Selenium supplementation and secondary prevention of nonmelanoma skin cancer in a randomized trial

J Natl Cancer Inst. 2003 Oct 1;95(19):1477-81. doi: 10.1093/jnci/djg061.

Abstract

The Nutritional Prevention of Cancer Trial was a double-blind, randomized, placebo-controlled clinical trial designed to test whether selenium as selenized yeast (200 microg daily) could prevent nonmelanoma skin cancer among 1312 patients from the Eastern United States who had previously had this disease. Results from September 15, 1983, through December 31, 1993, showed no association between treatment and the incidence of basal and squamous cell carcinomas of the skin. This report summarizes the entire blinded treatment period, which ended on January 31, 1996. The association between treatment and time to first nonmelanoma skin cancer diagnosis and between treatment and time to multiple skin tumors overall and within subgroups, defined by baseline characteristics, was evaluated. Although results through the entire blinded period continued to show that selenium supplementation was not statistically significantly associated with the risk of basal cell carcinoma (hazard ratio [HR] = 1.09, 95% confidence interval [CI] = 0.94 to 1.26), selenium supplementation was associated with statistically significantly elevated risk of squamous cell carcinoma (HR = 1.25, 95% CI = 1.03 to 1.51) and of total nonmelanoma skin cancer (HR = 1.17, 95% CI = 1.02 to 1.34). Results from the Nutritional Prevention of Cancer Trial conducted among individuals at high risk of nonmelanoma skin cancer continue to demonstrate that selenium supplementation is ineffective at preventing basal cell carcinoma and that it increases the risk of squamous cell carcinoma and total nonmelanoma skin cancer.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / blood
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Basal Cell / blood
  • Carcinoma, Basal Cell / epidemiology*
  • Carcinoma, Basal Cell / prevention & control*
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / chemically induced
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / prevention & control*
  • Dietary Supplements
  • Double-Blind Method
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Selenium / adverse effects
  • Selenium / blood
  • Selenium / therapeutic use*
  • Skin Neoplasms / blood
  • Skin Neoplasms / chemically induced
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / prevention & control*
  • Treatment Failure
  • United States / epidemiology

Substances

  • Antineoplastic Agents
  • Selenium