This is not the most recent version of the article. View current version (17 OCT 2012)

Intervention Review

Drugs for preventing lung cancer in healthy people

  1. Magali Caraballoso1,*,
  2. Montse Sacristan2,
  3. Consol Serra3,
  4. Xavier Bonfill Cosp4

Editorial Group: Cochrane Lung Cancer Group

Published Online: 22 APR 2003

Assessed as up-to-date: 30 JAN 2003

DOI: 10.1002/14651858.CD002141


How to Cite

Caraballoso M, Sacristan M, Serra C, Bonfill Cosp X. Drugs for preventing lung cancer in healthy people. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD002141. DOI: 10.1002/14651858.CD002141.

Author Information

  1. 1

    Escuela Nacional de Salud Pública de Cuba, Departament of Epidemiology, Ciudad de la Habana, Cuba

  2. 2

    Hospital de la Santa Creu i Sant Pau, Iberoamerican Cochrane Centre, Barcelona, Spain

  3. 3

    Department of Health and Experimental Sciences, Unit of Research in Occupational Health, Barcelona, Spain

  4. 4

    Universitat Autònoma de Barcelona, Iberoamerican Cochrane Centre. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain. Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain

*Magali Caraballoso, Departament of Epidemiology, Escuela Nacional de Salud Pública de Cuba, 31 entre 146 y 150, Cubanacan, Ciudad de la Habana, Cuba. mcara@infomed.sld.cu. magacaraballoso@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 22 APR 2003

SEARCH

This is not the most recent version of the article. View current version (17 OCT 2012)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Some studies have suggested a protective effect of antioxidant nutrients on lung cancer. Observational epidemiological studies suggest an association between higher dietary levels of fruits and vegetables containing beta carotene and a lower risk of lung cancer.

Objectives

To determine whether vitamins, minerals and other potential agents, alone or in combination, reduce incidence and mortality from lung cancer in healthy people.

Search methods

The electronic databases MEDLINE (1966-july 2001), EMBASE (1974-july 2001) and the Cochrane Controlled Trial Register (CENTRAL, Issue 3/2001) and bibliographies were searched. In addition authors of included studies were contacted to identify potentially eligible published and unpublished trials.

Selection criteria

Included studies were randomised controlled clinical trials comparing different supplements or comparing supplements with placebo, administered to healthy people with the aim of preventing lung cancer.

Data collection and analysis

Three authors independently selected the trials to be included in the review and assessed the methodological quality of each trial, and two extracted data using a standardised form. For each study, relative risk and 95% confidence limits were calculated for dichotomous outcomes.

Main results

Four studies were eligible for inclusion. All were population based trials, including a total of 109,394 participants. Two studies included smokers, one included workers exposed to asbestos and two studies were carried out in health professionals. A group of participants with no known risk factors for lung cancer was included in the study sample of two trials. Beta-carotene was evaluated in all trials, alone or combination with alpha-tocopherol or retinol, and one study tested alpha-tocopherol alone. Duration of treatment varied from 2 to 12 years and follow-up was from two to five years. All trials had a placebo group.

For people with risk factors for lung cancer no reduction in lung cancer incidence or mortality was found in those taking vitamins alone compared with placebo (incidence of lung cancer: RR 0.98, 95% CI 0.81-1.19; lung cancer mortality: RR 0.93, 95% CI 0.73-1.19). For people with no known risk factors of lung cancer, none of the vitamins or their combinations appeared to have any effect. Combined data from three studies showed a non-statistically significant increased risk of lung cancer incidence (RR 1.11, 95% CI 0.94-1.33) and mortality (RR 1.05, 95% CI 0.87-1.28) for beta-carotene alone at pharmacological doses in groups with risk factors for lung cancer. When beta-carotene was combined with retinol, data from a single study showed that there was a statistically significant, increased risk of lung cancer incidence (RR 1.42, 95% CI 1.13-1.80) and mortality (RR 1.75, 95% CI 1.29-2.38) in people with risk factors for lung cancer who took both vitamins compared with those who took placebo. Data from also from one study showed that the combination of beta-carotene with alpha-tocopherol in people with risk factors for lung cancer was associated with a non-statistically significant increased risk of lung cancer incidence (RR 1.16, 95% CI 0.96-1.39) and mortality (RR 1.15, 95% CI 0.91-1.45). No effect was observed for total cancer incidence, mortality or all-cause mortality.

