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Research: GOODMAN and co-workers,
Listed in Issue 112
Abstract
GOODMAN and co-workers, Fred Hutchinson Cancer Research Center, 1100 Fairview Avene North, Building M, M1-B514, Seattle, WA 98109, USA, gary.goodman@swedish.org, have reported on the 6-year follow-up of the beta-carotene and retinol trial.
Background
The beta-carotene and retinol efficacy trial (CARET) was designed to test the effect of daily 30 mg beta-carotene and 25,000 IU retinyl palmitate on the incidence of lung cancer and other cancers in 18,314 participants at risk from lung cancer. The trial was stopped prematurely in 1996 because participants who received the active intervention were found to have a 28% increase in lung cancer, a 17% increase in death, and a higher rate of cardiovascular disease compared with participants who received a placebo.
Methodology
After the end of the study, participants provided a final blood sample and were then followed up annually by telephone and by post.
Results
6 years after the end of the CARET, participants in the active intervention group had relative risks of lung cancer and all-cause mortality of 1.12 and 1.08, respectively. A time-course of relative risks showed that the risk of lung cancer remained above 1 for the entire period, whereas the risk of cardiovascular disease returned to baseline quickly after the end of the trial. Women had a larger risk of lung cancer mortality (1.33 compared to 1.14 for men), cardiovascular disease mortality (1.44 compared to 0.93) and all-cause mortality (1.37 compared to 0.98).
Conclusion
The previously reported increase in the risk of dying from lung cancer and cardiovascular disease after taking supplements of beta-carotene and retinol, but not the increase in the risk of dying from cardiovascular disease, persisted for 6 years after the supplementation was stopped, although it was no longer statistically significant. The people at increased risk are primarily women and former smokers.
References
Goodman GR, Thornquist MD, Balmes J, Cullen MR, Meyskens FL Jr., Omenn GS, Valanis B, Williams JH Jr. The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping beta-carotene and retinol supplements. Journal of the National Cancer Institute 96 (23): 1743-1759, Dec 1, 2004.
