Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Jan 7;301(1):52-62.
doi: 10.1001/jama.2008.862. Epub 2008 Dec 9.

Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial

J Michael Gaziano  1 , Robert J Glynn, William G Christen, Tobias Kurth, Charlene Belanger, Jean MacFadyen, Vadim Bubes, JoAnn E Manson, Howard D Sesso, Julie E Buring
Affiliations
Randomized Controlled Trial

Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial

J Michael Gaziano et al. JAMA. .

Abstract

Context: Many individuals take vitamins in the hopes of preventing chronic diseases such as cancer, and vitamins E and C are among the most common individual supplements. A large-scale randomized trial suggested that vitamin E may reduce risk of prostate cancer; however, few trials have been powered to address this relationship. No previous trial in men at usual risk has examined vitamin C alone in the prevention of cancer.

Objective: To evaluate whether long-term vitamin E or C supplementation decreases risk of prostate and total cancer events among men.

Design, setting, and participants: The Physicians' Health Study II is a randomized, double-blind, placebo-controlled factorial trial of vitamins E and C that began in 1997 and continued until its scheduled completion on August 31, 2007. A total of 14,641 male physicians in the United States initially aged 50 years or older, including 1307 men with a history of prior cancer at randomization, were enrolled.

Intervention: Individual supplements of 400 IU of vitamin E every other day and 500 mg of vitamin C daily.

Main outcome measures: Prostate and total cancer.

Results: During a mean follow-up of 8.0 years, there were 1008 confirmed incident cases of prostate cancer and 1943 total cancers. Compared with placebo, vitamin E had no effect on the incidence of prostate cancer (active and placebo vitamin E groups, 9.1 and 9.5 events per 1000 person-years; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.85-1.09; P = .58) or total cancer (active and placebo vitamin E groups, 17.8 and 17.3 cases per 1000 person-years; HR, 1.04; 95% CI, 0.95-1.13; P = .41). There was also no significant effect of vitamin C on total cancer (active and placebo vitamin C groups, 17.6 and 17.5 events per 1000 person-years; HR, 1.01; 95% CI, 0.92-1.10; P = .86) or prostate cancer (active and placebo vitamin C groups, 9.4 and 9.2 cases per 1000 person-years; HR, 1.02; 95% CI, 0.90-1.15; P = .80). Neither vitamin E nor vitamin C had a significant effect on colorectal, lung, or other site-specific cancers. Adjustment for adherence and exclusion of the first 4 or 6 years of follow-up did not alter the results. Stratification by various cancer risk factors demonstrated no significant modification of the effect of vitamin E on prostate cancer risk or either agent on total cancer risk.

Conclusions: In this large, long-term trial of male physicians, neither vitamin E nor C supplementation reduced the risk of prostate or total cancer. These data provide no support for the use of these supplements for the prevention of cancer in middle-aged and older men.

Trial registration: clinicaltrials.gov Identifier: NCT00270647.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Figure 2
Figure 2
Figure 3
Figure 3
See this image and copyright information in PMC

Comment in

References

    1. AICR. Food, Nutrition, Physical Activity, and the Prevention of Cancer. World Cancer Research Fund/American Institute for Cancer Research; 2007.
    1. Ames BN. Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative diseases. Science. 1983 Sep 23;221(4617):1256–1264. - PubMed
    1. Dusinska M, Kazimirova A, Barancokova M, et al. Nutritional supplementation with antioxidants decreases chromosomal damage in humans. Mutagenesis. 2003 Jul;18(4):371–376. - PubMed
    1. Federico A, Morgillo F, Tuccillo C, Ciardiello F, Loguercio C. Chronic inflammation and oxidative stress in human carcinogenesis. Int J Cancer. 2007 Dec 1;121(11):2381–2386. - PubMed
    1. Blot WJ, Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst. 1993 Sep 15;85(18):1483–1492. - PubMed

Publication types

Associated data