© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 20, 1738-1743,
October 20, 1999
© 1999 Oxford University Press
REPORTS |
Serum 
-Tocopherol and Subsequent Risk of Lung Cancer Among Male Smokers
Affiliations of authors: K. Woodson, J. A. Tangrea, P. R. Taylor, D. Albanes, Cancer Prevention Studies Branch, Division of Clinical Sciences, National Cancer Institute, Bethesda, MD; M. J. Barrett, Information Management Services, Inc., Silver Spring, MD; J. Virtamo, National Public Health Institute, Helsinki, Finland.
Correspondence to: Karen Woodson, Ph.D., M.P.H., National Institutes of Health, 6006 Executive Blvd. MSC 7058, Bethesda, MD 20892-7058.
BACKGROUND: Higher blood levels of 
-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 -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 -tocopherol (50 mg), ß-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 -tocopherol determination.
-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 -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 -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 -tocopherol
supplementation. CONCLUSIONS: In the ATBC Study cohort, higher serum -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 -tocopherol, if present during the early critical stages of tumorigenesis, may inhibit
lung cancer development.
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