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Selenium supplementation and prostate cancer mortality.

Abstract

BACKGROUND

Few studies have evaluated the relation between selenium supplementation after diagnosis and prostate cancer outcomes.

METHODS

We prospectively followed 4459 men initially diagnosed with nonmetastatic prostate cancer in the Health Professionals Follow-Up Study from 1988 through 2010 and examined whether selenium supplement use (from selenium-specific supplements and multivitamins) after diagnosis was associated with risk of biochemical recurrence, prostate cancer mortality, and, secondarily, cardiovascular disease mortality and overall mortality, using Cox proportional hazards models. All P values were from two-sided tests.

RESULTS

We documented 965 deaths, 226 (23.4%) because of prostate cancer and 267 (27.7%) because of cardiovascular disease, during a median follow-up of 8.9 years. In the biochemical recurrence analysis, we documented 762 recurrences during a median follow-up of 7.8 years. Crude rates per 1000 person-years for prostate cancer death were 5.6 among selenium nonusers and 10.5 among men who consumed 140 or more μg/day. Crude rates per 1000 person-years were 28.2 vs 23.5 for all-cause mortality and 28.4 vs 29.3 for biochemical recurrence, for nonuse vs highest-dose categories, respectively. In multivariable analyses, men who consumed 1 to 24 μg/day, 25 to 139 μg/day, and 140 or more μg/day of supplemental selenium had a 1.18 (95% confidence interval [CI] = 0.73 to 1.91), 1.33 (95% CI = 0.77 to 2.30), and 2.60-fold (95% CI = 1.44 to 4.70) greater risk of prostate cancer mortality compared with nonusers, respectively, P trend = .001. There was no statistically significant association between selenium supplement use and biochemical recurrence, cardiovascular disease mortality, or overall mortality.

CONCLUSION

Selenium supplementation of 140 or more μg/day after diagnosis of nonmetastatic prostate cancer may increase risk of prostate cancer mortality. Caution is warranted regarding usage of such supplements among men with prostate cancer.

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    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG). KenfieldS@urology.ucsf.edu.

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG).

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG).

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG).

    ,

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG).

    Department of Urology, University of California, San Francisco, San Francisco, CA (ELVB, SAK, JMC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SAK, ND, MJS, EG); Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (ELVB, JMC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (MJS, EG); Department of Nutrition, Harvard School of Public Health, Boston, MA (MJS, EG).

    Source

    MeSH

    Aged
    Aged, 80 and over
    Dietary Supplements
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Neoplasm Recurrence, Local
    Proportional Hazards Models
    Prostatic Neoplasms
    Risk Factors
    Selenium
    Trace Elements

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    25505227

    Citation

    Kenfield, Stacey A., et al. "Selenium Supplementation and Prostate Cancer Mortality." Journal of the National Cancer Institute, vol. 107, no. 1, 2015, p. 360.
    Kenfield SA, Van Blarigan EL, DuPre N, et al. Selenium supplementation and prostate cancer mortality. J Natl Cancer Inst. 2015;107(1):360.
    Kenfield, S. A., Van Blarigan, E. L., DuPre, N., Stampfer, M. J., L Giovannucci, E., & Chan, J. M. (2015). Selenium supplementation and prostate cancer mortality. Journal of the National Cancer Institute, 107(1), p. 360. doi:10.1093/jnci/dju360.
    Kenfield SA, et al. Selenium Supplementation and Prostate Cancer Mortality. J Natl Cancer Inst. 2015;107(1):360. PubMed PMID: 25505227.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Selenium supplementation and prostate cancer mortality. AU - Kenfield,Stacey A, AU - Van Blarigan,Erin L, AU - DuPre,Natalie, AU - Stampfer,Meir J, AU - L Giovannucci,Edward, AU - Chan,June M, Y1 - 2014/12/12/ PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/2/24/medline SP - 360 EP - 360 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 107 IS - 1 N2 - BACKGROUND: Few studies have evaluated the relation between selenium supplementation after diagnosis and prostate cancer outcomes. METHODS: We prospectively followed 4459 men initially diagnosed with nonmetastatic prostate cancer in the Health Professionals Follow-Up Study from 1988 through 2010 and examined whether selenium supplement use (from selenium-specific supplements and multivitamins) after diagnosis was associated with risk of biochemical recurrence, prostate cancer mortality, and, secondarily, cardiovascular disease mortality and overall mortality, using Cox proportional hazards models. All P values were from two-sided tests. RESULTS: We documented 965 deaths, 226 (23.4%) because of prostate cancer and 267 (27.7%) because of cardiovascular disease, during a median follow-up of 8.9 years. In the biochemical recurrence analysis, we documented 762 recurrences during a median follow-up of 7.8 years. Crude rates per 1000 person-years for prostate cancer death were 5.6 among selenium nonusers and 10.5 among men who consumed 140 or more μg/day. Crude rates per 1000 person-years were 28.2 vs 23.5 for all-cause mortality and 28.4 vs 29.3 for biochemical recurrence, for nonuse vs highest-dose categories, respectively. In multivariable analyses, men who consumed 1 to 24 μg/day, 25 to 139 μg/day, and 140 or more μg/day of supplemental selenium had a 1.18 (95% confidence interval [CI] = 0.73 to 1.91), 1.33 (95% CI = 0.77 to 2.30), and 2.60-fold (95% CI = 1.44 to 4.70) greater risk of prostate cancer mortality compared with nonusers, respectively, P trend = .001. There was no statistically significant association between selenium supplement use and biochemical recurrence, cardiovascular disease mortality, or overall mortality. CONCLUSION: Selenium supplementation of 140 or more μg/day after diagnosis of nonmetastatic prostate cancer may increase risk of prostate cancer mortality. Caution is warranted regarding usage of such supplements among men with prostate cancer. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/25505227/full_citation L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/dju360 DB - PRIME DP - Unbound Medicine ER -