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Efficacy of Vitamin C Supplements in Prevention of Cancer: A Meta-Analysis of Randomized Controlled Trials

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Background: Previous randomized controlled trials (RCTs) have reported inconsistent findings regarding the association between vitamin C supplementation and the risk of cancer. Methods: We performed a meta-analysis of RCTs to investigate the efficacy of vitamin C supplements for prevention of cancer. We searched the PubMed, EMBASE, and Cochrane Library databases in November 2014 using common keywords related to vitamin C supplements and cancer. Results: Among 785 articles, a total of seven trials were identified, which included 62,619 participants; 31,326 and 31,293 were randomized to vitamin C supplementation and control or placebo groups, respectively, which were included in the final analysis. A fixed-effects meta-analysis of all seven RCTs revealed no significant association between vitamin C supplementation and cancer (relative risk, 1.00; 95% confidence intervals, 0.95–1.05). Similarly, subgroup meta-analysis by dose of vitamin C administered singly or in combination with other supplements, follow- up period, methodological quality, cancer mortality, gender, smoking status, country, and type of cancer also showed no efficacy of vitamin C supplementation for cancer prevention. Conclusion: This meta-analysis shows that there is no evidence to support the use of vitamin C supplements for prevention of cancer.

Abstract

Background: Previous randomized controlled trials (RCTs) have reported inconsistent findings regarding the association between vitamin C supplementation and the risk of cancer. Methods: We performed a meta-analysis of RCTs to investigate the efficacy of vitamin C supplements for prevention of cancer. We searched the PubMed, EMBASE, and Cochrane Library databases in November 2014 using common keywords related to vitamin C supplements and cancer. Results: Among 785 articles, a total of seven trials were identified, which included 62,619 participants; 31,326 and 31,293 were randomized to vitamin C supplementation and control or placebo groups, respectively, which were included in the final analysis. A fixed-effects meta-analysis of all seven RCTs revealed no significant association between vitamin C supplementation and cancer (relative risk, 1.00; 95% confidence intervals, 0.95–1.05). Similarly, subgroup meta-analysis by dose of vitamin C administered singly or in combination with other supplements, follow- up period, methodological quality, cancer mortality, gender, smoking status, country, and type of cancer also showed no efficacy of vitamin C supplementation for cancer prevention. Conclusion: This meta-analysis shows that there is no evidence to support the use of vitamin C supplements for prevention of cancer.

참고문헌 (46)

