Selenium retinol, retinol-binding protein, and uric acid associations with cancer mortality in a population-based prospective case-control study

doi:10.1016/1047-2797(91)90008-Z

Annals of Epidemiology

Volume 1, Issue 5, August 1991, Pages 385-393

https://doi.org/10.1016/1047-2797(91)90008-Z Get rights and content

Abstract

Using a prospective case-control study design, baseline levels of plasma selenium, retinol, and retinol-binding protein, and baseline blood uric acid levels were compared in 136 case patients who subsequently died from cancer and 238 matched control subjects. Subjects were followed for an average of $812$ years. In matched analyses, selenium levels were lower in case patients with gastrointestinal or prostate cancer; retinol levels, lower in those with gastrointestinal or breast cancer; retinol-binding protein levels, lower in case patients with gastrointestinal cancer; and uric acid levels, lower in a group with “other” cancers. However, only the uric acid association with “other” cancers and the retinol-binding protein association with gastrointestinal cancer were statistically significant (P ≤ .02) in conditional logistic regression analyses controlling for multiple potential covariates. Relationships for each of the substances varied by cancer site, and although some relationships were suggestive, our results point to the need for larger studies with adequate numbers for site-specific analyses.

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Cited by (66)

Gout drugs use and risk of cancer: A case-control study
2019, Revue du Rhumatisme (Edition Francaise)
Objectif Aucune conclusion définitive n’a été tirée à ce jour concernant le risque de cancer lié aux traitements de la goutte administrés à court et long terme. Cette étude avait pour objectif d’évaluer l’association entre l’utilisation des traitements antigoutteux et le risque de cancer.
Nous avons mené une étude rétrospective longitudinale cas-témoins basée sur la population à Taïwan. Tous les patients âgés de 20 ans et plus, ayant reçu un premier diagnostic de cancer entre 2001 et 2011 ont été inclus dans cette étude. Les valeurs des odds ratio ajustés (ORa) et de leurs intervalles de confiance (IC) à 95 % ont été calculées par régression logistique conditionnelle.
Nous avons analysé 601 733 cas et 2 406 932 témoins appariés. L’odd ratio ajusté pour l’utilisation des traitements antigoutteux et le risque global de cancer était de 1,007 (IC 95 %, 0,994–1,020). Il existait un risque significatif de leucémie (ORa : 1,34, IC 95 % : 1,20–1,50), de cancer de l’endomètre (ORa : 1,33, IC 95 % 1,12–1,57), de lymphome non hodgkinien (ORa : 1,24, IC 95 % : 1,13–1,35), de cancer du sein féminin (ORa : 1,21, IC 95 % : 1,13–1,29) et de cancer du col de l’utérus (ORa : 1,21, IC 95 % : 1,07–1,37). Cependant, aucune association n’a été observée dans le groupe des hommes (ORa : 0,97, IC 95 % : 0,95–0,98) mais un risque accru de cancer, tous sites confondus, a été retrouvé chez les femmes (ORa : 1,107, IC 95 % : 1,08–1,13).
En résumé, nos résultats suggèrent que les traitements de la goutte augmentent le risque de survenue des cancers les plus courants, en particulier la leucémie, le lymphome non hodgkinien, le cancer de l’endomètre, du sein et du col de l’utérus.
Gout drugs use and risk of cancer: A case-control study
2018, Joint Bone Spine
Citation Excerpt :
In addition, Fini et al. [26] reported the elevated serum uric acid might be a risk factor for cancer incidence and mortality. These studies contradict with Criqui et al. [27] findings that cancer risk was not associated with serum uric level. Under a causal assumption, the most plausible hypothesis would be the limitation on an increased or decreased risk induced by long-term use of anti-gout drugs.
Firm conclusion about whether short and long-term gout medications use has an impact on cancer risk remain inconclusive. The aim of this study was to investigate the association between gout drugs use and risk of cancer.
We conducted a retrospective longitudinal population-based case-control study in Taiwan. Cases were identified all patients who were aged 20 years or above, and had a first time diagnosis of cancers for the period between 2001 and 2011. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated by using conditional logistic regression.
We examined 601,733 cases and 2,406,932 matched controls. The adjusted odd ratio for any gout drugs use and overall cancer risk was 1.007 (95% CI: 0.994–1.020). There was a significant risk of leukemia (AOR: 1.34, 95% CI: 1.20–1.50), endometrial cancer (AOR: 1.33, 95% CI: 1.12–1.57), non-Hodgkin's (AOR: 1.24, 95% CI: 1.13–1.35), female breast cancer (AOR: 1.21, 95% CI: 1.13–1.29), cervical cancer (AOR: 1.21, 95% CI: 1.07–1.37). However, no association was observed in male group (AOR: 0.97, 95% CI: 0.95–0.98) but female showed a significantly increased risk of cancer at any site (AOR: 1.107, 95% CI: 1.08–1.13).
In summary, our results suggest that gout drugs increase risk of the most common cancers, particularly in leukemia, non-Hodgkin's, endometrial, breast and cervical cancer.
Selenium and prostate cancer: Systematic review and meta-analysis
2012, American Journal of Clinical Nutrition
Background: Prostate cancer is a growing public health problem. Several human studies have shown a potentially protective effect of selenium, but the conclusions from published reports are inconsistent.
Objective: The objective was to examine the evidence for relations between selenium intake, selenium status, and prostate cancer risk.
