with statistically significantly elevated risk of total lung cancer and histologic cell types; for example, hazard ratio = 2.02, 95% confidence interval: 1.28, 3.17 for individual supplemental lutein with total lung cancer and hazard ratio = 3.22, 95% confidence interval: 1.29, 8.07 for individual beta-carotene with small-cell lung cancer for >4 years versus no use. There was little evidence for effect modification by gender or smoking status. Long-term use of individual beta-carotene, retinol, and lutein supplements should not be recommended for lung cancer prevention, particularly among smokers.
Satia
Jessie A
JA
Departments of Nutrition and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. jsatia@unc.edu
Littman
Alyson
A
Slatore
Christopher G
CG
Galanko
Joseph A
JA
White
Emily
E
D000368:Aged; D002338:Carotenoids / Q000009:adverse effects; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000209:etiology; D014975:Lutein / Q000009:adverse effects; D000077276:Lycopene; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000009:adverse effects; D014815:Vitamins / Q000009:adverse effects*; D019207:beta Carotene / Q000009:adverse effects
D014815:Vitamins; D019207:beta Carotene; D014801:Vitamin A; D002338:Carotenoids; D000077276:Lycopene; D014975:Lutein