Dietary Supplement Use and Risk of Neoplastic Progression in Esophageal Adenocarcinoma: A Prospective Study

Abstract

The incidence of esophageal adenocarcinoma (EA) and its precursor condition, Barrett's esophagus, has risen rapidly in the United States for reasons that are not fully understood. Therefore, we evaluated the association between use of supplemental vitamins and minerals and risk of neoplastic progression of Barrett's esophagus and EA. The Seattle Barrett's Esophagus Program is a prospective study based on 339 men and women with histologically confirmed Barrett's esophagus. Participants underwent baseline and periodic follow-up exams, which included endoscopy and self-administered questionnaires on diet, supplement use, and lifestyle characteristics. Use of multivitamins and 4 individual supplements was calculated using time-weighted averages of reported use over the observational period. Cox proportional-hazards models were used to calculate hazard ratios (HR) for each endpoint: EA, tetraploidy, and aneuploidy. During a mean follow-up of 5 yr, there were 37 cases of EA, 42 cases of tetraploidy, and 34 cases of aneuploidy. After controlling for multiple covariates including diet, nonsteroidal anti-inflammatory drug use, obesity, and smoking, participants who took 1 or more multivitamin pills/day had a significantly decreased risk of tetraploidy [HR = 0.19; 95% confidence interval (CI) = 0.08-0. and supplemental vitamin C (≥250 mg vs. none: HR = 0.25; 95% 0.25; 95% CI = 0.11-0.58) and vitamin E (≥ 180 mg vs. none: HR = 0.25; 95% CI = 0.10-0.60). In this cohort study, use of multivitamins and single antioxidant supplements was associated with a significantly reduced risk of EA and markers of neoplastic progression among individuals with Barrett's esophagus. NIH Public Access

58 Jahre Barrett's Ösophagus

“…An understanding and correction of these dietary factors could avert escalation of the disease in these countries. Recent studies have shown that dietary supplements of multivitamins and antioxidants significantly reduced the risk of oesophageal adenocarcinoma and markers of neoplastic progression among individuals with Barrett's oesophagus [44].…”

Chemoprevention of Adenocarcinoma Associated with Barrett’s Esophagus: Potential Options

“…The Seattle BE Program is a prospective study which is prospectively following 339 men and women with histologically confirmed BE. In this cohort study, use of multivitamins and single antioxidant supplements was associated with a significantly reduced risk of EAC and markers of neoplastic progression among individuals with BE [39] .…”

Nutraceuticals and Nutraceutical Supplementation Criteria in Cancer: A Literature Survey

“…However, there are hypes and controversies in risk assessment of nutraceutical in esophageal and gastrointestinal cancer management [173]. The several reports highlighted the trade-off between increased neoplasia in gastric cancer and the limits of nutraceuticals to reduce cancer growth [173,174].…”

“…The several reports highlighted the trade-off between increased neoplasia in gastric cancer and the limits of nutraceuticals to reduce cancer growth [173,174]. Still efforts are in the direction of antioxidant nutraceuticals to prevent or arrest the gastric cancer growth [175].…”

“…In other recent reports the investigators showed a positive response of different nutraceutical supplements and foods in cancer prevention of different organs in the body as shown in Table 3 with nutraceuticals and references. Bone cancer soy isoflavones [5] Breast cancer lycopene, phytoesterogen [122][123][124][125][126][127][128][129][130][131][132] Common cancer cruciferous vegetables [25,184] Colon cancer nuts, fibers [158][159][160][161][162][163][164][165][166][167][168][169][170][171][172] Gastric cancer herbs [173][174][175] Intestinal cancer sphingolipids [64,65,176] Liver cancer silbinin, citrous flavonoids [25] Lung cancer vitamins A and E [154][155][156][157] Ovary cancer Vitamin A, D, antioxidants [176][177][178] Pancreatic cancer Vitamins and isoflavones …”