Serum selenium, genetic variation in selenoenzymes, and risk of colorectal cancer: primary analysis from the Women's Health Initiative Observational Study and meta-analysis

Abstract

Background: Selenium may prevent colorectal cancer. However, several previous studies are small and few investigated the association between selenium and colorectal cancer among women whose selenium metabolism may differ from men. Furthermore, genetic variants in selenoenzymes may be associated with colorectal cancer risk.

Methods: This nested case-control study investigated whether serum selenium concentration and genetic variants in five selenoenzymes (glutathione peroxidase 1-4 and selenoprotein P) were associated with colorectal cancer risk in 804 colorectal cancer cases and 805 matched controls from the Women's Health Initiative (WHI) Observational Study. A meta-analysis was conducted to compare the WHI result with previous studies including 12 observational studies and two clinical trials on selenium.

Results: Within the WHI, selenium concentrations were relatively high (mean = 135.6 μg/L) and were not associated with colorectal cancer risk (P(trend) = 0.10); the adjusted OR comparing the fifth with first quintile was 1.26 (95% CI, 0.91-1.73). Moreover, genetic variants in selenoenzymes were not significantly associated with colorectal cancer risk. Consistent with the finding in WHI, our meta-analysis showed no association between selenium and colorectal tumor risk in women (OR = 0.97; 95% CI, 0.79-1.18) comparing the highest quantile with the lowest); however, in men, there was a significant inverse association (OR = 0.68; 95% CI, 0.57-0.82) (P = 0.01).

Conclusion: Consistent with previous studies, we observed no protective effect of selenium on colorectal cancer among women.

Impact: Our analyses suggest that a population with relatively high selenium concentrations, especially women, would not benefit from increasing selenium intake.

Figure 1. Meta-analysis of Selenium and the Risk of Colorectal Tumors*

*Ordered by biospecimen type (serum/plasma and toenail samples) and by selenium concentrations within each biospecimen type; C=colon cancer, CR=colorectal cancer, R=rectal cancer, A=adenoma, AR=adenoma recurrence, CT = Clinical trial; The dot in each study indicates the OR/HR, bars represent the 95% CI and the size of gray square box reflects the study’s weight in the meta-analysis. The dashed line indicates the summary OR across all studies. The open diamond on the bottom indicates the 95% CI of the summary OR. ‡Risk estimate is based on a given cut-off (the median for Clark 1995 study and the 75th percentile for Fernandez-Banares 2002 study).

Figure 2. Meta-analysis of Selenium and the Risk of Colorectal Tumors, Stratified by Gender*

*Ordered by biospecimen type (serum/plasma and toenail samples) and by selenium concentrations within each biospecimen type; C=colon cancer, CR=colorectal cancer, R=rectal cancer, A=adenoma, AR=adenoma recurrence, CT = Clinical trial; The dot in each study indicates the OR/HR, bars represent the 95% CI and the size of gray square box reflects the study’s weight in the meta-analysis. The dashed line indicates the summary OR across all studies. The open diamond on the bottom indicates the 95% CI of the summary OR. ‡Risk estimate is based on a given cut-off (the median for Clark 1995 study).