Journal of the National Cancer Institute Advance Access originally published online on September 25, 2007
JNCI Journal of the National Cancer Institute 2007 99(19):1492-1493; doi:10.1093/jnci/djm139
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Published by Oxford University Press 2007.
CORRESPONDENCE |
Response: Re: Multivitamin Use and Risk of Prostate Cancer in the National Institutes of Health—AARP Diet and Health Study
Affiliations of authors: Trauma Services Department, Dell Children's Medical Center, Austin, TX (KAL); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health/Department of Health and Human Services, Bethesda, MD (KAL, MEW, TM, AS, MFL); Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL (MEW); AARP Research Group, AARP, Washington, DC (AH)
Correspondence to: Michael F. Leitzmann, 6120 Executive Blvd, EPS Ste 320, Rockville, MD 20852-7232 (e-mail: leitzmann{at}mail.nih.gov).
Hickey et al. suggest that our results have limited public health relevance. However, we observed a substantial increase in risk for fatal prostate cancer (relative risk = 1.98; 95% confidence interval = 1.07 to 3.66) among men reporting excessive use of multivitamins (1). If, as in our study, 5% of men older than age 50 take multivitamins more than once a day, then, in light of the large number of prostate cancer–related deaths in the United States (2), our findings have potentially important consequences for public health.
With respect to multiple testing of subgroups, our results section did include a list of the total number of nutrients and foods tested. In addition, our discussion section noted the possibility of chance findings due to multiple comparisons.
We did not evaluate vitamin C because there is no a priori hypothesis linking vitamin C to prostate cancer risk. In contrast, we did examine vitamin E and its isoforms in detail in a separate recent publication (3) because vitamin E holds promise for prostate cancer prevention.
Our study was not designed to address the effect of pharmacologic doses of nutrients on cancer prognosis or survival. We did, however, find strong epidemiologic evidence against a protective effect of excessive use of multivitamins on prostate carcinogenesis.
The conclusion that people should use natural antioxidant supplements and avoid synthetic forms does not follow from our study. Our study did not compare the effect of natural versus synthetic ingredients contained in multivitamin supplements.
REFERENCES
(1) Lawson KA, Wright ME, Subar A, Mouw T, Hollenbeck A, Schatzkin A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health–AARP Diet and Health Study. J Natl Cancer Inst (2007) 99:754–64.
(2) Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer Statistics, 2007. CA Cancer J Clin (2007) 57:43–66.
(3) Wright ME, Weinstein SJ, Lawson KA, Albanes D, Subar AF, Dixon LB, et al. Supplemental and dietary vitamin e intakes and risk of prostate cancer in a large prospective study. In: Cancer Epidemioal Biomarkers Prev (2007) 16:1128–35.[CrossRef]
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J Natl Cancer Inst 2007 99: 1491-1492.
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