Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
J Nutr. 2022 Jan 11;152(1):211-216. doi: 10.1093/jn/nxab322.
Multivitamins are among the most commonly used supplements in the United States, but their effectiveness in preventing cancer remains unclear.
We prospectively examined the association between multivitamin use and risks of overall and site-specific cancer in a large, well-characterized cohort to ascertain potential preventive or harmful relationships.
We examined 489,640 participants ages 50-71 in the NIH-American Association of Retired Persons (AARP) Diet and Health Study who were enrolled from 1995 to 1998. We linked to 11 state cancer registries in order to identify incident cancers. Multivitamin use was assessed by a baseline questionnaire. Cox proportional hazards regression models of multivitamin use were used to estimate HRs and 95% CIs for cancer risks in men and women, adjusted for potential confounders, including age, BMI, smoking, physical activity, the Healthy Eating Index 2015 score, and use of single-vitamin/-mineral supplements.
A slightly higher overall cancer risk was observed in men (but not women) who consumed 1 or more multivitamins daily compared to nonusers [HRs, 1.02 (95% CI: 1.01-1.04) and 1.03 (95% CI: 1.00-1.07), respectively; P-trend = 0.002]. The latter reflected higher risks for prostate cancer (HR, 1.04; 95% CI: 0.98-1.10; P-trend = 0.005), lung cancer (HR, 1.07; 95% CI: 0.96-1.20; P-trend = 0.003), and leukemia (HR, 1.26; 95% CI: 1.02-1.57; P-trend = 0.003). Taking more than 1 multivitamin daily was also strongly positively associated with the risk of oropharyngeal cancer in women (HR, 1.53, 95% CI: 1.04-2.24; P-trend < 0.0001). By contrast, daily multivitamin use was inversely associated with the colon cancer risk in both sexes (HR, 0.82; 95% CI: 0.73-0.93; P-trend = 0.0003).
We found little evidence to support a cancer-preventive role for multivitamin use, with the exception of colon cancer, in both sexes in the NIH-AARP Diet and Health Study. In addition, slightly higher risks of overall, prostate, and lung cancer, as well as leukemia, were observed for greater multivitamin use in men, with a higher oropharyngeal cancer risk in women.
复合维生素是美国最常用的补充剂之一，但它们在预防癌症方面的效果仍不清楚。
我们前瞻性地研究了大量特征明确的队列中复合维生素使用与整体和特定部位癌症风险之间的关联，以确定潜在的预防或有害关系。
我们研究了美国国立卫生研究院-美国退休人员协会（AARP）饮食与健康研究中的 489640 名年龄在 50-71 岁的参与者，他们于 1995 年至 1998 年期间入组。我们与 11 个州的癌症登记处进行了联系，以确定癌症的发病情况。复合维生素的使用情况通过基线问卷进行评估。多变量 Cox 比例风险回归模型用于估计男性和女性癌症风险的 HR 和 95%CI，调整了潜在的混杂因素，包括年龄、BMI、吸烟、身体活动、2015 年健康饮食指数评分和单一维生素/矿物质补充剂的使用情况。
与非使用者相比，每天服用 1 种或多种复合维生素的男性（但不是女性）整体癌症风险略高[HRs，1.02（95%CI：1.01-1.04）和 1.03（95%CI：1.00-1.07）；P 趋势=0.002]。后者反映了前列腺癌（HR，1.04；95%CI：0.98-1.10；P 趋势=0.005）、肺癌（HR，1.07；95%CI：0.96-1.20；P 趋势=0.003）和白血病（HR，1.26；95%CI：1.02-1.57；P 趋势=0.003）的风险更高。每天服用超过 1 种复合维生素也与女性口咽癌风险呈强烈正相关（HR，1.53，95%CI：1.04-2.24；P 趋势<0.0001）。相比之下，复合维生素的每日使用与两性的结肠癌风险呈负相关（HR，0.82；95%CI：0.73-0.93；P 趋势=0.0003）。
我们在 NIH-AARP 饮食与健康研究中发现，除了结肠癌外，复合维生素的使用对两性的癌症预防作用证据很少。此外，男性复合维生素使用量较高与整体、前列腺和肺癌以及白血病风险略有增加有关，女性口咽癌风险较高。
