Long-term use of beta-carotene, retinol, lycopene, and lutein supplements and lung cancer risk: results from the VITamins And Lifestyle (VITAL) study

Am J Epidemiol. 2009 Apr 1;169(7):815-28. doi: 10.1093/aje/kwn409. Epub 2009 Feb 10.

Abstract

High-dose beta-carotene supplementation in high-risk persons has been linked to increased lung cancer risk in clinical trials; whether effects are similar in the general population is unclear. The authors examined associations of supplemental beta-carotene, retinol, vitamin A, lutein, and lycopene with lung cancer risk among participants, aged 50-76 years, in the VITamins And Lifestyle (VITAL) cohort Study in Washington State. In 2000-2002, eligible persons (n = 77,126) completed a 24-page baseline questionnaire, including detailed questions about supplement use (duration, frequency, dose) during the previous 10 years from multivitamins and individual supplements/mixtures. Incident lung cancers (n = 521) through December 2005 were identified by linkage to the Surveillance, Epidemiology, and End Results cancer registry. Longer duration of use of individual beta-carotene, retinol, and lutein supplements (but not total 10-year average dose) was associated with statistically significantly elevated risk of total lung cancer and histologic cell types; for example, hazard ratio = 2.02, 95% confidence interval: 1.28, 3.17 for individual supplemental lutein with total lung cancer and hazard ratio = 3.22, 95% confidence interval: 1.29, 8.07 for individual beta-carotene with small-cell lung cancer for >4 years versus no use. There was little evidence for effect modification by gender or smoking status. Long-term use of individual beta-carotene, retinol, and lutein supplements should not be recommended for lung cancer prevention, particularly among smokers.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Carotenoids / adverse effects
  • Dietary Supplements / adverse effects*
  • Female
  • Humans
  • Lung Neoplasms / chemically induced*
  • Lung Neoplasms / etiology
  • Lutein / adverse effects
  • Lycopene
  • Male
  • Middle Aged
  • Risk Factors
  • Smoking / adverse effects
  • Surveys and Questionnaires
  • Vitamin A / adverse effects
  • Vitamins / adverse effects*
  • beta Carotene / adverse effects

Substances

  • Vitamins
  • beta Carotene
  • Vitamin A
  • Carotenoids
  • Lycopene
  • Lutein