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Vitamin C and survival among women with breast cancer: a meta-analysis.

Abstract

BACKGROUND

The association between dietary vitamin C intake and breast cancer survival is inconsistent and few studies have specifically examined vitamin C supplement use among women with breast cancer. The purpose of this study was to summarise results from prospective studies on the association between vitamin C supplement use and dietary vitamin C intake and breast cancer-specific mortality and total mortality.

METHODS

Studies were identified using the PubMed database through February 6, 2014 and by examining the references of retrieved articles. Prospective studies were included if they reported relative risks (RR) with 95% confidence intervals (95% CIs) for at least two categories or as a continuous exposure. Random-effects models were used to combine study-specific results.

RESULTS

The ten identified studies examined vitamin C supplement use (n=6) and dietary vitamin C intake (n=7) and included 17,696 breast cancer cases, 2791 total deaths, and 1558 breast cancer-specific deaths. The summary RR (95% CI) for post-diagnosis vitamin C supplement use was 0.81 (95% CI 0.72-0.91) for total mortality and 0.85 (95% CI 0.74-0.99) for breast cancer-specific mortality. The summary RR for a 100mg per day increase in dietary vitamin C intake was 0.73 (95% CI 0.59-0.89) for total mortality and 0.78 (95% CI 0.64-0.94) for breast cancer-specific mortality.

CONCLUSION

Results from this meta-analysis suggest that post-diagnosis vitamin C supplement use may be associated with a reduced risk of mortality. Dietary vitamin C intake was also statistically significantly associated with a reduced risk of total mortality and breast cancer-specific mortality.

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  • Authors+Show Affiliations

    ,

    Unit of Nutritional Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden; Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA. Electronic address: holly.harris@ki.se.

    ,

    Unit of Nutritional Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.

    Unit of Nutritional Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.

    Source

    MeSH

    Antioxidants
    Ascorbic Acid
    Breast Neoplasms
    Diet
    Dietary Supplements
    Female
    Humans
    Prospective Studies
    Survival Analysis
    Vitamins

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    24613622

    Citation

    Harris, Holly R., et al. "Vitamin C and Survival Among Women With Breast Cancer: a Meta-analysis." European Journal of Cancer (Oxford, England : 1990), vol. 50, no. 7, 2014, pp. 1223-31.
    Harris HR, Orsini N, Wolk A. Vitamin C and survival among women with breast cancer: a meta-analysis. Eur J Cancer. 2014;50(7):1223-31.
    Harris, H. R., Orsini, N., & Wolk, A. (2014). Vitamin C and survival among women with breast cancer: a meta-analysis. European Journal of Cancer (Oxford, England : 1990), 50(7), pp. 1223-31. doi:10.1016/j.ejca.2014.02.013.
    Harris HR, Orsini N, Wolk A. Vitamin C and Survival Among Women With Breast Cancer: a Meta-analysis. Eur J Cancer. 2014;50(7):1223-31. PubMed PMID: 24613622.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin C and survival among women with breast cancer: a meta-analysis. AU - Harris,Holly R, AU - Orsini,Nicola, AU - Wolk,Alicja, Y1 - 2014/03/07/ PY - 2013/10/13/received PY - 2014/02/06/revised PY - 2014/02/15/accepted PY - 2014/3/12/entrez PY - 2014/3/13/pubmed PY - 2014/5/13/medline KW - Breast cancer KW - Meta-analysis KW - Mortality KW - Supplement use KW - Vitamin C SP - 1223 EP - 31 JF - European journal of cancer (Oxford, England : 1990) JO - Eur. J. Cancer VL - 50 IS - 7 N2 - BACKGROUND: The association between dietary vitamin C intake and breast cancer survival is inconsistent and few studies have specifically examined vitamin C supplement use among women with breast cancer. The purpose of this study was to summarise results from prospective studies on the association between vitamin C supplement use and dietary vitamin C intake and breast cancer-specific mortality and total mortality. METHODS: Studies were identified using the PubMed database through February 6, 2014 and by examining the references of retrieved articles. Prospective studies were included if they reported relative risks (RR) with 95% confidence intervals (95% CIs) for at least two categories or as a continuous exposure. Random-effects models were used to combine study-specific results. RESULTS: The ten identified studies examined vitamin C supplement use (n=6) and dietary vitamin C intake (n=7) and included 17,696 breast cancer cases, 2791 total deaths, and 1558 breast cancer-specific deaths. The summary RR (95% CI) for post-diagnosis vitamin C supplement use was 0.81 (95% CI 0.72-0.91) for total mortality and 0.85 (95% CI 0.74-0.99) for breast cancer-specific mortality. The summary RR for a 100mg per day increase in dietary vitamin C intake was 0.73 (95% CI 0.59-0.89) for total mortality and 0.78 (95% CI 0.64-0.94) for breast cancer-specific mortality. CONCLUSION: Results from this meta-analysis suggest that post-diagnosis vitamin C supplement use may be associated with a reduced risk of mortality. Dietary vitamin C intake was also statistically significantly associated with a reduced risk of total mortality and breast cancer-specific mortality. SN - 1879-0852 UR - https://www.unboundmedicine.com/medline/citation/24613622/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-8049(14)00175-0 DB - PRIME DP - Unbound Medicine ER -