© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 24, 2102-2106,
December 15, 1999
© 1999 Oxford University Press
REPORTS |
ß-Carotene Supplementation and Incidence of Cancer and Cardiovascular Disease: the Women's Health Study
Affiliations of authors: I.-M. Lee, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston, MA; N. R. Cook, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; J. E. Manson, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Department of Epidemiology, Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; J. E. Buring, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Department of Epidemiology, Harvard School of Public Health, and Department of Ambulatory Care and Prevention, Harvard Medical School; C. H. Hennekens, Department of Epidemiology and Public Health, University of Miami School of Medicine, FL.
Correspondence to: I.-Min Lee, M.B.B.S., Sc.D., 900 Commonwealth Ave. East, Boston, MA 02215 (e-mail: i-min.lee{at}channing.harvard.edu).
Present address: C. H. Hennekens, 1415 West Camino Real, Boca Raton, FL 33486.
BACKGROUND: In observational studies, individuals with high intakes of fruits and vegetables containing ß-carotene experience lower risks of developing cancer. However, the few randomized trials of ß-carotene supplementation show no overall benefits; some even suggest harm. This trial was designed to test the effects of ß-carotene supplementation in women. METHODS: The Women's Health Study is a randomized, double-blind, placebo-controlled trial originally testing aspirin, vitamin E, and ß-carotene in the prevention of cancer and cardiovascular disease among 39 876 women aged 45 years or older. The ß-carotene component was terminated early after a median treatment duration of 2.1 years (range = 0.00-2.72 years). Statistical tests were two-sided. RESULTS: Among women randomly assigned to receive ß-carotene (50 mg on alternate days; n = 19 939) or placebo (n =19 937), there were no statistically significant differences in incidence of cancer, cardiovascular disease, or total mortality after a median of 4.1 years (2.1 years' treatment plus another 2.0 years' follow-up). There were 378 cancers in the ß-carotene group and 369 cancers in the placebo group (relative risk [RR] = 1.03; 95% confidence interval [CI] = 0.89-1.18). There were no statistically significant differences for any site-specific cancer or during years 1 and 2 combined and years 3 and up combined. For cardiovascular disease, there were no statistically significant differences for myocardial infarction (42 in the ß-carotene group versus 50 in the placebo group), stroke (61 versus 43), deaths from cardiovascular causes (14 versus 12), or the combined end point of these three events (116 versus 102; among women with more than one event, only the first was counted). Deaths from any cause were similar in the two groups (59 versus 55). Among smokers at baseline (13% of all women), there were no statistically significant differences in overall incidence of cancer (RR = 1.11; 95% CI = 0.78-1.58) or cardiovascular disease (RR = 1.01; 95% CI = 0.62-1.63). CONCLUSION: Among apparently healthy women, there was no benefit or harm from ß-carotene supplementation for a limited period on the incidence of cancer and of cardiovascular disease.
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N. Rifai, J. E. Buring, I-M. Lee, J. E. Manson, and P. M Ridker Is C-Reactive Protein Specific for Vascular Disease in Women? Ann Intern Med, April 2, 2002; 136(7): 529 - 533. [Abstract] [Full Text] [PDF]
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E. Barrett-Connor, D. Grady, A. Sashegyi, P. W. Anderson, D. A. Cox, K. Hoszowski, P. Rautaharju, K. D. Harper, and for the MORE Investigators Raloxifene and Cardiovascular Events in Osteoporotic Postmenopausal Women: Four-Year Results From the MORE (Multiple Outcomes of Raloxifene Evaluation) Randomized Trial JAMA, February 20, 2002; 287(7): 847 - 857. [Abstract] [Full Text] [PDF]
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P. Prakash, T. G. Manfredi, C. L. Jackson, and L. E. Gerber {beta}-Carotene Alters the Morphology of NCI-H69 Small Cell Lung Cancer Cells J. Nutr., January 1, 2002; 132(1): 121 - 124. [Abstract] [Full Text] [PDF]
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R. J. Glynn, G. J. L'Italien, H. D. Sesso, E. A. Jackson, and J. E. Buring Development of Predictive Models for Long-Term Cardiovascular Risk Associated With Systolic and Diastolic Blood Pressure Hypertension, January 1, 2002; 39(1): 105 - 110. [Abstract] [Full Text] [PDF]
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T. P. Erlinger, E. Guallar, E. R. Miller III, R. Stolzenberg-Solomon, and L. J. Appel Relationship Between Systemic Markers of Inflammation and Serum {beta}-Carotene Levels Arch Intern Med, August 13, 2001; 161(15): 1903 - 1908. [Abstract] [Full Text] [PDF]
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 C. Liu, X.-D. Wang, R. T. Bronson, D. E. Smith, N. I. Krinsky, and R. M. Russell Effects of physiological versus pharmacological {beta}-carotene supplementation on cell proliferation and histopathological changes in the lungs of cigarette smoke-exposed ferrets Carcinogenesis, December 1, 2000; 21(12): 2245 - 2253. [Abstract] [Full Text] [PDF]
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 J. M. Miano and B. C. Berk Retinoids : Versatile Biological Response Modifiers of Vascular Smooth Muscle Phenotype Circ. Res., September 1, 2000; 87(5): 355 - 362. [Full Text] [PDF]
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J. R. Marshall {beta}-Carotene: a Miss for Epidemiology J Natl Cancer Inst, December 15, 1999; 91(24): 2068 - 2069. [Full Text] [PDF]
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