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Beta-Carotene and Chemoprevention of Cancer

  • Charles H. Hennekens

Abstract

Cancer is the second leading cause of mortality in the U.S., responsible for over 20% of the approximately two million total annual deaths (1). Treatment of cancer has provided and will continue to provide enormous benefits to some categories of affected individuals. At the same time, however, interventions that may prevent cancer in healthy individuals could, at least in theory, also afford great benefits to society as a whole. For example, a complete cure for acute leukemia, which accounts for several thousand of the approximately 400,000 total cancer deaths in the U.S. each year, would certainly be a remarkable breakthrough in medical research. In terms of public health impact, however, even a small reduction, on the order of 30%, in the development of epithelial cell cancers, which account for 90% of U.S. cancer deaths, due to dietary supplementation with micronutrients could conceivably prevent over 100,000 cancer deaths annually. With respect to known etiologies, cigarette smoking is the leading identified avoidable cause of cancer as well as mortality from all causes, accounting for about 30% of all deaths due to malignancy in the United States (2). Heavy alcohol consumption, which ranks second, is responsible for about 3% of cancer deaths. Recently, promising, but unproven, hypotheses have suggested that a substantial percentage of cancers may be preventable through dietary changes. Although diet has been postulated to account for as many as 35% of the annual deaths from cancer, which characteristics of diet, if any, increase or decrease the risk of cancer remains unclear (2).

