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Departments of Epidemiology [J. M. C., M. J. S., E. B. R., W. C. W., E. L. G.] and Nutrition [J. M. C., M. J. S., E. B. R., W. C. W., E. L. G.], Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School [M. J. S., J. M., E. B. R., W. C. W., E. L. G.], Boston, Massachusetts 02115
A clinical trial of vitamin E and ß-carotene supplementation for lung cancer prevention among male smokers in Finland recently reported an unexpected, strong protective effect of vitamin E against prostate cancer incidence and mortality. Our objective was to prospectively examine supplemental vitamin E intake and prostate cancer risk in a distinct U.S. population. In 1986, we identified 47,780 U.S. male health professionals, free from diagnosed cancer, who completed a dietary and lifestyle questionnaire; supplemental vitamin E and prostate cancer incidence were updated biennially through 1996. We estimated relative risks (RRs) from multivariate pooled logistic regression models.
There were 1896 total (non-stage A1), 522 extraprostatic, and 232 metastatic or fatal incident prostate cancer cases diagnosed between 1986–1996. Men consuming at least 100 IU of supplemental vitamin E daily had multivariate RRs of 1.07 (95% confidence interval [CI], 0.95–1.20) for total and 1.14 (95% CI, 0.82–1.59) for metastatic or fatal prostate cancer compared with those consuming none. Current use, dosage, and total duration of use of specific vitamin E supplements or multivitamins were not associated with risk. However, among current smokers and recent quitters, those who consumed at least 100 IU of supplemental vitamin E per day had a RR of 0.44 (95% CI, 0.18–1.07) for metastatic or fatal prostate cancer compared with nonusers.
Thus, supplemental vitamin E was not associated with prostate cancer risk generally, but a suggestive inverse association between supplemental vitamin E and risk of metastatic or fatal prostate cancer among current smokers and recent quitters was consistent with the Finnish trial among smokers and warrants further investigation.
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