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Post-diagnostic multivitamin supplement use and colorectal cancer survival: a prospective cohort study

Background: Use of multivitamin supplements has been associated with lower incidence of colorectal cancer (CRC). However, its influence on CRC survival remains unknown. Methods: Among 2424 patients with stage I-III CRC who provided detailed information about multivitamin supplements in the Nurses’ H...

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Main Authors: He, Ming-ming (Author) , Wang, Kai (Author) , Lo, Chun-Han (Author) , Zhang, Yiwen (Author) , Polychronidis, Georgios (Author) , Knudsen, Markus D. (Author) , Zhong, Rong (Author) , Ma, Yuan (Author) , Wu, Kana (Author) , Chan, Andrew T. (Author) , Giovannucci, Edward L. (Author) , Ogino, Shuji (Author) , Ng, Kimmie (Author) , Meyerhardt, Jeffrey A. (Author) , Song, Mingyang (Author)
Format: Article (Journal)
Language:English
Published: 15 June 2024
In: Cancer
Year: 2024, Volume: 130, Issue: 12, Pages: 2169-2179
ISSN:1097-0142
DOI:10.1002/cncr.35234
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/cncr.35234
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.35234
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Author Notes:Ming‐ming He MD, Kai Wang MD, PhD, Chun‐Han Lo MD, MPH, Yiwen Zhang PhD, Georgios Polychronidis MD, Markus D. Knudsen PhD, Rong Zhong PhD, Yuan Ma PhD, Kana Wu MD, PhD, Andrew T. Chan MD, MPH, Edward L. Giovannucci MD, ScD, Shuji Ogino MD, PhD, Kimmie Ng MD, MPH, Jeffrey A. Meyerhardt MD, MPH, Mingyang Song MD, ScD
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Summary:Background: Use of multivitamin supplements has been associated with lower incidence of colorectal cancer (CRC). However, its influence on CRC survival remains unknown. Methods: Among 2424 patients with stage I-III CRC who provided detailed information about multivitamin supplements in the Nurses’ Health Study and Health Professionals Follow-up Study, the authors calculated multivariable hazard ratios (HRs) of multivitamin supplements for all-cause and CRC-specific mortality according to post-diagnostic use and dose of multivitamin supplements. Results: During a median follow-up of 11 years, the authors documented 1512 deaths, among which 343 were of CRC. Compared to non-users, post-diagnostic users of multivitamin supplements at a dose of 3-5 tablets/week had lower CRC-specific mortality (HR, 0.55; 95% confidence interval [CI], 0.36-0.83, p = .005), and post-diagnostic users at doses of 3-5 and 6-9 tablets/week had lower all-cause mortality (HR, 0.81; 95% CI, 0.67-0.99, p = .04; HR, 0.79; 95% CI, 0.70-0.88), p < .001). The dose-response analysis showed a curvilinear relationship for both CRC-specific (pnonlinearity < .001) and all-cause mortality (pnonlinearity = .004), with the maximum risk reduction observed at 3-5 tablets/week and no further reduction at higher doses. Compared to non-users in both pre- and post-diagnosis periods, new post-diagnostic users at dose of <10 tablets/week had a lower all-cause mortality (HR, 0.81; 95% CI, 0.71-0.94, p = .005), whereas new users at a dose of ≥10 tablets/week (HR, 1.58; 95% CI, 1.07-2.33) and discontinued users (HR, 1.35; 95% CI, 1.14-1.59) had a higher risk of mortality. Conclusions: Use of multivitamin supplements at a moderate dose after a diagnosis of nonmetastatic CRC is associated with lower CRC-specific and overall mortality, whereas a high dose (≥10 tablets/week) use is associated with higher CRC-specific mortality.
Item Description:Zuerst veröffentlicht: 06. Februar 2024
Gesehen am 28.06.2024
Physical Description:Online Resource
ISSN:1097-0142
DOI:10.1002/cncr.35234

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