ONCOLOGY
Antioxidants for prevention of cancer:
- In a meta-analysis
of 14 trials (only 7 of which were judged to be of "high" methodologic
quality) of antioxidants vs. placebo for prevention of GI cancers (esophageal,
gastric, colorectal, pancreatic, of hepatic) (Lancet 364:1219, 2004--JW):
- Selenium was ass'd with RR 0.49 of GI Ca's
- None of the following had any sig. effect: Beta-carotene and vitamins A,
C, or E
- 13,017 adult pts randomized to (ascorbic acid 120 mg,
vitamin E 30 IU), beta-carotene 6 mg, selenium 100 micrograms, and zinc 20 mg)
QD vs. placebo. Over mean 7.5y f/u, men (but not women) had sig. reduction in
incidence of cancer (RR 0.69) and all-cause mortality (RR 0.63)
("SU.VI.MAX" Study, Arch. Int. Med. 164:2335, 2004--JW)
- The HOPE-TOO trial
evaluated the effect of vitamin E on Ca incidence and mortality; click link
for details
- In the Women's
Health Study (click on link for details), over mean 10y f/u, there was
no sig. diff. between vitamin E vs. placebo recipients in incidence of all
cancers, overall cancer mortality, or of incidence of breast, colorectal, or
lung Ca (JAMA 294:56, 2005--JW)
- In a study in 1,021 adults with h/o
colorectal adenoma but no h/o colon Ca randomized to folic acid 1mg/d vs.
placebo, over 6-8y f/u, there was no sig. diff. in overall incidence of
colorectal adenoma, but incidence of "advanced lesions" (25% or
more villous features, high-grade displasia, size 1cm or greater, or
invasive Ca) was higher in the folic acid recipients, with the
difference approaching statistical significance (11.6% vs. 6.9%; p = 0.05)
("Polyp Prevention Study", JAMA 297:2351, 2007--JW)
Antithrombotics for prevention of Cancer
- In the Women's
Health Study (click on link for details), over mean 10y f/u, there was
no sig. diff. between aspirin vs. placebo recipients in incidence of all
cancers, overall cancer mortality, or of incidence of breast, colorectal, or
lung Ca (JAMA 294:47, 2005--JW)
- In a case-control study of 1,442 women with breast Ca and 1,420 controls,
ever-use of ASA or other NSAIDs 1 or more times/wk for > 6mow was ass'd
with OR 0.80 for breast Ca (sig.); no such association w/acetaminophen (JAMA
291:2433, 2004--abst)
- In a case-control study in 7,006 women with breast Ca and 3,622 controls,
after adjustment for potential confounders, regular NSAID use was associated
with sig. lower risk (RR 0.78) of breast Ca; RR for premenopausal women was
0.62; no diff. in risk reduction according to hormone receptor status of the
tumor. (Am. J. Epidem. 162:165, 2005--abst)