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Beta-carotene
While observational epidemiological
studies have
consistently shown that beta-carotene is associated with decreased
cancer risk, particularly of lung cancer, findings of seven
randomised
trials testing the effect of beta-carotene supplementation
on
cancer incidence and mortality generally have not been supportive.
Two of these trials even suggested the possibility of harmful
effects.
Two
large trials of beta-carotene conducted among persons at average
risk of cancer found no statistically significant benefit
or harm associated with beta-carotene supplementation [16-17].
Two other large trials tested beta-carotene among persons
at high risk of cancer [18, 19]. One (The Alpha-Tocopherol,
Beta carotene Cancer Prevention Study, 1996) reported a statistically
significant 18% increase in lung cancer incidence after 5–8
years of treatment with beta-carotene among male Finnish smokers
[18].
Another that used a combination of beta- carotene and retinol,
reported a statistically significant 28% increase in lung
cancer incidence among United States Smokers, former smokers
and asbestos workers[19].
Only one large trial, which tested a combination of beta-carotene,
vitamin E and selenium in a poorly nourished Chinese population,
found that after 5 years, the treated group experienced a
statistically significant 9% reduction in total mortality,
primarily as a result of a statistically significant 21%lower
stomach cancer mortality rate [20].
The
indirect evidence that beta-carotene may protect from stomach
cancer comes from the randomised, controlled double-blinded
chemoprevention trial in subjects with gastric dysplasia in
an area with a very high gastric cancer risk in Columbia.
Gastric biopsy taken at baseline was compared with those taken
at 72 months. Treatment with 30 mg beta-carotene resulted
in a statistically significant increase in the frequency of
regression of preneoplastic lesions of the stomach [relative
risk (RR) = 5.1, 95% CI 1.6–14.2][21].
One small trial of 1805 people with previous non-melanoma
skin cancer that tested treatment with beta-carotene (50 mg
per day) to reduce the occurrence of new skin cancer did not
find any effect of this intervention[22]
It
can be concluded that there is evidence at present that beta-carotene
supplements have no value as cancer chemoprevention agents
and
cannot be recommended for use in the general population in
this
context.
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