Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Br J Cancer. 2024 Jan;130(1):82-87. doi: 10.1038/s41416-023-02421-9. Epub 2023 Nov 28.
Despite no sufficient evidence on benefits and harms of multivitamin use, cancer survivors use multivitamins as a self-care strategy to improve or maintain health. We examined if multivitamin use was associated with mortality in cancer survivors.
15,936 male and 7026 female cancer survivors in the NIH-AARP Diet and Health Study were included in the analysis. Types and frequency of multivitamin use at on average 4.6 years after cancer diagnosis were assessed. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression models.
Multivitamin use was not associated with lower all-cause mortality risk in all female (RR = 0.94, 95% CI:0.87-1.01 daily vs. no use) or male cancer survivors (RR = 0.96, 95% CI:0.91-1.00); however, a modest inverse association for CVD mortality was observed in female survivors of reproductive cancers (RR = 0.75, 95% CI:0.61-0.92) and male survivors of non-reproductive cancers (RR = 0.81, 95% CI:0.70-0.94). Multivitamin use was also associated with a lower risk of cancer-specific mortality in survivors of skin (RR = 0.65, 95% CI:0.48-0.88) and breast (RR = 0.79, 95% CI:0.65-0.95) cancer.
Multivitamin use may provide a modest survival benefit to some cancer survivors. Cancer care providers should talk with cancer survivors about potential benefits and harms of multivitamin use.
尽管没有足够的证据表明使用多种维生素有益还是有害，但癌症幸存者将其作为自我保健策略来改善或维持健康，因此会使用多种维生素。我们研究了癌症幸存者使用多种维生素是否与死亡率相关。
共纳入 NIH-AARP 饮食与健康研究中的 15936 名男性和 7026 名女性癌症幸存者，平均在癌症确诊后 4.6 年评估其使用多种维生素的类型和频率。采用 Cox 比例风险回归模型，估计多变量调整后的相对风险（RR）和 95%置信区间（CI）。
在所有女性（RR=0.94，95%CI：0.87-1.01 每日 vs. 不使用）或男性癌症幸存者（RR=0.96，95%CI：0.91-1.00）中，使用多种维生素与全因死亡率降低无关；然而，在女性生殖系统癌症幸存者（RR=0.75，95%CI：0.61-0.92）和非生殖系统癌症男性幸存者（RR=0.81，95%CI：0.70-0.94）中，心血管疾病死亡率与使用多种维生素之间存在适度的反比关系。在皮肤（RR=0.65，95%CI：0.48-0.88）和乳腺（RR=0.79，95%CI：0.65-0.95）癌症幸存者中，使用多种维生素也与癌症特异性死亡率降低相关。
多种维生素的使用可能会给一些癌症幸存者带来适度的生存获益。癌症护理提供者应与癌症幸存者讨论使用多种维生素的潜在益处和危害。
