Gaziano J M, Hennekens C H
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204, USA.
Pathol Biol (Paris). 1996 Jan;44(1):42-5.
Advances in diagnosis and treatment of cancer, as well as increased understanding of the mechanisms of the disease, have provided and will certainly continue to provide enormous benefit to affected individuals. At the same time, interventions that may prevent common cancers from developing in healthy people could, at least in theory, afford even greater benefits to society as a whole. The hypothesis that antioxidant vitamins might reduce cancer risk is based on a large body of both basic and human epidemiologic research. A large number of case-control and cohort studies provide remarkably consistent data suggesting that consumption of foods rich in antioxidant vitamins reduce risks of developing epithelial cancers. These data raise the question of a possible role of antioxidants, such as vitamins C and E, and beta carotene, in the primary prevention of cancer as well ar cardiovascular disease but do not provide a definitive answer. Despite the lack of clear benefit, there has been a rapid increase in the consumption of supplements of these micronutrients. Limited randomized trial data on the role of supplemental antioxidants are available. A number of randomized trials are currently underway designed to test the hypothesis that antioxidants prevent chronic diseases and to evaluate the long term safety of the widespread practice of supplementation. Well designed and well conducted large-scale randomized trials are necessary to provide a definitive positive or negative result on which public policy can be based, or a null result that is truly informative and that can then safely permit the rechanneling of already limited resources to other areas of research.
癌症诊断与治疗方面的进展，以及对该疾病发病机制的深入了解，已经并必将继续为患者带来巨大益处。与此同时，至少在理论上，能够预防健康人群发生常见癌症的干预措施可能会给整个社会带来更大的益处。抗氧化维生素可能降低癌症风险这一假说，是基于大量基础研究和人类流行病学研究得出的。大量病例对照研究和队列研究提供了高度一致的数据，表明食用富含抗氧化维生素的食物可降低患上皮癌的风险。这些数据引发了关于抗氧化剂（如维生素C、维生素E和β-胡萝卜素）在癌症一级预防以及心血管疾病预防中可能发挥作用的问题，但并未给出明确答案。尽管缺乏明确的益处，但这些微量营养素补充剂的消费量却迅速增加。关于补充抗氧化剂作用的随机试验数据有限。目前正在进行一些随机试验，旨在检验抗氧化剂预防慢性病的假说，并评估广泛补充抗氧化剂做法的长期安全性。要得出明确的阳性或阴性结果，从而为公共政策提供依据，或者得出真正有参考价值的无效结果，以便能够安全地将有限资源重新导向其他研究领域，就必须开展设计良好且实施得当的大规模随机试验。
