Long-term risk of upper digestive cancer in people with different baseline characteristics and supplementation with various combinations of multivitamins and minerals: 27-year Follow-up Results from the Linxian Nutrition Intervention Trial
Shao-Ming WANG, Cancer Institute/ Hospital, Chinese Academy of Medical Sciences, China
FAN J. 1
, QIAO Y. 1
, ABNET C. 2
, TAYLOR P. 2
1 Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health
- Purpose: To investigate the long-term risk of upper digestive cancer in people with different baseline characteristics and supplementation with various combinations of multivitamins and minerals, and to provide suggestions for primary prevention of cancers.
- Methods: The Nutrition Intervention Trial was a randomized, double-blind, placebo-controlled trial conducted in Linxian, China. 29,584 Chinese residences without cancer initially aged 40-69 years old were randomly assigned, accepting nine nutrients in combination into four factors based on a one-half 24 fractional factorial design. The intervention began from March 1, 1986 to May 31, 1991, and follow-up through March 31, 2013. Risk factors and demographic information were interviewed for by a questionnaire, and physical examination was performed to each participant; Mortality of different diseases was collected through village doctors and Cancer Registry.
- Results: During 27.08 years follow-up, there were 18,210 subjects died, including 5443 from cancer. Male, elder age, smoking, and low BMI was associated with an increased risk of esophageal cancer (EC), and goiter was associated with a high risk of gastric cancer. Though the intervention group D had lower overall mortality, cancer mortality, and EC mortality within 10 years after cessation of the intervention, it disappeared at longer period of follow-up. The benefits were mostly attributable to subjects younger than 55 years at baseline, and was still evident on gastric cancer mortality (HR= 0.85, 95%CI= 0.75 to 0.97) and cardiac cancer mortality at 27-year follow-up (HR= 0.80, 95%CI= 0.69 to 0.93), but was not significant for the old group.
- Conclusions: Appropriate lifestyles are recommended for the long-term cancer prevention. Younger-age, long-term supplementation with selenium, vitamin E, and beta-carotene is essential to keep the sustained effects on the reduction of gastric cancer and other cancer mortality in poor nutrient population.
- Funding Source: National Cancer Institute contracts (HHSN261201200034C to Cancer Hospital, Chinese Academy of Medical Sciences)