Keywords

Natl Cancer Inst Standardize Mortality Ratio Cancer Chemoprevention Observational Epidemiologic Study Oral Mucosal Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    E. Silverberg and J. Lubera, Cancer statistics, 1986. Ca 36, 9–25. (1986).PubMedGoogle Scholar
  2. 2.
    R. Doll and R. Peto, The causes of cancer. J Natl Cancer Inst 66, 1191–1308 (1981).PubMedGoogle Scholar
  3. 3.
    C.H. Hennekens and K.A. Eberlein, for the Physicians’ Health Study Research Group, A randomized trial of aspirin and beta-carotene among U.S. physicians. Prev Med 14, 165–168 (1985).PubMedCrossRefGoogle Scholar
  4. 4.
    R. Peto, R. Doll, J.D. Buckley, and M.B. Sporn, Can dietary beta-carotene materially reduce human cancer rates? Nature (London) 290, 201–208 (1981).CrossRefGoogle Scholar
  5. 5.
    C.H. Hennekens, Vitamin A analogues in cancer chemoprevention. In Important Advances in Oncology (V.T. DeVita Jr, S. Hellman, and S.A. Rosenberg, Eds.) pp. 23–55. J.B. Lippincott, Philadelphia (1986).Google Scholar
  6. 6.
    R.G. Ziegler, T.J. Mason, A. Stemhagen, R. Hoover, J.B. Schoenberg, G. Gridley, P.W. Virgo, R. Altman, and J.F. Fraumeni Jr., Dietary carotene and vitamin A and risk of lung cancer among white men in New Jersey. J Natl Cancer Inst 73, 1429–1435 (1984).PubMedGoogle Scholar
  7. 7.
    E. Bjelke, Dietary vitamin A and lung cancer. Int J Cancer 15, 56–565 (1975).CrossRefGoogle Scholar
  8. 8.
    G. Kvale, E. Bjelke, and J.J. Gart, Dietary habits and lung cancer risk. Int J Cancer 31, 397–405 (1983).PubMedCrossRefGoogle Scholar
  9. 9.
    C. Mettlin, S. Graham, and M. Swanson, Vitamin A and lung cancer. J Natl Cancer Inst 62, 1435–1438 (1979).PubMedGoogle Scholar
  10. 10.
    R. MacLennan and J. DeCosta, Risk factors for lung cancer in Singapore Chinese, a population with high female incidence rates. Int J Cancer 20, 854–860 (1977).PubMedCrossRefGoogle Scholar
  11. 11.
    T. Hirayama, Diet and cancer. Nutr Cancer 1, 67–81 (1979).CrossRefGoogle Scholar
  12. 12.
    R.B. Shekelle, S. Liu, W.R. Raynor Jr., M. Lepper, C. Maliza, A.H. Rosof, O. Paul, A.M. Shyrock, and J. Stamler, Dietary vitamin A and risk of cancer in the Western Electric Study. Lancet 2, 1185–1189 (1981).PubMedCrossRefGoogle Scholar
  13. 13.
    M.W. Hinds, L.N. Kolonel, J.E. Hankin-, and J. Lee, Dietary vitamin A, carotene, vitamin C and risk of lung cancer in Hawaii. Am J Epidemiol 119, 227–237 (1984).PubMedGoogle Scholar
  14. 14.
    P. Cook-Mozaffari, F. Azordegan, N.E. Day, A. Ressicaud, C. Sabal, and B. Aramesh, Oesophageal cancer studies in the Caspian littoral of Iran: Results of a case-control study. Br J Cancer 39, 293–309 (1979).PubMedCrossRefGoogle Scholar
  15. 15.
    C. Mettlin, S. Graham, R. Priore, J. Marshall, and M. Swanson, Diet and cancer of the esophagus. Nutr Cancer 2, 143–147 (1981).PubMedCrossRefGoogle Scholar
  16. 16.
    A.J. Tuyns, G. Pequignot, and O.M. Jensen, Nutrition, alcool et cancer de l’oesophage. Bull Cancer 65, 58–64 (1978).PubMedGoogle Scholar
  17. 17.
    E. Bjelke, Dietary factors and the epidemiology of cancer of the stomach and large bowel. In: Aktuelle Probleme der Klinischen Diätetik (Suppl. to Aktuelle Ernahrungsmedizin), pp. 10–17. George Thieme Verlag, Stuttgart, 1978.Google Scholar
  18. 18.
    S. Graham, H. Dayal, M. Swanson, A. Mittelman, and G. Wilkinson, Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst 61, 709–714 (1978).PubMedGoogle Scholar
  19. 19.
    R.L. Phillips, Role of life-style and dietary habits in risk of cancer among Seventh-Day Adventists. Cancer Res 35, 3513–3522 (1975).PubMedGoogle Scholar
  20. 20.
    B. Modan, H. Cudde, and F. Lubin, A note on the role of dietary retinol and carotene in human gastrointestinal cancer. Int J Cancer 28, 421–424 (1981).PubMedCrossRefGoogle Scholar
  21. 21.
    P. Stocks, Cancer incidence in North Wales and Liverpool region in relation to habits and environment. In: British Empire Cancer Campaign 35th Annual Report, Part II, (Suppl.), pp. 111–113 (1958).Google Scholar
  22. 22.
    S. Graham, C. Mettlin, J. Marshall, R. Priore, T. Rzepka, and D. Shedd, Dietary factors in the epidemiology of cancer of the larynx. Am J Epidemiol 113, 675–680 (1981).PubMedGoogle Scholar
  23. 23.
    S. Graham and C. Mettlin, Dietary risk factors in human bladder cancer. Am J Epidemiol 110, 255–263 (1979).PubMedGoogle Scholar
  24. 24.
    S. Graham, J. Marshall, C. Mettlin, T. Rzepka, T. Nemotot, and T. Byers, Diet in the epidemiology of breast cancer. Am J Epidemiol 116, 68–75 (1982).PubMedGoogle Scholar
  25. 25.
