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Baseline selenium status and effects of selenium and vitamin e supplementation on prostate cancer risk.

Abstract

BACKGROUND

The Selenium and Vitamin E Cancer Prevention Trial found no effect of selenium supplementation on prostate cancer (PCa) risk but a 17% increased risk from vitamin E supplementation. This case-cohort study investigates effects of selenium and vitamin E supplementation conditional upon baseline selenium status.

METHODS

There were 1739 total and 489 high-grade (Gleason 7-10) PCa cases and 3117 men in the randomly selected cohort. Proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for effects of supplementation within quintiles of baseline toenail selenium. Cox proportional hazards models were used to estimate hazard ratios, and all statistical tests are two-sided.

RESULTS

Toenail selenium, in the absence of supplementation, was not associated with PCa risk. Selenium supplementation (combined selenium only and selenium + vitamin E arms) had no effect among men with low selenium status (<60th percentile of toenail selenium) but increased the risk of high-grade PCa among men with higher selenium status by 91% (P = .007). Vitamin E supplementation (alone) had no effect among men with high selenium status (≥40th percentile of toenail selenium) but increased the risks of total, low-grade, and high-grade PCa among men with lower selenium status (63%, P = .02; 46%, P = .09; 111%, P = .008, respectively).

CONCLUSIONS

Selenium supplementation did not benefit men with low selenium status but increased the risk of high-grade PCa among men with high selenium status. Vitamin E increased the risk of PCa among men with low selenium status. Men should avoid selenium or vitamin E supplementation at doses that exceed recommended dietary intakes.

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    Affiliations of authors: Cancer Prevention Program (ARK) and SWOG Statistical Center (AKD, CMT, PJG), Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology (ARK, GEG) and Department of Environmental Health (GEG), University of Washington, Seattle, WA; University of Missouri, Research Reactor Center, Columbia, MO (JSM); Harry S. Truman Memorial Veterans Hospital, Columbia, MO (JSM); Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX (IMT); Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA (FLM); Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD (LMM, HLP); Moores Cancer Center, University of California San Diego, San Diego, CA (SML); Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH (EAK).

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    Source

    MeSH

    African Americans
    Aged
    Antioxidants
    Canada
    Cohort Studies
    Dietary Supplements
    Humans
    Male
    Middle Aged
    Nails
    Neoplasm Grading
    Odds Ratio
    Proportional Hazards Models
    Prostatic Neoplasms
    Puerto Rico
    Randomized Controlled Trials as Topic
    Risk
    Selenium
    Trace Elements
    United States
    Vitamin E
    Vitamins

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24563519

    Citation

    Kristal, Alan R., et al. "Baseline Selenium Status and Effects of Selenium and Vitamin E Supplementation On Prostate Cancer Risk." Journal of the National Cancer Institute, vol. 106, no. 3, 2014, pp. djt456.
    Kristal AR, Darke AK, Morris JS, et al. Baseline selenium status and effects of selenium and vitamin e supplementation on prostate cancer risk. J Natl Cancer Inst. 2014;106(3):djt456.
    Kristal, A. R., Darke, A. K., Morris, J. S., Tangen, C. M., Goodman, P. J., Thompson, I. M., ... Klein, E. A. (2014). Baseline selenium status and effects of selenium and vitamin e supplementation on prostate cancer risk. Journal of the National Cancer Institute, 106(3), pp. djt456. doi:10.1093/jnci/djt456.
    Kristal AR, et al. Baseline Selenium Status and Effects of Selenium and Vitamin E Supplementation On Prostate Cancer Risk. J Natl Cancer Inst. 2014;106(3):djt456. PubMed PMID: 24563519.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Baseline selenium status and effects of selenium and vitamin e supplementation on prostate cancer risk. AU - Kristal,Alan R, AU - Darke,Amy K, AU - Morris,J Steven, AU - Tangen,Catherine M, AU - Goodman,Phyllis J, AU - Thompson,Ian M, AU - Meyskens,Frank L,Jr AU - Goodman,Gary E, AU - Minasian,Lori M, AU - Parnes,Howard L, AU - Lippman,Scott M, AU - Klein,Eric A, Y1 - 2014/02/22/ PY - 2014/2/25/entrez PY - 2014/2/25/pubmed PY - 2014/8/19/medline SP - djt456 EP - djt456 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 106 IS - 3 N2 - BACKGROUND: The Selenium and Vitamin E Cancer Prevention Trial found no effect of selenium supplementation on prostate cancer (PCa) risk but a 17% increased risk from vitamin E supplementation. This case-cohort study investigates effects of selenium and vitamin E supplementation conditional upon baseline selenium status. METHODS: There were 1739 total and 489 high-grade (Gleason 7-10) PCa cases and 3117 men in the randomly selected cohort. Proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for effects of supplementation within quintiles of baseline toenail selenium. Cox proportional hazards models were used to estimate hazard ratios, and all statistical tests are two-sided. RESULTS: Toenail selenium, in the absence of supplementation, was not associated with PCa risk. Selenium supplementation (combined selenium only and selenium + vitamin E arms) had no effect among men with low selenium status (<60th percentile of toenail selenium) but increased the risk of high-grade PCa among men with higher selenium status by 91% (P = .007). Vitamin E supplementation (alone) had no effect among men with high selenium status (≥40th percentile of toenail selenium) but increased the risks of total, low-grade, and high-grade PCa among men with lower selenium status (63%, P = .02; 46%, P = .09; 111%, P = .008, respectively). CONCLUSIONS: Selenium supplementation did not benefit men with low selenium status but increased the risk of high-grade PCa among men with high selenium status. Vitamin E increased the risk of PCa among men with low selenium status. Men should avoid selenium or vitamin E supplementation at doses that exceed recommended dietary intakes. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/24563519/Baseline_selenium_status_and_effects_of_selenium_and_vitamin_e_supplementation_on_prostate_cancer_risk_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djt456 DB - PRIME DP - Unbound Medicine ER -