Serum α-Tocopherol and Subsequent Risk of Lung Cancer Among Male Smokers

• Published in: JNCI : Journal of the National Cancer Institute Vol. 91; no. 20; pp. 1738 - 1743
• Main Authors: Woodson, Karen, Tangrea, Joseph A., Barrett, Michael J., Virtamo, Jarmo, Taylor, Philip R., Albanes, Demetrius
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 20.10.1999; Oxford Publishing Limited (England)
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - etiology; Aged; beta Carotene - administration & dosage; beta Carotene - blood; Biological and medical sciences; Carcinoma - blood; Carcinoma - epidemiology; Carcinoma - etiology; Carcinoma, Small Cell - blood; Carcinoma, Small Cell - etiology; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - etiology; Dietary Supplements; Finland - epidemiology; Humans; Lung cancer; Lung Neoplasms - blood; Lung Neoplasms - epidemiology; Lung Neoplasms - etiology; Male; Medical research; Medical sciences; Middle Aged; Pneumology; Prevention; Prospective Studies; Risk; Risk Factors; Smoking - adverse effects; Studies; Treatment Outcome; Tumors of the respiratory system and mediastinum; Vitamin E - administration & dosage; Vitamin E - blood; Finland; Human; Lung disease; Carcinoma; Respiratory disease; Male; Malignant tumor; Bronchopulmonary; Prevention; Treatment; Follow up study; Smoker; Risk factor; Bronchus disease; Serum; Tocopherol
• ISSN: 0027-8874; 1460-2105
• DOI: 10.1093/jnci/91.20.1738

BACKGROUND: Higher blood levels of α-tocopherol, the predominant form of vitamin E, have been associated in some studies with a reduced risk of lung cancer, but other studies have yielded conflicting results. To clarify this association, we examined the relationship between prospectively collected serum α-tocopherol and lung cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort. METHODS: The ATBC Study was a randomized, clinical trial of 29 133 white male smokers from Finland who were 50-69 years old and who had received α-tocopherol (50 mg), β-carotene (20 mg), both, or neither daily for 5-8 years. Data regarding medical histories, smoking, and dietary factors were obtained at study entry, as was a serum specimen for baseline α-tocopherol determination. α -Tocopherol measurements were available for 29 102 of the men, among whom 1144 incident cases of lung cancer were diagnosed during a median observation period of 7.7 years. The association between α-tocopherol and lung cancer was evaluated with the use of multivariate proportional hazards regression. RESULTS: A 19% reduction in lung cancer incidence was observed in the highest versus lowest quintile of serum α-tocopherol (relative risk = 0.81; 95% confidence interval = 0.67-0.97). There was a stronger inverse association among younger men (<60 years), among men with less cumulative tobacco exposure (<40 years of smoking), and possibly among men receiving α-tocopherol supplementation. CONCLUSIONS: In the ATBC Study cohort, higher serum α-tocopherol status is associated with lower lung cancer risk; this relationship appears stronger among younger persons and among those with less cumulative smoke exposure. These findings suggest that high levels of α-tocopherol, if present during the early critical stages of tumorigenesis, may inhibit lung cancer development.