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Antioxidants vitamin C and vitamin E for the prevention and treatment of cancer

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Abstract

OBJECTIVE: To evaluate the evidence of the supplements vitamin C and vitamin E for treatment and prevention of cancer.

METHODS: Systematic review of trials and meta-analysis.

DATA SOURCES AND MAIN RESULTS: Thirty-eight studies showed scant evidence that vitamin C or vitamin E beneficially affects survival. In the ATBC Cancer Prevention Study Group, no statistically significant effect of treatment was seen for any cancer individually, and our pooled relative risk (regardless of tumor type) for α-tocopherol alone was 0.91 (95% confidence interval [CI]: 0.74, 1.12). All cause mortality was not significant. In the Linxian General Population Trial, the relative risks for cancer death for vitamin C (combined with molybdenum) was 1.06 (95% CI: 0.92, 1.21) and for vitamin E (combined with β-carotene and selenium) was 0.87 (95% CI: 0.76, 1.00). We identified only 3 studies that reported statistically significant beneficial results: vitamin C (in combination with BCG) was found to be beneficial in a single trial of bladder cancer and vitamin E (in combination with ω-3 fatty acid) increased survival in patients with advanced cancer. In the ATBC trial, in analyses of 6 individual cancers, the prevention of prostate cancer in subjects treated with α-tocopherol was statistically significant (RR=0.64, 95% CI: 0.44, 0.94).

CONCLUSIONS: The systematic review of the literature does not support the hypothesis that the use of supplements of vitamin C or vitamin E in the doses tested helps prevent and/or treat cancer in the populations tested. There were isolated findings of benefit, which require confirmation.

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Authors and Affiliations

  1. RAND, Southern California Evidence-based Practice Center, Santa Monica, CA, USA

    Ian D. Coulter PhD, Mary L. Hardy MD, Sally C. Morton PhD, Lara G. Hilton, Wenli Tu MS,  Di Valentine JD & Paul G. Shekelle MD

  2. School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA

    Ian D. Coulter PhD

  3. Southern California University of Health Sciences, Los Angeles, CA, USA

    Ian D. Coulter PhD

  4. Cedars-Sinai Integrative Medicine Medical Group Inc., Los Angeles, CA, USA

    Mary L. Hardy MD

  5. Greater Los Angeles VA Healthcare System, RAND, Los Angeles, CA, USA

    Paul G. Shekelle MD

  6. Samueli Institute for Information Biology, Alexandria, VA, USA

    Ian D. Coulter PhD & Paul G. Shekelle MD

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Correspondence to Ian D. Coulter PhD.

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None of the authors have any conflicts of interest to declare.

This research was conducted by the Southern California Evidence-Based Practice Center based at RAND, Santa Monica, CA under contract to the Agency for Healthcare Research and Quality (AHRQ) (Contract No. 290-97-0001). The research was requested and funded by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH). The authors of this manuscript are responsible for its contents, including any clinical or treatment recommendations. The opinions expressed in this article are those of the authors and do not necessarily reflect the official position of AHRQ, or of NCCAM, NIH, or of the U.S. Department of Health and Human Services. We wish to acknowledge the work of Leigh Rohr, RAND Corporation, in the preparation of this manuscript.

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Coulter, I.D., Hardy, M.L., Morton, S.C. et al. Antioxidants vitamin C and vitamin E for the prevention and treatment of cancer. J Gen Intern Med 21, 735–744 (2006). https://doi.org/10.1111/j.1525-1497.2006.00483.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00483.x

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