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Research: PLUMMER and co-workers,
Listed in Issue 146
Abstract
PLUMMER and co-workers, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France, plummer@iarc.fr, have tested the efficacy of vitamin supplementation in removing pre-cancerous stomach lesions.
Background
Gastric cancer is one of the most common malignancies worldwide. Histopathological studies have identified a sequence of changes in the gastric mucosa that mark the slow progression from normal tissue to carcinoma. Epidemiological evidence suggests that a diet rich in fresh fruit and vegetables could be a protective factor. The ain of this study was to test the hypothesis that this effect might be mediated through antioxidant vitamins.
Methodology
A randomized, double-blind chemoprevention trial was conducted among 1980 subjects in Tachira State, Venezuela, a population at high risk for gastric cancer. Subjects were randomly assigned to receive either a combination of vitamin C (750 mg/day), vitamin E (600 mg/day), and beta-carotene (18 mg/day) or placebo for 3 years. Changes in the gastric mucosa were determined by histological diagnosis based on five biopsies taken at baseline and annually for 3 years..
Results
Median plasma vitamin levels were increased in the treatment group between baseline and 1 year after randomization from 0.43 micromol/L to 2.89 micromol/L for beta-carotene, from 26.7 micromol/L to 54.9 micromol/L for vitamin E, and from 47.70 micromol/L to 61.9 micromol/L for vitamin C. Overall progression rates per 100 person-years were 74.3 in the placebo group and 67.8 in the vitamin group. Overall regression rates were 109.4 in the placebo group and 116.5 in the group randomly assigned to vitamins. There was no statistically significant difference in progression rate or regression rate between vitamin and placebo groups.
Conclusion
Supplementation with antioxidant micronutrients is not an effective tool for gastric cancer control in this high-risk population.
References
Plummer M et al. Chemoprevention of precancerous gastric lesions with antioxidant vitamin supplementation: a randomized trial in a high-risk population. Journal of the National Cancer Institute 99 (2): 137-146, Jan 17, 2007.
