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.
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- Dizdaroglu M, "Mechanisms of free radical-induced damage to DNA", Free Radic Res, 46, pp.382~419 (2012)
- Pitocco D, "Oxidative stress, nitric oxide, and diabetes", Rev Diabet Stud, 7, pp.15~25 (2010)
- Cameron E, "The orthomolecular treatment of cancer. I. The role of ascorbic acid in host resistance", Chem Biol Interact, 9, pp.273~283 (1974)
- 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)
- 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)
- 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)
- 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)
- 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)
- Coulter ID, "Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer", J Gen Intern Med, 21, pp.735~744 (2006)
- Bjelakovic G, "Systematic review:primary and secondary prevention of gastrointestinal cancers with antioxidant supplements", Aliment Pharmacol Ther, 28, pp.689~703 (2008)
- 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)
- Jadad AR, "Assessing the quality of reports of randomized clinical trials:is blinding necessary?", Control Clin Trials, 17, pp.1~12 (1996)
- 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)
- 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
- 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
- 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
- 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)
- 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)
- 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)
- Buettner GR, "EPR spin trapping of free radicals produced by bleomycin and ascorbate", Free Radic Res Commun, 19(Suppl 1), pp.S89~S93 (1993)
- Bielski BH, "Some properties of the ascorbate free radical", Ann N Y Acad Sci, 258, pp.231~237 (1975)
- Lewin S., "its molecular biology and medical potential" (1976), Academic Press
- 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)
- Pollard HB, "Pharmacological ascorbic acid suppresses syngeneic tumor growth and metastases in hormone-refractory prostate cancer", In Vivo, 24, pp.249~255 (2010)
- Takemura Y, "High dose of ascorbic acid induces cell death in mesothelioma cells", Biochem Biophys Res Commun, 394, pp.249~253 (2010)
- Du J, "Mechanisms of ascorbate-induced cytotoxicity in pancreatic cancer", Clin Cancer Res, 16, pp.509~520 (2010)
- Abdel-Latif MM, "Vitamin C enhances chemosensitization of esophageal cancer cells in vitro", J Chemother, 17, pp.539~549 (2005)
- Farbstein D, "Antioxidant vitamins and their use in preventing cardiovascular disease", Molecules, 15, pp.8098~8110 (2010)
- 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)
- 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)
- Mayne ST, "Beta-Carotene and lung cancer promotion in heavy smokers: a plausible relationship?", J Natl Cancer Inst, 88, pp.1513~1515 (1996)
- Bandera EV, "Antioxidant vitamins and the risk of endometrial cancer: a dose-response meta-analysis", Cancer Causes Control, 20, pp.699~711 (2009)
- 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)
- Key TJ, "The effect of diet on risk of cancer", Lancet, 360, pp.861~868 (2002)
- 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)
- Hercberg S, "The potential role of antioxidant vitamins in preventing cardiovascular diseases and cancers", Nutrition, 14, pp.513~520 (1998)
- Biasco G, "European trials on dietary supplementation for cancer prevention", Ann N Y Acad Sci, 889, pp.152~156 (1999)
- 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)
- Myung SK, "Effects of antioxidant supplements on cancer prevention: meta-analysis of randomized controlled trials", Ann Oncol, 21, pp.166~179 (2010)
- Honegger CG, "Quantitative determination of water-soluble scavengers in neoplastic and non-neoplastic human breast tissue", Int J Cancer, 41, pp.690~694 (1988)
- 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)
- Agus DB, "Stromal cell oxidation: a mechanism by which tumors obtain vitamin C", Cancer Res, 59, pp.4555~4558 (1999)
- Benade L, "Synergistic killing of Ehrlich ascites carcinoma cells by ascorbate and 3-amino-1,2,4,-triazole", Oncology, 23, pp.33~43 (1969)
- Bram S, "Vitamin C preferential toxicity for malignant melanoma cells", Nature, 284, pp.629~631 (1980)
- Leung PY, "Cytotoxic effect of ascorbate and its derivatives on cultured malignant and nonmalignant cell lines", Anticancer Res, 13, pp.475~480 (1993)
- 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)
