Long-term, supplemental, one-carbon metabolism–Related Vitamin B use in relation to lung cancer risk in the vitamins and lifestyle (VITAL) cohort
Journal
Journal of Clinical Oncology
Journal Volume
35
Journal Issue
30
Pages
3440-3448
Date Issued
2017
Author(s)
Abstract
Purpose Inconsistent findings have been reported of a link between the use of one-carbon metabolism–related B vitamins and lung cancer risk. Because of the high prevalence of supplemental vitamin B use, any possible increased association warrants further investigation. We examined the association between long-term use of supplemental B vitamins on the one-carbon metabolism pathway and lung cancer risk in the Vitamins and Lifestyle (VITAL) cohort, which was designed specifically to look at supplement use relative to cancer risk. Methods A total of 77,118 participants of the VITAL cohort, 50 to 76 years of age, were recruited between October 2000 and December 2002 and included in this analysis. Incident, primary, invasive lung cancers (n = 808) were ascertained by prospectively linking the participants to a population-based cancer registry. The 10-year average daily dose from individual and multivitamin supplements were the exposures of primary interest. Results Use of supplemental vitamins B6, folate, and B12 was not associated with lung cancer risk among women. In contrast, use of vitamin B6 and B12 from individual supplement sources, but not from multivitamins, was associated with a 30% to 40% increase in lung cancer risk among men. When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (. 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (. 55mg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline. In addition, the B6 and B12 associations were apparent in all histologic types except adenocarcinoma, which is the type less related to smoking. Conclusion This sex- and source-specific association provides further evidence that vitamin B supplements are not chemopreventive for lung cancer and may be harmful. ? 2017 American Society of Clinical Oncology. All rights reserved.
SDGs
Other Subjects
cyanocobalamin; folic acid; multivitamin; pyridoxine; cyanocobalamin; folic acid; pyridoxine; vitamin B complex; adult; aged; alcohol consumption; Article; cancer registry; cancer risk; carbon metabolism; cohort analysis; comparative study; dietary intake; female; food frequency questionnaire; histology; human; long term care; lung adenocarcinoma; lung cancer; major clinical study; male; middle aged; one carbon metabolism; priority journal; prospective study; small cell lung cancer; smoking; squamous cell lung carcinoma; vitamin supplementation; dietary supplement; health survey; incidence; lifestyle; Lung Neoplasms; multivariate analysis; procedures; proportional hazards model; risk factor; statistics and numerical data; time factor; Washington; Aged; Cohort Studies; Dietary Supplements; Female; Folic Acid; Health Surveys; Humans; Incidence; Life Style; Lung Neoplasms; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Risk Factors; Time Factors; Vitamin B 12; Vitamin B 6; Vitamin B Complex; Washington
Publisher
American Society of Clinical Oncology
Type
journal article