    J.R. Marshall, S. Graham, T. Byers, M. Swanson, and J. Erasure, Diet and smoking in the epidemiology of cancer of the cervix. J Natl Cancer Inst 70, 847–851 (1983).PubMedGoogle Scholar
  26. 26.
    L.M. Schuman, J.S. Mandell, A. Radke, U. Seal, and F. Balberg, Some selected features of the epidemiology of prostatic cancer: Minneapolis-St.Paul, Minnesota case-control study, 1976–1979. In: Trends in Cancer Incidence: Causes and Practical Implications (K. Magnus, Ed.), pp. 345–354. Hemisphere Publishing, Washington, D.C. (1982).Google Scholar
  27. 27.
    S. Graham, B. Haughey, J. Marshall, R. Priore, T. Byers, T. Rzepka, M. Mettline, and J.E. Pontes, Diet in the epidemiology of carcinoma of the prostate gland. J Natl Cancer Inst 70, 687–692 (1983).PubMedGoogle Scholar
  28. 28.
    L. Kolonel, J. Hankin, and J. Lee, Diet and prostate cancer (abstract). Am J Epidemiol 118, 454 (1983).Google Scholar
  29. 29.
    B.E. Henderson, Summary report of the fifth symposium on cancer registries and epidemiology in the Pacific Basin. J Natl Cancer Inst in press (1987).Google Scholar
  30. 30.
    W.C. Willett, M.J. Stampfer, B.A. Underwood, J.O. Taylor, and C.H. Hennekens, Vitamins A, E and carotene: effect of supplementation on their plasma levels. Am J Clin Nutr 38, 559–566 (1983).PubMedGoogle Scholar
  31. 31.
    N. Wald, M. Idle, J. Boreham, and A. Bailey, Low serum-vitamin A and subsequent risk of cancer. Preliminary results of a prospective study. Lancet 2, 813–815 (1980).PubMedCrossRefGoogle Scholar
  32. 32.
    H.B. Stahelin, R. Rosel, E. Buess, and G. Brubacher, Cancer, vitamins, and plasma lipids: Prospective Basel study. J Natl Cancer Inst 73, 1463–1468 (1984).PubMedGoogle Scholar
  33. 33.
    M.S. Menkes, G.W. Comstook, J.P. Vuilleumier, K.J. Heising, A.A. Rider, and R. Brookmeyer, Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer. N Engl J Med 315, 1250–1254 (1986).PubMedCrossRefGoogle Scholar
  34. 34.
    W. Willett, B.F. Polk, B.A. Underwood, M.J. Stampfer, S. Pressel, B. Rosner, J.O. Taylor, K. Schneider, C.G. Hames, Relation of serum vitamins A and E and carotenoids to the risk of cancer. N Engl J Med 310, 430–434 (1984).PubMedCrossRefGoogle Scholar
  35. 35.
    W.C. Willett, B.F. Polk, B.A. Underwood, and C.G. Hames, Hypertension Detection and Follow-up Program study of serum retinol, retinol-binding protein, total carotenoids, and cancer risk: A summary. J Natl Cancer Inst 73, 1459–1462 (1984).PubMedGoogle Scholar
  36. 36.
    J. Connett, M. Kjelsberg, and L. Kuller, for the MRFIT Group, A prospective study of the relationship between serum beta carotene, vitamin A, E, selenium and lung cancer (abstract). American Epidemiology Society (1987).Google Scholar
  37. 37.
    C.H. Hennekens, M.J. Stampfer, and W. Willett, Micronutrients and cancer chemoprevention. Cancer Detect Prev 7, 147–148 (1984).PubMedGoogle Scholar
  38. 38.
    C.H. Hennekens, Issues in the design and conduct of clinical trials. J Natl Cancer Inst 73, 1473–1476 (1984).PubMedGoogle Scholar
  39. 39.
    H.F. Stich, M.P. Rosin, and M.O. Vallejera, Reduction with vitamin A and beta-carotene administration of the proportion of micronucleated buccal mucosal cells in Asian betel nut and tobacco chewers. Lancet 2, 1204–1206 (1984).CrossRefGoogle Scholar
  40. 40.
    H.F. Stich, W. Stich, M.P. Rosin, and M.O. Vallejera, Use of the micronucleus test to monitor the effect of vitamin A, beta-carotene and canthaxanthin on the buccal mucosa of betel nut/tobacco chewers. Int J Cancer 34, 745–750 (1984).PubMedCrossRefGoogle Scholar
  41. 41.
    W. Willett, L. Sampson, C. Bain, B. Rosner, C.H. Hennekens, J. Witschie, and F.E. Speizer, Vitamin supplement use among registered nurses. Am J Clin Nutr 34, 1121–1125 (1981).PubMedGoogle Scholar
  42. 42.
    V. Herbert, The vitamin craze. Arch Intern Med 140, 173–176 (1980).PubMedCrossRefGoogle Scholar
  43. 43.
    M.J. Stampfer, J. Buring, W. Willett, B. Rosner, K. Eberlein, and C.H. Hennekens, The 2x2 factorial design: its application to a randomized trial of aspirin and carotene among US physicians. Stat Med 4, 111–116 (1985).PubMedCrossRefGoogle Scholar
  44. 44.
    S. Satterfield, for the Physicians’ Health Study Research Group, Biochemical markers of compliance in the Physicians’ Health Study. Controlled Clin Trials, in press (1987).Google Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Charles H. Hennekens
    • 1
  1. 1.Channing Laboratory, Department of Medicine, Department of Preventive Medicine and Clinical Epidemiology Harvard Medical SchoolBrigham and Women’s HospitalUSA

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