Incidence of skin cancers during 5-year follow-up after stopping antioxidant vitamins and mineral supplementation.
BACKGROUND
In the SU.VI.MAX study, antioxidant supplementation for 7.5 years was found to increase skin cancer risk in women but not in men.


OBJECTIVE
To investigate the potential residual or delayed effect of antioxidant supplementation on skin cancer incidence after a 5-year post-intervention follow-up.


METHODS
Assessment of skin cancer including melanoma and non-melanoma during the post-intervention follow-up (September 2002-August 2007). The SU.VI.MAX study was a double-blind, placebo-controlled, randomised trial, in which 12,741 French adults (7713 women aged 35-60 years and 5028 men aged 45-60 years) received daily a placebo or a combination of ascorbic acid (120 mg), vitamin E (30 mg), β-carotene (6 mg), selenium (100 μg) and zinc (20mg), from inclusion in 1994 to September 2002.


METHODS
Total skin cancer incidence, including melanoma, squamous cell carcinoma and basal cell carcinoma.


RESULTS
During the post-intervention period, 10 melanomas appeared in women and 9 in men (26 and 18, respectively, for the total period of supplementation+post-supplementation). Six squamous cell carcinomas were found in women and 15 in men (10 and 25, respectively, for the total period). Finally, 40 basal cell carcinomas appeared in women and 36 in men (98 and 94, respectively, for the total period). Regarding potential residual or delayed effects of supplementation in women, no increased risk of melanoma was observed during the post-intervention follow-up period. No delayed effects, either on melanoma or non-melanoma skin cancers, were observed for either gender.


CONCLUSIONS
The risk of skin cancers associated with antioxidant intake declines following interruption of supplementation. This supports a causative role for antioxidants in the evolution of skin cancers.
Ezzedine
Khaled
K
Department of Dermatology, Skin Cancer Unit, and National Centre for Rare Skin Diseases, CHU St-André, Bordeaux, France. Khaled.ezzedine@chu-bordeaux.fr
Latreille
Julie
J
Kesse-Guyot
Emmanuelle
E
Galan
Pilar
P
Hercberg
Serge
S
Guinot
Christiane
C
Malvy
Denis
D
D000328:Adult; D000975:Antioxidants / Q000009:adverse effects*; D002280:Basal Cell Carcinoma / Q000139:chemically induced / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000453:epidemiology*; D019587:Dietary Supplements / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D014815:Vitamins / Q000009:adverse effects*
D000975:Antioxidants; D014815:Vitamins