Authors' conclusions

There is currently no evidence to support recommending vitamins such as alpha-tocopherol, beta-carotene or retinol, alone or in combination, to prevent lung cancer. A harmful effect was found for beta-carotene with retinol at pharmacological doses in people with risk factors for lung cancer (smoking and/or occupational exposure to asbestos). More research from larger trials and with longer follow-up is needed to analyse the effectiveness of other supplements.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Vitamins should not be prescribed for preventing lung cancer in healthy people

It has been suggested that antioxidant nutrients such as beta-carotene, vitamin C, vitamin E, selenium and zinc may help reduce the incidence of cancer. This review addresses the effectiveness of these supplements in preventing lung cancer in healthy people. The report concludes that there is no evidence at present that these antioxidants prevent lung cancer. The review also found that when beta-carotene was taken at the same time as a high dose of retinol by people who were at risk of lung cancer, because they smoked or had been exposed to asbestos in the air they breathed, the risk of getting lung cancer actually increased.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

健康人的預防肺癌用藥

有些研究認為抗氧化的營養素對肺癌有保護效果,流行病學的觀察性研究認為攝食較多含有β胡蘿蔔素的蔬菜水果和較低的肺癌風險有關聯

目標

去確定單獨使用維他命,礦物質或合併使用是否能降低肺癌在健康人的發生率和死亡率

搜尋策略

搜尋了書籍和電子資料庫〔MEDLINE 1966年到2001年7月, EMBASE 1974年到2001年7月和the Cochrane Controlled Trial Register (CENTRAL, Issue 3/2001)〕。並且與試驗的作者連絡以確定潛在的合資格的已發表和未發表的試驗。

選擇標準

在健康人預防肺癌的研究包含了比較補給品以及補給品加上安慰劑的隨機對照試驗

資料收集與分析

有三位不同的作者選擇要收進回顧文章的試驗並且評估每個試驗方法的品質,由二位作者用標準格式以取得資料。對於每個研究的相對危險性和95%的信賴區間都有做兩各不同結果的計算。

主要結論

蒐集了4個符合資格的試驗,都是以人口為基礎的試驗,總共有109394參與者。2個試驗包括了抽菸者,1個試驗包括了石綿暴露工作者,2個試驗的對象是衛生專業人員。1部分的參與者不知道肺癌的危險因素是包括在2個試驗的研究樣本。在所有的試驗中,評估單獨β胡蘿蔔素或是加上α維生素E或是視黃醇的使用,只有1個試驗評估單獨α維生素E的使用。治療時間有2到12年的不同,追蹤時間有2到5年。所有的試驗都有安慰劑組。 在有肺癌危險因子的人中,單獨使用維他命比起安慰劑組沒有降低肺癌的發生率或死亡率(肺癌的發生率:RR 0.98,95% CI 0.81 – 1.19;肺癌死亡率:RR 0.93,95% CI 0.73 – 1.19)。沒有肺癌危險因子的人,維生素或者是其組合沒有任何影響。3個試驗的合併資料顯示單獨使用β胡蘿蔔素的藥用劑量在有肺癌危險因子的組別有非統計學的風險增加肺癌發生率(RR 1.11, 95% CI 0.94 – 1.33)和死亡率(RR 1.05, 95% CI 0.87 – 1.28)。當β胡蘿蔔素合併視黃醇,1個試驗得到的結果顯示在有肺癌危險因子的組別使用2種維生素或者是安慰劑都有統計顯著增加的肺癌發生率(RR 1.42, 95% CI 1.13 – 1.80)和死亡率(RR 1.75, 95% CI 1.29 – 2.38)。同樣從1個試驗得到的結果顯示在有肺癌危險因子的組別合併使用β胡蘿蔔素和α維生素E有非統計學的風險增加肺癌發生率(RR 1.16, 95% CI 0.96 – 1.39)和死亡率(RR 1.15, 95% CI 0.91 – 1.45)。整體肺癌發生率、死亡率或所有致死因的死亡率沒有影響。

作者結論

目前沒有證據支持單獨或合併使用維生素如α維生素E、β胡蘿蔔素或視黃醇來預防肺癌。在有肺癌危險因子(抽菸或者是有石綿的職業暴露史)的人使用藥用劑量的β胡蘿蔔素加視黃醇有傷害性的影響。須要更多更大型的試驗和更久的追蹤時間來評估其他補充的效益。

翻譯人

本摘要由臺北榮民總醫院馮嘉毅翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有總結