Prostate Cancer and Supplementation With α-Tocopherol and β-Carotene: Incidence and Mortality in a Controlled Trial

• Published in: JNCI : Journal of the National Cancer Institute Vol. 90; no. 6; pp. 440 - 446
• Main Authors: Heinonen, Olli P., Koss, Leopold, Albanes, Demetrius, Taylor, Philip R., Hartman, Anne M., Edwards, Brenda K., Virtamo, Jarmo, Huttunen, Jussi K., Haapakoski, Jaason, Malila, Nea, Rautalahti, Matti, Ripatti, Samuli, Mäenpää, Hanna, Teerenhovi, Lasse, Virolainen, Martti
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 18.03.1998
• Subjects: Anticarcinogenic Agents - therapeutic use; beta Carotene - therapeutic use; Biological and medical sciences; Carcinogenesis, carcinogens and anticarcinogens; Double-Blind Method; Foods and miscellaneous; Humans; Incidence; Male; Medical sciences; Medicin och hälsovetenskap; Nephrology. Urinary tract diseases; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - mortality; Prostatic Neoplasms - prevention & control; Treatment Outcome; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Vitamin E - therapeutic use; Human; Correlation; Urinary system disease; Prostate disease; Carotene; Mortality; Male; Supplemented diet; Malignant tumor; Long term; Prevention; Clinical trial; Tocopherol; Male genital diseases; Prostate
• ISSN: 0027-8874; 1460-2105
• DOI: 10.1093/jnci/90.6.440

Background: Epidemiologic studies have suggested that vitamin E and β-carotene may each influence the development of prostate cancer. In the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, a controlled trial, we studied the effect of α-tocopherol (a form of vitamin E) and β-carotene supplementation, separately or together, on prostate cancer in male smokers. Methods: A total of 29 133 male smokers aged 50–69 years from southwestern Finland were randomly assigned to receive α-tocopherol (50 mg), β-carotene (20 mg), both agents, or placebo daily for 5–8 years (median, 6.1 years). The supplementation effects were estimated by a proportional hazards model, and two-sided P values were calculated. Results: We found 246 new cases of and 62 deaths from prostate cancer during the follow-up period. A 32% decrease (95% confidence interval [CI] = −47% to −12%) in the incidence of prostate cancer was observed among the subjects receiving α-tocopherol (n = 14 564) compared with those not receiving it (n = 14 569). The reduction was evident in clinical prostate cancer but not in latent cancer. Mortality from prostate cancer was 41% lower (95% CI = −65% to −1%) among men receiving α-tocopherol. Among subjects receiving β-carotene (n = 14 560), prostate cancer incidence was 23% higher (95% CI = −4%–59%) and mortality was 15% higher (95% CI = −30%–89%) compared with those not receiving it (n = 14 573). Neither agent had any effect on the time interval between diagnosis and death. Conclusions: Long-term supplementation with α-tocopherol substantially reduced prostate cancer incidence and mortality in male smokers. Other controlled trials are required to confirm the findings.