Chemoprevention of primary liver cancer: a randomized, double-blind trial in Linxian, China
| Autor: | Xiu-Di Sun, Binbing Yu, Sanford M. Dawsey, Chen-xu Qu, Bingshu E. Chen, Farin Kamangar, Jin-Hu Fan, Steven D. Mark, Philip R. Taylor, You-Lin Qiao, Christian C. Abnet |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty China Antibodies Neoplasm Gastroenterology Chemoprevention Double-Blind Method Internal medicine medicine Humans Minerals Proportional hazards model business.industry Incidence Hazard ratio Liver Neoplasms Cancer Vitamins Middle Aged medicine.disease Ascorbic acid B vitamins Endocrinology Oncology Chemoprophylaxis Drug Therapy Combination Female Liver cancer business Niacin |
| Zdroj: | Journal of the National Cancer Institute. 99(16) |
| ISSN: | 1460-2105 |
| Popis: | Background Primary liver cancer is a common malignancy with a dismal prognosis. New primary prevention strategies are needed to reduce mortality from this disease. We examined the effects of supplementation with four different combinations of vitamins and minerals on primary liver cancer mortality among 29 450 initially healthy adults from Linxian, China. Methods Participants were randomly assigned to take either a vitamin – mineral combination (“factor”) or a placebo daily for 5.25 years (March 1986 – May 1991). Four factors (at doses one to two times the US Recommended Daily Allowance) — retinol and zinc (factor A); riboflavin and niacin (factor B); ascorbic acid and molybdenum (factor C); and beta-carotene, alpha-tocopherol, and selenium (factor D) — were tested in a partial factorial design. The study outcome was primary liver cancer death occurring from 1986 through 2001. Adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of liver cancer death with and without each factor. All P values are two-sided. Results A total of 151 liver cancer deaths occurred during the analysis period. No statistically significant differences in liver cancer mortality were found comparing the presence and absence of any of the four intervention factors. However, both factor A and factor B reduced liver cancer mortality in individuals younger than 55 years at randomization (HR = 0.59, 95% CI = 0.34 to 1.00, and HR = 0.54, 95% CI = 0.31 to 0.93, respectively) but not in older individuals (HR = 1.06, 95% CI = 0.71 to 1.59, and HR = 1.12, 95% CI = 0.75 to 1.68, respectively). Factor C reduced liver cancer death, albeit with only borderline statistical significance in males (HR = 0.70, 95% CI = 0.47 to 1.02) but not in females (HR = 1.30, 95% CI = 0.72 to 2.37). Cumulative risks of liver cancer death were 6.0 per 1000 in the placebo arm, 5.4 per 1000 in the arms with two factors, and 2.4 per 1000 in the arm with all four factors. Conclusion None of the factors tested reduced overall liver cancer mortality. However, three factors reduced liver |
| Databáze: | OpenAIRE |
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