Design: This was a systematic review and meta-analysis of randomized controlled trials, case-control studies, and prospective cohort studies. The World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project database was searched up to September 2010. The studies included reported measurements of selenium intake or status (plasma, serum, or toenail selenium), assessments of prostate cancer cases (number of events), and the RR in the adult population. Meta-analyses were performed, and study quality, heterogeneity, and small study effects were assessed. Dose-response meta-analyses were used, with restricted cubic splines and fractional polynomials for nonlinear trends, to investigate the association between selenium status and prostate cancer risk.
Results: Twelve studies with a total of 13,254 participants and 5007 cases of prostate cancer were included. The relation between plasma/serum selenium and prostate cancer in a nonlinear dose-response meta-analysis showed that the risk decreased with increasing plasma/serum selenium up to 170 ng/mL. Three high-quality studies included in the meta-analysis of toenail selenium and cancer risk indicated a reduction in prostate cancer risk (estimated RR: 0.29; 95% CI: 0.14, 0.61) with a toenail selenium concentration between 0.85 and 0.94 μg/g.
Conclusion: The relation between selenium status and decreased prostate cancer risk was examined over a relatively narrow range of selenium status; further studies in low-selenium populations are required.
High risk of cancer among patients with gout: Study of the Taiwanese national population
2012, Revue du Rhumatisme (Edition Francaise)
Peu d’études se sont intéressées à l’association entre goutte et cancer. Cette étude examine le risque relatif de cancers au sein d’une cohorte nationale.
La base de données de l’assurance maladie nationale de Taïwan constituait la source de données primaires. Les données recueillies de 2000 à 2008 chez des sujets âgés de plus de 20 ans et sans antécédent de cancer ont été inclues dans l’analyse. La définition des cas de la goutte correspondait aux dossiers mentionnant un diagnostic de goutte et les traitements adaptés (médicaments hypo-uricémiants, incluant allopurinol, benzbromarone, probénécide et sulfinpyrazone, ainsi que la colchicine). Un modèle de régression de Cox (modèle à risques proportionnels) a été utilisé pour estimer l’association entre goutte et cancer.
Un total de 694 361 patients (355 278 hommes, 339 083 femmes) ont été inclus ; parmi eux, 25 943 présentaient un antécédent de goutte. L’âge moyen (± écart-type) était de 42,3 ± 16,3 ans. Pendant les 5 471 272 années-patients de suivi, un cancer a été détecté chez 24 088 patients (1745 atteints de goutte et 22 343 témoins). La plupart des cancers concernaient le foie, le poumon et le côlon. L’incidence globale du cancer était significativement plus élevée parmi les patients goutteux que parmi les témoins (8,7 vs 4,2 cas par 1000 années-patients, p < 0,001). Après ajustement sur l’âge et le sexe, la goutte s’est révélée associée au cancer avec un « hazard ratio » (HR) (rapport des risques instantanés) de 1,15 (intervalle de confiance à 95 % [IC], 1,10–1,21 ; p < 0,001). La goutte était associée dans la majeure partie des cas au cancer de la prostate, avec un HR ajusté sur l’âge et le sexe de 1,71 (1,45–2,02). D’un autre côté, la goutte tendait à une association inverse, bien que négligeable, avec le cancer du sein (HR ajusté, 0,81 ; IC 95 %, 0,63–1,04).
La goutte était associée à un risque de cancer plus élevé, notamment celui de la prostate chez les hommes.
Increased risk of cancer among gout patients: A nationwide population study
2012, Joint Bone Spine
Citation Excerpt :
However, the results have been conflicting. Criqui et al. reported that cancer risk was not associated with serum uric level [12]. By contrast, Petersson et al. found significant associations between SUA level and cancer deaths. [13].
Few studies have investigated the association between gout and cancer. The present study examined the relative risk of cancer in a nationwide cohort.
The primary data source was the National Health Insurance database of Taiwan. Data recorded between 2000 and 2008 for subjects ≥ 20 years and with no history of malignancy were included for the analysis. A gout case definition was defined by records of gout diagnosis and anti-gout treatment (urate-lowering drugs, including allopurinol, benzbromazone, probenacid and sulfinpyrazone, and colchicine). Cox proportional hazards models were used to examine the association between gout and cancer.
A total of 694,361 patients (355,278 men, 339,083 women) were included; among them, 25,943 had a history of gout. Mean age (± standard deviation) was 42.3 ± 16.3 years. During 5,471,272 patient-years of follow-up, cancer was detected in 24,088 patients (1745 with gout and 22,343 controls). The most cancers were liver, lung, and colonic cancers. The overall incidence of cancer was significantly higher among gout patients than controls (8.7 vs. 4.2 cases per 1000 patient-years, P < 0.001). After adjustment for age and sex, gout was found to be associated with a hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.10–1.21; P < 0.001) for cancer. Gout was most closely associated with prostate cancer, with an age- and sex-adjusted HR of 1.71 (1.45–2.02). On the other hand, gout tended to have an inverse, albeit insignificant, association with breast cancer (adjusted HR, 0.81; 95% CI, 0.63–1.04).
Gout was associated with increased risk of cancer, particularly that of prostate cancer in males.
Alternative Medicine for Prostate Cancer: Diet, Vitamins, Minerals, and Supplements
2010, Early Diagnosis and Treatment of Cancer Series: Prostate Cancer

