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- Title
Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial.
- Authors
Gaziano JM; Sesso HD; Christen WG; Bubes V; Smith JP; MacFadyen J; Schvartz M; Manson JE; Glynn RJ; Buring JE; Gaziano, J Michael; Sesso, Howard D; Christen, William G; Bubes, Vadim; Smith, Joanne P; MacFadyen, Jean; Schvartz, Miriam; Manson, JoAnn E; Glynn, Robert J; Buring, Julie E
- Abstract
<bold>Context: </bold>Multivitamin preparations are the most common dietary supplement, taken by at least one-third of all US adults. Observational studies have not provided evidence regarding associations of multivitamin use with total and site-specific cancer incidence or mortality.<bold>Objective: </bold>To determine whether long-term multivitamin supplementation decreases the risk of total and site-specific cancer events among men.<bold>Design, Setting, and Participants: </bold>A large-scale, randomized, double-blind, placebo controlled trial (Physicians" Health Study II) of 14 641 male US physicians initially aged 50 years or older (mean [SD] age, 64.3 [9.2] years), including 1312 men with a history of cancer at randomization, enrolled in a common multivitamin study that began in 1997 with treatment and follow-up through June 1, 2011.<bold>Intervention: </bold>Daily multivitamin or placebo.<bold>Main Outcome Measures: </bold>Total cancer (excluding nonmelanoma skin cancer), with prostate, colorectal, and other site-specific cancers among the secondary end points.<bold>Results: </bold>During a median (interquartile range) follow-up of 11.2 (10.7-13.3) years, there were 2669 men with confirmed cancer, including 1373 cases of prostate cancer and 210 cases of colorectal cancer. Compared with placebo, men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer (multivitamin and placebo groups, 17.0 and 18.3 events, respectively, per 1000 person-years; hazard ratio [HR], 0.92; 95% CI, 0.86-0.998; P=.04). There was no significant effect of a daily multivitamin on prostate cancer (multivitamin and placebo groups, 9.1 and 9.2 events, respectively, per 1000 person-years; HR, 0.98; 95% CI, 0.88-1.09; P=.76), colorectal cancer (multivitamin and placebo groups, 1.2 and 1.4 events, respectively, per 1000 person-years; HR, 0.89; 95% CI, 0.68-1.17; P=.39), or other site-specific cancers. There was no significant difference in the risk of cancer mortality (multivitamin and placebo groups, 4.9 and 5.6 events, respectively, per 1000 person-years; HR, 0.88; 95% CI, 0.77-1.01; P=.07). Daily multivitamin use was associated with a reduction in total cancer among 1312 men with a baseline history of cancer (HR, 0.73; 95% CI, 0.56-0.96; P=.02), but this did not differ significantly from that among 13 329 men initially without cancer (HR, 0.94; 95% CI, 0.87-1.02; P=.15; P for interaction=.07). Conclusion In this large prevention trial of male physicians, daily multivitamin supplementation modestly but significantly reduced the risk of total cancer.<bold>Trial Registration: </bold>clinicaltrials.gov Identifier: NCT00270647.
- Publication
JAMA: Journal of the American Medical Association, 2012, Vol 308, Issue 18, p1871
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.2012.14641