  1. Dizdaroglu M, "Mechanisms of free radical-induced damage to DNA", Free Radic Res, 46, pp.382~419 (2012)
  2. Pitocco D, "Oxidative stress, nitric oxide, and diabetes", Rev Diabet Stud, 7, pp.15~25 (2010)
  3. Cameron E, "The orthomolecular treatment of cancer. I. The role of ascorbic acid in host resistance", Chem Biol Interact, 9, pp.273~283 (1974)
  4. Cameron E, "The orthomolecular treatment of cancer. II. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer", Chem Biol Interact, 9, pp.285~315 (1974)
  5. Cameron E, "Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival times in terminal human cancer", Proc Natl Acad Sci U S A, 73, pp.3685~3689 (1976)
  6. Cameron E, "Supplemental ascorbate in the supportive treatment of cancer: reevaluation of prolongation of survival times in terminal human cancer", Proc Natl Acad Sci U S A, 75, pp.4538~4542 (1978)
  7. Creagan ET, "Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer: a controlled trial", N Engl J Med, 301, pp.687~690 (1979)
  8. Moertel CG, "High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy: a randomized double-blind comparison", N Engl J Med, 312, pp.137~141 (1985)
  9. Coulter ID, "Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer", J Gen Intern Med, 21, pp.735~744 (2006)
  10. Bjelakovic G, "Systematic review:primary and secondary prevention of gastrointestinal cancers with antioxidant supplements", Aliment Pharmacol Ther, 28, pp.689~703 (2008)
  11. Jiang L, "Efficacy of antioxidant vitamins and selenium supplement in prostate cancer prevention:a meta-analysis of randomized controlled trials", Nutr Cancer, 62, pp.719~727 (2010)
  12. Jadad AR, "Assessing the quality of reports of randomized clinical trials:is blinding necessary?", Control Clin Trials, 17, pp.1~12 (1996)
  13. Hercberg S, "The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals", Arch Intern Med, 164, pp.2335~2342 (2004)
  14. Li JY, "Nutrition intervention trials in Linxian, China: multiple vitamin", mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia, 1993, pp.85, 1492~1498
  15. Wang GQ, "Effects of vitamin", mineral supplementation on the prevalence of histological dysplasia and early cancer of the esophagus and stomach: results from the General Population Trial in Linxian, China, 1994, pp.3, 161~166
  16. Heart Protection Study Collaborative Group, "MRC", BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomized placebo-controlled trial, 2002, pp.360, 23~33
  17. You WC, "Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions", J Natl Cancer Inst, 98, pp.974~983 (2006)
  18. Gaziano JM, "Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians’ Health Study II randomized controlled trial", JAMA, 301, pp.52~62 (2009)
  19. Lin J, "Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial", J Natl Cancer Inst, 101, pp.14~23 (2009)
  20. Buettner GR, "EPR spin trapping of free radicals produced by bleomycin and ascorbate", Free Radic Res Commun, 19(Suppl 1), pp.S89~S93 (1993)
  21. Bielski BH, "Some properties of the ascorbate free radical", Ann N Y Acad Sci, 258, pp.231~237 (1975)
  22. Lewin S., "its molecular biology and medical potential" (1976), Academic Press
  23. Papaioannou D, "Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis", Colorectal Dis, 13, pp.1085~1099 (2011)
  24. Pollard HB, "Pharmacological ascorbic acid suppresses syngeneic tumor growth and metastases in hormone-refractory prostate cancer", In Vivo, 24, pp.249~255 (2010)
  25. Takemura Y, "High dose of ascorbic acid induces cell death in mesothelioma cells", Biochem Biophys Res Commun, 394, pp.249~253 (2010)
  26. Du J, "Mechanisms of ascorbate-induced cytotoxicity in pancreatic cancer", Clin Cancer Res, 16, pp.509~520 (2010)
  27. Abdel-Latif MM, "Vitamin C enhances chemosensitization of esophageal cancer cells in vitro", J Chemother, 17, pp.539~549 (2005)
  28. Farbstein D, "Antioxidant vitamins and their use in preventing cardiovascular disease", Molecules, 15, pp.8098~8110 (2010)
  29. De Flora S, "Modulation of genotoxic and related effects by carotenoids and vitamin A in experimental models: mechanistic issues", Mutagenesis, 14, pp.153~172 (1999)
  30. Cui Y, "Beta-Carotene induces apoptosis and up-regulates peroxisome proliferator-activated receptor gamma expression and reactive oxygen species production in MCF-7 cancer cells", Eur J Cancer, 43, pp.2590~2601 (2007)
  31. Mayne ST, "Beta-Carotene and lung cancer promotion in heavy smokers: a plausible relationship?", J Natl Cancer Inst, 88, pp.1513~1515 (1996)
  32. Bandera EV, "Antioxidant vitamins and the risk of endometrial cancer: a dose-response meta-analysis", Cancer Causes Control, 20, pp.699~711 (2009)
  33. Park Y, "Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies", Cancer Causes Control, 21, pp.1745~1757 (2010)
  34. Key TJ, "The effect of diet on risk of cancer", Lancet, 360, pp.861~868 (2002)
  35. Giovannucci E, "A comparison of prospective and retrospective assessments of diet in the study of breast cancer", Am J Epidemiol, 137, pp.502~511 (1993)
  36. Hercberg S, "The potential role of antioxidant vitamins in preventing cardiovascular diseases and cancers", Nutrition, 14, pp.513~520 (1998)
  37. Biasco G, "European trials on dietary supplementation for cancer prevention", Ann N Y Acad Sci, 889, pp.152~156 (1999)
  38. Bjelakovic G, "Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis", JAMA, 297, pp.842~857 (2007)
  39. Myung SK, "Effects of antioxidant supplements on cancer prevention: meta-analysis of randomized controlled trials", Ann Oncol, 21, pp.166~179 (2010)
  40. Honegger CG, "Quantitative determination of water-soluble scavengers in neoplastic and non-neoplastic human breast tissue", Int J Cancer, 41, pp.690~694 (1988)
  41. Langemann H, "Quantitative determination of water- and lipid-soluble antioxidants in neoplastic and non-neoplastic human breast tissue", Int J Cancer, 43, pp.1169~1173 (1989)
  42. Agus DB, "Stromal cell oxidation: a mechanism by which tumors obtain vitamin C", Cancer Res, 59, pp.4555~4558 (1999)
  43. Benade L, "Synergistic killing of Ehrlich ascites carcinoma cells by ascorbate and 3-amino-1,2,4,-triazole", Oncology, 23, pp.33~43 (1969)
  44. Bram S, "Vitamin C preferential toxicity for malignant melanoma cells", Nature, 284, pp.629~631 (1980)
  45. Leung PY, "Cytotoxic effect of ascorbate and its derivatives on cultured malignant and nonmalignant cell lines", Anticancer Res, 13, pp.475~480 (1993)
  46. Chen Q, "Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues", Proc Natl Acad Sci U S A, 102, pp.13604~13609 (2005)

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