Abdel-Rahman Omar
Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada.
Nutr Cancer. 2021;73(10):1856-1863. doi: 10.1080/01635581.2020.1820050. Epub 2020 Sep 15.
To assess the patterns of use of dietary supplements among cancer survivors in the United States in a population-based setting. National Health and Nutrition Examination Survey (NHANES) datasets (1999-2016) were accessed, and adult respondents (≥ 20 years old) with a known status of cancer diagnosis and a known status of dietary supplements intake were included. Multivariable logistic regression analysis was then used to assess factors associated with dietary supplements intake. Moreover, and to evaluate the impact of dietary supplements on overall survival among respondents with cancer, multivariable Cox regression analysis was conducted. A total of 49,387 respondents were included in the current analysis, including a total of 4,575 respondents with cancer. Among respondents with cancer, 3,024 (66.1%) respondents have reported the use of dietary supplements; while 1,551 (33.9%) did not report the use of dietary supplements. Using multivariable logistic regression analysis, factors associated with the use of dietary supplements included older age (OR: 1.028; 95% CI: 1.027-1.030); white race (OR for black race vs. white race: 0.67; 95% CI: 0.63-0.72); female gender (OR for males vs. females: 0.56; 95% CI: 0.53-0.59), higher income (OR: 1.13; 95% CI: 1.11-1.14), higher educational level (0.59; 95% CI: 0.56-0.63), better self-reported health (OR: 1.36; 95% CI: 1.17-1.58), health insurance (OR: 1.35; 95% CI: 1.27-1.44), and history of cancer (OR: 1.20; 95% CI: 1.10-1.31). Using multivariable Cox regression analysis and within the subgroup of respondents with a history of cancer, the use of dietary supplements was not found to be associated with a difference in overall survival (HR: 1.13; 95% CI: 0.98-1.30). Dietary supplement use has increased in the past two decades among individuals with cancer in the United States, and this increase seems to be driven mainly by an increase in the use of vitamins. The use of dietary supplements was not associated with any improvement in overall survival for respondents with cancer in the current study cohort.
在基于人群的背景下评估美国癌症幸存者使用膳食补充剂的模式。获取了国家健康与营养检查调查（NHANES）数据集（1999 - 2016年），纳入了已知癌症诊断状态和膳食补充剂摄入状态的成年受访者（≥20岁）。然后使用多变量逻辑回归分析来评估与膳食补充剂摄入相关的因素。此外，为了评估膳食补充剂对癌症受访者总体生存的影响，进行了多变量Cox回归分析。本分析共纳入49387名受访者，其中共有4575名癌症受访者。在癌症受访者中，3024名（66.1%）受访者报告使用了膳食补充剂；而1551名（33.9%）未报告使用膳食补充剂。使用多变量逻辑回归分析，与使用膳食补充剂相关的因素包括年龄较大（OR：1.028；95%CI：1.027 - 1.030）；白人种族（黑人种族与白人种族相比的OR：0.67；95%CI：0.63 - 0.72）；女性（男性与女性相比的OR：0.56；95%CI：0.53 - 0.59），收入较高（OR：1.13；95%CI：1.11 - 1.14），教育水平较高（0.59；95%CI：0.56 - 0.63），自我报告的健康状况较好（OR：1.36；95%CI：1.17 - 1.58），有健康保险（OR：1.35；95%CI：1.27 - 1.44），以及癌症病史（OR：1.20；95%CI：1.10 - 1.31）。在有癌症病史的受访者亚组中使用多变量Cox回归分析，未发现使用膳食补充剂与总体生存差异相关（HR：1.13；95%CI：0.98 - 1.30）。在过去二十年中，美国癌症患者使用膳食补充剂的情况有所增加，这种增加似乎主要是由维生素使用的增加所驱动。在当前研究队列中，膳食补充剂的使用与癌症受访者的总体生存改善无关。
