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Certain vitamin supplements may increase
lung cancer risk, especially in smokers
Vitamin supplements do not protect against lung cancer, according
to a study of more than 77,000 vitamin
users. In fact, some supplements may even
increase the risk of developing it.
“Our study of supplemental multivitamins, vitamin C, vitamin E and
folate did not show any evidence for a
decreased risk of lung cancer,” wrote the
study’s author, Christopher G. Slatore,
M.D., of the University of Washington, in
Seattle.
“Indeed, increasing intake of supplemental vitamin E was associated
with a slightly increased risk of lung
cancer.”
The findings were published in the first issue for March of the
American Thoracic Society’s American Journal
of Respiratory and Critical Care Medicine.
Dr. Slatore and colleagues selected a prospective cohort of 77,126
men and women between 50 and 76 years of age
in the Washington state VITAL (VITamins And
Lifestyle) study, and determined their rate
of developing lung cancer over four years
with respect to their current and past
vitamin usage, smoking, and other
demographic and medical characteristics.
Of the original cohort, 521 developed lung cancer, the expected
rate for a low-risk cohort such as VITAL.
But among those who developed lung cancer,
in addition to the unsurprising associations
with smoking history, family history, and
age, there was a slight but significant
association between use of supplemental
vitamin E and lung cancer.
“In contrast to the often assumed benefits or at least lack of
harm, supplemental vitamin E was associated
with a small increased risk of lung cancer,”
said Dr. Slatore.
When modeled continuously, the increased risk was equivalent to a
seven percent rise for every 100 mg/day.
“This risk translates into a 28 percent increased risk of
lung cancer at a dose of 400 mg/day for ten
years,” wrote Dr. Slatore. The increased
risk was most prominent in current smokers.
The idea that vitamin supplements are healthy, or at the very
least, do no harm, comes from the desire of
many people to mimic the benefits of a
healthy diet with a convenient pill says Tim
Byers, M.D., M.P.H., of the University of
Colorado School of Medicine in an editorial
in the same issue of the journal.
However, he points out, “fruits contain not only vitamins but also
many hundreds of other phytochemical
compounds whose functions are not well
understood.”
The World Cancer Research Fund and the American Cancer Society
recommend two servings of fruit each day,
based on a study that previously found a 20
percent increase in cancer risk among people
who ate the least amount of fruit.
This recommendation “would likely lead to a reduced risk for lung
cancer, as well as reduced risk of several
other cancers and cardiovascular disease,”
writes Dr. Byers.
“However, any benefit to the population of smokers from increasing
fruit intake to reduce cancer risk by 20
percent would be more than offset if even a
small proportion of smokers decided to
continue tobacco use in favor of such a diet
change.”
These findings have broad public health implications, given the
large population of current and former
smokers and the widespread use of vitamin
supplements. “Future studies may focus on
other components of fruits and vegetables
that may explain the decreased risk [of
cancer] that has been associated with fruits
and vegetables,” writes Dr. Slatore.
“Meanwhile,” he says, “our results should prompt clinicians to
counsel patients that these supplements are
unlikely to reduce the risk of lung cancer
and may be detrimental.”
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