Serum alpha-tocopherol and subsequent risk of lung cancer among male smokers

J Natl Cancer Inst. 1999 Oct 20;91(20):1738-43. doi: 10.1093/jnci/91.20.1738.

Abstract

Background: Higher blood levels of alpha-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 alpha-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 alpha-tocopherol (50 mg), beta-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 alpha-tocopherol determination. alpha-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 alpha-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 alpha-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 alpha-tocopherol supplementation.

Conclusions: In the ATBC Study cohort, higher serum alpha-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 alpha-tocopherol, if present during the early critical stages of tumorigenesis, may inhibit lung cancer development.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / etiology
  • Aged
  • 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 Neoplasms / blood*
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / etiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk
  • Risk Factors
  • Smoking / adverse effects*
  • Treatment Outcome
  • Vitamin E / administration & dosage
  • Vitamin E / blood*
  • beta Carotene / administration & dosage
  • beta Carotene / blood*

Substances

  • beta Carotene
  • Vitamin E