Association of supplement use with all-cause and cause-specific mortality in cancer: UK Biobank study
Other conference paper
CUHK Authors
Full Text
There are no full text file(s) associated with this record. |
Other information
AbstractBackground:
The use of dietary supplements has become increasingly popular among the cancer community. However, the current evidence on the effect of supplement intake on mortality is inconclusive. This study examined the association between dietary supplement use among patients diagnosed with cancer and the risk of all-cause mortality and cause-specific mortality in a large population-based cohort in the UK Biobank.
Methods:
The UK Biobank recruited approximately 500,000 participants. Participants were included in this analysis if they 1) were diagnosed with cancer (ICD codes C00-C97 except C44) at any time from prior to baseline recruitment to subsequent follow-up, and 2) reported whether they had regular intake of dietary supplements after their cancer diagnoses. In this study, we included vitamins, minerals, herbal, and other non-vitamin non-mineral (NVNM) dietary supplements. Associations of the use of supplements with all-cause mortality and cause-specific (i.e. cancer, cardiovascular, respiratory, digestive, and nervous system diseases) mortality were analyzed using Cox proportional hazards models. The model was adjusted for potential confounders including age, sex, socio-economics, lifestyle (BMI, fruit and vegetable consumption, smoking and alcohol status, physical activity), age at cancer diagnosis, and Charlson Comorbidity Index. This study has been registered with the UK Biobank (Ref: 74158).
Results:
This analysis included 30,239 participants (mean age: 60.0 years [SD=7.0 years]; 61.9% female; top 3 common cancers: breast, male genital organs, and digestive cancer). Over half (n=17,464, 57.8%) reported the use of dietary supplements after their cancer diagnoses. Most supplement users reported the use of NVNM dietary supplements (n=12,460, 41.2%) and vitamins (n=12,043, 39.8%). During a median follow-up of 11.9 years, a total of 5,577 all-cause deaths were registered. Cause-specific mortality included 4,208 cancer-related deaths, 516 CVD deaths, 213 respiratory deaths, 145 digestive disease-related deaths, and 126 nervous system disease-related deaths.
Protective effects of supplement use on the risk of all-cause and cancer mortality were found, but not the risk of mortality due to other causes. In the multivariate model, the adjusted hazard ratio (aHR) associated with supplement use were 0.94 (95% CI=0.89-0.99, p=0.02) for all-cause mortality, and 0.88 (95% CI=0.83-0.94, p<0.001) for cancer mortality. In subgroup analyses, only NVNM dietary supplements were significantly associated with a lower risk of all-cause mortality (aHR=0.86, 95% CI=0.81-0.91, p<0.001). Both vitamins (aHR=0.93, 95% CI=0.87-0.99, p=0.03) and NVNM dietary supplements (aHR=0.85, 95%CI=0.80-0.91, p<0.001) were significantly associated with lower risk of cancer mortality.
Conclusion:
Over half of the participants in the UK Biobank reported the use of supplements after their cancer diagnosis – this finding supports the increasing popularity of supplement use among the adult cancer population. The use of supplements was associated with a 6% lower risk of all-cause mortality and a 12% lower risk of cancer mortality, after adjusting for clinically-relevant factors. This finding suggests the potential benefits of dietary supplements, especially NVNM supplements, on survival benefits to the cancer population. Future work should include validating our findings in other cancer cohorts. More in-depth epidemiological and clinical studies should investigate the potential benefits of supplements on clinical outcomes that can influence mortality and quality of life in patients with cancer, thereby guiding the integration of dietary supplements in the routine cancer care.
The use of dietary supplements has become increasingly popular among the cancer community. However, the current evidence on the effect of supplement intake on mortality is inconclusive. This study examined the association between dietary supplement use among patients diagnosed with cancer and the risk of all-cause mortality and cause-specific mortality in a large population-based cohort in the UK Biobank.
Methods:
The UK Biobank recruited approximately 500,000 participants. Participants were included in this analysis if they 1) were diagnosed with cancer (ICD codes C00-C97 except C44) at any time from prior to baseline recruitment to subsequent follow-up, and 2) reported whether they had regular intake of dietary supplements after their cancer diagnoses. In this study, we included vitamins, minerals, herbal, and other non-vitamin non-mineral (NVNM) dietary supplements. Associations of the use of supplements with all-cause mortality and cause-specific (i.e. cancer, cardiovascular, respiratory, digestive, and nervous system diseases) mortality were analyzed using Cox proportional hazards models. The model was adjusted for potential confounders including age, sex, socio-economics, lifestyle (BMI, fruit and vegetable consumption, smoking and alcohol status, physical activity), age at cancer diagnosis, and Charlson Comorbidity Index. This study has been registered with the UK Biobank (Ref: 74158).
Results:
This analysis included 30,239 participants (mean age: 60.0 years [SD=7.0 years]; 61.9% female; top 3 common cancers: breast, male genital organs, and digestive cancer). Over half (n=17,464, 57.8%) reported the use of dietary supplements after their cancer diagnoses. Most supplement users reported the use of NVNM dietary supplements (n=12,460, 41.2%) and vitamins (n=12,043, 39.8%). During a median follow-up of 11.9 years, a total of 5,577 all-cause deaths were registered. Cause-specific mortality included 4,208 cancer-related deaths, 516 CVD deaths, 213 respiratory deaths, 145 digestive disease-related deaths, and 126 nervous system disease-related deaths.
Protective effects of supplement use on the risk of all-cause and cancer mortality were found, but not the risk of mortality due to other causes. In the multivariate model, the adjusted hazard ratio (aHR) associated with supplement use were 0.94 (95% CI=0.89-0.99, p=0.02) for all-cause mortality, and 0.88 (95% CI=0.83-0.94, p<0.001) for cancer mortality. In subgroup analyses, only NVNM dietary supplements were significantly associated with a lower risk of all-cause mortality (aHR=0.86, 95% CI=0.81-0.91, p<0.001). Both vitamins (aHR=0.93, 95% CI=0.87-0.99, p=0.03) and NVNM dietary supplements (aHR=0.85, 95%CI=0.80-0.91, p<0.001) were significantly associated with lower risk of cancer mortality.
Conclusion:
Over half of the participants in the UK Biobank reported the use of supplements after their cancer diagnosis – this finding supports the increasing popularity of supplement use among the adult cancer population. The use of supplements was associated with a 6% lower risk of all-cause mortality and a 12% lower risk of cancer mortality, after adjusting for clinically-relevant factors. This finding suggests the potential benefits of dietary supplements, especially NVNM supplements, on survival benefits to the cancer population. Future work should include validating our findings in other cancer cohorts. More in-depth epidemiological and clinical studies should investigate the potential benefits of supplements on clinical outcomes that can influence mortality and quality of life in patients with cancer, thereby guiding the integration of dietary supplements in the routine cancer care.
Acceptance Date09/07/2022
All Author(s) ListChun Sing Lam, Ho Kee Koon, Herbert Ho-Fung Loong, Vincent Chi-Ho Chung, Yin Ting Cheung
Name of ConferenceSociety for Integrative Oncology 19th International Conference
Start Date of Conference20/10/2022
End Date of Conference22/10/2022
Place of ConferenceArizona
Country/Region of ConferenceUnited States of America
Year2022
LanguagesEnglish-United States
