We studied the relation of serum vitamin A (retinol), beta-carotene, vitamin E, and selenium to the risk of lung cancer, using serum that had been collected during a large blood-collection study performed in Washington County, Maryland, in 1974. Levels of the nutrients in serum samples from 99 persons who were subsequently found to have lung cancer (in 1975 to 1983) were compared with levels in 196 controls who were matched for age, sex, race, month of blood donation, and smoking history. A strong inverse association between serum beta-carotene and the risk of squamous-cell carcinoma of the lung was observed (relative odds, 4.30; 95 percent confidence limits, 1.38 and 13.41). Mean (±SD) levels of vitamin E were lower among the cases than the controls (10.5±3.2 vs. 11.9±4.90 mg per liter), when all histologic types of cancer were considered together. In addition, a linear trend in risk was found (P = 0.04), so that persons with serum levels of vitamin E in the lowest quintile had a 2.5 times higher risk of lung cancer than persons with levels in the highest quintile. These data support an association between low levels of serum vitamin E and the risk of any type of lung cancer and between low levels of serum beta-carotene and the risk of squamous-cell carcinoma of the lung. (N Engl J Med 1986;315:1250–4.), VITAMIN A (retinol), its provitamin, beta-carotene, vitamin E (alpha-tocopherol), and selenium are dietary factors that have recently come to the forefront as potential inhibitors of cancers. Laboratory studies have shown that vitamin A is essential to the normal growth of epithelial tissues1,2 and that supplementation with retinol or its synthetic analogues can inhibit tumor induction.3 4 5 6 Beta-carotene traps free radicals,7 and a few studies in animals suggest that it may also reduce tumor development.8 9 10 Vitamin E supplementation reduces oxidant damage to the lung epithelium of animals exposed to ozone11 or cigarette smoke,12 and decreases the frequency of chemically induced tumors in.
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