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^☆: This work was supported by Lipid Research Clinics collaborative National Institutes of Health (NIH) contracts N01-HV12159, N01-HV12156, N01-HV12160, N01-HV22914, N01-HV30010, N01-HV22913, N01-HV12158, N01-HV12161, N01-HV22915, N01-HV22932, N01-HV22917, N01-HV12157, N01-HV12243, N01-HV32961, and N01-HV62941, and NIH grants DK 05968 and HL 21006.

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Original reportSelenium retinol, retinol-binding protein, and uric acid associations with cancer mortality in a population-based prospective case-control study☆

Abstract

Lancet

Lancet

J Lipid Res.

Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative diseases

Science

The role of retinoids in differentiation and carcinogenesis

Cancer Res.

Association between serum selenium and the risk of cancer

Am J Epidemiol.

Risk of cancer in relation to serum concentrations of selenium and vitamins A and E: Matched case-control analysis of prospective data

Br Med J.

Is serum selenium a risk factor for cancer in men only?

Am J Epidemiot.

Serum selenium and the risk of cancer, by specific sites: Case control analysis of prospective data

J Natl Cancer Inst.

Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer

N Engl J Med.

Serum levels of selenium and retinol and the subsequent risk of cancer

Am J Epidemiol.

Serum vitamin A (retinol) and cancer incidence in Evans County, Georgia

J Natl Cancer Inst.

Serum retinol and the inverse relationship between serum cholesterol and cancer

Br Med J.

Relation of serum vitamins A and E and carotenoids to the risk of cancer

N Engl J Med.

Original report
Selenium retinol, retinol-binding protein, and uric acid associations with cancer mortality in a population-based prospective case-control study☆