1273 EVALUATION OF VITAMIN E AND SELENIUM SUPPLEMENTATION ON THE PREVENTION OF BLADDER CANCER IN SWOG-COORDINATED SELECT (2012)

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20121273 EVALUATION OF VITAMIN E AND SELENIUM SUPPLEMENTATION ON THE PREVENTION OF BLADDER CANCER IN SWOG-COORDINATED SELECT Yair Lotan, Phyllis Goodman, Ramy Youssef, Robert Svatek, Shahrokh Shariat, Catherine Tangen, Ian M. Thompson, and Eric A. Klein Yair LotanYair Lotan Dallas, TX More articles by this author , Phyllis GoodmanPhyllis Goodman Seattle, WA More articles by this author , Ramy YoussefRamy Youssef Dallas, TX More articles by this author , Robert SvatekRobert Svatek San Antonio, TX More articles by this author , Shahrokh ShariatShahrokh Shariat New York, NY More articles by this author , Catherine TangenCatherine Tangen Seattle, WA More articles by this author , Ian M. ThompsonIan M. Thompson San Antonio, TX More articles by this author , and Eric A. KleinEric A. Klein Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1605AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Epidemiological and biological evidence suggest a preventative effect of selenium and vitamin E on bladder cancer. The objective of this study was to assess the effect of selenium, vitamin E, or the combinationon bladder cancer development. METHODS This was a secondary analysis of the randomized, placebo-controlled trial (Selenium and Vitamin E Cancer Prevention Trial [SELECT]) which included 34,887 men randomly assigned to four groups (selenium, vitamin E, selenium + vitamin E, and placebo) in a double-blind fashion between August 22, 2001, and June 24, 2004. The primary end point was bladder cancer incidence as determined by routine clinical management. RESULTS Within a median follow-up of 7.1 years (interquartile range, 6.4 – 8.0 years), 224 bladder cancer cases were recorded. Bladder cancer cases were older, more likely to be Caucasian and to have a smoking history compared to non bladder cancer subjects. Most cancers were urothelial and non-muscle invasive cancers. There were no significant differences in bladder cancer incidence among subjects in the placebo, selenium, vitamin E or selenium+vitamin E arms (placebo, n=53; vitamin E, n=56, HR=1.05 (0.64, 1.73), p=0.79; selenium, n=60, HR=1.13 (0.70, 1.84), p=0.52; vitamin E + selenium, n=55, HR=1.05 (0.63, 1.70, p=0.86). CONCLUSIONS This secondary analysis found no preventative effect of selenium or vitamin E, alone or in combination on bladder cancer in this population of men. Further studies are necessary to assess the effect in females and at different doses and formulations. Table 1. Baseline Characteristics – SELECT Bladder Cancers Characteristic All SELECT No Bladder Cancer Bladder Cancer p-value 34,887 34,663 224 Age Median (IQ range) 62(58,67) 67(58,72) 67(62,72) <.001 50 - 54 1480(4.2%) 1476(4.3%) 4(1.8%) 55 – 59 11,172(32.0%) 11,144(32.2%) 28(12.5%) 60 – 64 9,174(26.3%) 9,124(26.3%) 50(22.3%) 65 – 69 6,859(19.7%) 6,799(19.6%) 60(26.8%) 70 – 74 3,950(11.3%) 3,903(11.3%) 47(21.0%) 75 + 2,252(6.5%) 2,217(6.4%) 35(15.6%) Race White 27,571(79.0%) 27,367(79.0%) 204(91.0%) <.001 African American (non-Hispanic) 4,318(12.4%) 4,304(12.4%) 14(6.3%) Hispanic (non-AA) 1,940(5.6%) 1,939(5,6%) 1(0.5%) Hispanic (AA) 361(1.0%) 359(1.0%) 2(0.9%) Other 697(2.0%) 694(2.0%) 3(1.4%) Education < HS graduate 2,339(6.7%) 2,323(6.7%) 16(7.1%) <.001 HS graduate 5,343(15.3%) 5,297(15.3%) 46(20.5%) Vocational/some college 9,355(26.8%) 9,281(26.8%) 74(33.0%) College graduate 6,605(18.9%) 6,575(19.0%) 30(13.4%) Post-college 10,910(31.3%) 10,853(31.3%) 57(25.5%) Missing 335(1.0%) 334(1.0%) 1(0.5%) Smoking Status Never 15,110(43.3%) 15,056(43.4%) 54(24.1%) <.001 Former 17,053(49.0%) 16,899(48.8%) 154(68.8%) Current 2,700(7.7%) 2,684(7.7%) 16(7.1%) Missing 24(0.1%) 24(0.0%) 0(0.0%) 1 p-values based on Cox proportional hazards model parameterized as follows: Age (continuous); race (white vs. other), education (≤ high school vs. some vocational/some college vs. college graduate vs. post-college education) smoking (never vs. former vs. current). Missing values excluded. Table 2. Bladder Cancers Detected Placebo Vitamin E Selenium Combination Years of Follow-up (median, IQR) 7.0(6.1, 8.0) 7.0(6.0, 8.0) 7.0(6.0, 8.0) 7.0(6.0, 8.0) No. of Bladder Cancers 53 56 60 55 Stage CIS 3 4 4 3 TA 32 26 30 36 T1 10 18 19 7 ≥ T1 6 6 6 7 Unknown 2 2 1 2 Grade Well differentiated 21 18 23 29 Moderately differentiated 9 7 10 5 Poorly differentiated 22 29 26 19 Unknown 1 2 1 2 N-stage N0 3 2 3 5 N1 3 2 1 0 NX 47 52 56 50 M-stage M0 2 0 3 3 M1 3 3 0 1 MX 48 53 57 51 Histology Urothelial cell 51 53 59 50 Squamous cell 1 0 1 0 Adenocarcinoma 0 0 0 1 Small cell 0 1 0 0 Other/Unknown 1 2 0 4 Deaths (cause) Bladder cancer 6 6 3 3 Other cause 5 3 4 5 1 p-values based on Cox proportional hazards model parameterized as follows © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e515-e516 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yair Lotan Dallas, TX More articles by this author Phyllis Goodman Seattle, WA More articles by this author Ramy Youssef Dallas, TX More articles by this author Robert Svatek San Antonio, TX More articles by this author Shahrokh Shariat New York, NY More articles by this author Catherine Tangen Seattle, WA More articles by this author Ian M. Thompson San Antonio, TX More articles by this author Eric A. Klein Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...