In one of perhaps the largest cancer chemoprevention trials ever conducted, researchers found that vitamin E or selenium supplementation (whether used alone or in combination) was not associated with a reduction in prostate cancer or other cancer risks. The study will be published in the January 7, 2009 issue of JAMA along with another cancer prevention research report. Because of their significance to public health, both reports will be published on the Internet in advance.
In recent years, the number of prostate cancer deaths in the United States has declined, but this cancer is still one of the most common malignant tumors in American men. It is estimated that there will be about 186,000 new cases and 29,000 new cases in 2008. Deaths (the second leading cause of cancer death). According to the background information of the article, if there is an effective prostate cancer prevention strategy, it will bring significant benefits to public health. Previous research has shown that selenium and vitamin E may prevent prostate cancer.
American doctors and researchers have conducted a trial called Selenium and Vitamin E Cancer Prevention Trial (SELECT), which aims to test whether selenium and vitamin E are separate or combined in relatively healthy men. When used, it affects prostate cancer and other health consequences. The trial included 35,553 African-American men aged 50 years or older at the beginning of the study and men of other ethnicities from the United States, Canada, and Puerto Rico aged 55 years or older. Participants were randomly assigned to one of the 4 intervention groups, with a time span from August 2001 to June 2004, and a minimum follow-up period of 7 years was planned. The four intervention groups were: selenium (200 μg / day), vitamin E (400 IU / day), selenium + vitamin E, and placebo.
On September 15, 2008, an independent data and safety monitoring committee recommended that the supplement study be discontinued because of the replacement hypothesis. The hypothesis believes that neither of the two study drugs convincingly presents any evidence of benefit, and that it is not possible to obtain the planned degree of treatment benefit during additional follow-up. On October 23, 2008, the notice to suspend the study of these supplements reached all sites where the study was conducted. The median (midpoint) overall follow-up time at that time was 5.46 years.
The researchers found that in 4 different groups, there was no statistically significant difference between the absolute number of people diagnosed with prostate cancer (or 5-year incidence): 416 patients in the placebo group (5-year incidence Rate was 4.43%); 432 cases (4.56%) in the selenium group; 473 cases (4.93%) in the vitamin E group; 437 cases (4.56%) in the selenium + vitamin E group. In the vitamin E group, there is an insignificant increase in the risk of prostate cancer, and in the group taking selenium (not the selenium + vitamin E group), the risk of type 2 diabetes has an insignificant increase.
The author of the article wrote: "In short, SELECT clearly shows selenium, vitamin E, or selenium + vitamin E (at the dose and formula tested). Among men of different ethnic groups participating in the overall health of SELECT, there is no prevention of prostate cancer The role of these data emphasizes that if there is no convincing clinical trial results, people need to take a cautious attitude when considering the use of drugs to prevent or control disease. These findings also urge the medical community to continue to look for prevention of prostate cancer New and effective drugs. "
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