2003, English, Article edition: Neoplastic and Antineoplastic Effects of <IMG SRC="/math/beta.gif" ALT="{beta}" BORDER="0">-Carotene on Colorectal Adenoma Recurrence: Results of a Randomized Trial Baron, John A.; Cole, Bernard F.; Mott, Leila; ...

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  • Oxford University Press
  • 2003-05-21 00:00:00.0
Language
  • English

Edition details

Title
  • Neoplastic and Antineoplastic Effects of <IMG SRC=​"/​math/​beta.gif" ALT=​"{beta}" BORDER=​"0">-Carotene on Colorectal Adenoma Recurrence: Results of a Randomized Trial
Author
  • Baron, John A.
  • Cole, Bernard F.
  • Mott, Leila
  • Haile, Robert
  • Grau, Maria
  • Church, Timothy R.
  • Beck, Gerald J.
  • Greenberg, E. Robert
Published
  • Oxford University Press
  • 2003-05-21 00:00:00.0
Physical Description
  • text/​html
Subjects
Notes
  • Background: In two large, randomized prevention trials, supplementation with β-carotene increased the risk of lung cancer. Subjects in these studies were predominantly cigarette smokers, and the adverse effects were concentrated among those who also drank alcohol. Although β-carotene supplementation appeared not to increase the risk of cancer generally, it is not clear if smoking and/​or alcohol use alters the effect of β-carotene on carcinogenesis at sites outside the lung. Methods: We studied the effect of β-carotene supplementation on colorectal adenoma recurrence among subjects in a multicenter double-blind, placebo-controlled clinical trial of antioxidants for the prevention of colorectal adenomas. A total of 864 subjects who had had an adenoma removed and were polyp-free were randomly assigned (in a factorial design) to receive β-carotene (25 mg or placebo) and/​or vitamins C and E in combination (1000 mg and 400 mg, respectively, or placebo), and were followed with colonoscopy for adenoma recurrence 1 year and 4 years after the qualifying endoscopy. A total of 707 subjects had two follow-up examinations and provided smoking and alcohol use data. Adjusted multivariate risk ratios (RRs) and 95% confidence intervals (CIs) were used to assess the effects of β-carotene on adenoma recurrence. Results: Among subjects who neither smoked cigarettes nor drank alcohol, β-carotene was associated with a marked decrease in the risk of one or more recurrent adenomas (RR =​ 0.56, 95% CI =​ 0.35 to 0.89), but β-carotene supplementation conferred a modest increase in the risk of recurrence among those who smoked (RR =​ 1.36, 95% CI =​ 0.70 to 2.62) or drank (RR =​ 1.13, 95% CI =​ 0.89 to 1.43). For participants who smoked cigarettes and also drank more than one alcoholic drink per day, β-carotene doubled the risk of adenoma recurrence (RR =​ 2.07, 95% CI =​ 1.39 to 3.08; P for difference from nonsmoker/​nondrinker RR < .001). Conclusion: Alcohol intake and cigarette smoking appear to modify the effect of β-carotene supplementation on the risk of colorectal adenoma recurrence.
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