Editorials represent the opinions EDITORIAL of the authors and JAMA and not those of the American Medical Association. Randomized Trials of Antioxidant Supplementation for Cancer Prevention First Bias, Now Chance—Next, Cause line serum levels, smoking status, and genetic factors that might Peter H. Gann, MD, ScD have modified response. After that, like Voyager space probes, each study will continue to contribute a wide range of valu- N 1996, A WAVE OF HOPE AROSE WHEN THE NUTRITIONAL able data as observational cohorts, before they fade away. Prevention of Cancer trial reported a 65% reduction in What can clinicians, researchers, and men concerned about prostatecancerincidenceinmenreceivingseleniumsupple- 1 prostate cancer prevention learn from the main results of these Imentation. This came only 2 years after the ATBC phase3trials?Threeoverarchingpointsareworthconsideration. (-Tocopherol, Beta Carotene) Cancer Prevention Trial had First, widespread use of prostate-specific antigen (PSA) reporteda35%reductioninprostatecanceroccurrenceamong 2 testing has substantially restricted the design and interpre- men taking vitamin E supplements. Suddenly, it appeared to tation of prostate cancer prevention trials, perhaps perma- make sense that this cancer could be prevented by bolstering nently. Neither trial mandated regular PSA testing; thus, end antioxidant defenses in middle-aged and older men. Prostate points were determined by routine clinical management.
JAMA – American Medical Association
Published: Jan 7, 2009