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Epidemiology

Multivitamin use after diagnosis and prostate cancer survival among men with nonmetastatic prostate cancer

British Journal of Cancer (2024)Cite this article

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Abstract

Background

Multivitamin use is common among cancer patients. Whether post-diagnostic multivitamin supplementation is beneficial for prostate cancer survival is largely unknown, and some evidence even suggests potential harm.

Methods

We prospectively assessed post-diagnostic multivitamin use in relation to prostate cancer survival among 4756 men with nonmetastatic prostate cancer at diagnosis in the Health Professionals Follow-up Study (1986–2016). Cox regression models were used to evaluate the association between post-diagnostic multivitamin use and frequency and risk of lethal prostate cancer (distant metastases or prostate cancer-specific death) and all-cause mortality.

Results

We observed 438 lethal prostate cancer and 2609 deaths during a median follow-up of 11 years. Compared to non-users, post-diagnostic multivitamin use was not associated with risk of lethal prostate cancer (HR [95% CI], 0.98 [0.74–1.30]) or all-cause mortality (1.00 [0.88–1.12]), after adjustment for potential confounders. Similarly, null associations were observed across various categories of use frequency. Compared to non-users, men who used multivitamins regularly (6–9 tablets/week) after cancer diagnosis had similar risk of lethal prostate cancer (0.96 [0.72–1.28]) and all-cause mortality (0.99 [0.88–1.12]).

Conclusions

We found no evidence that post-diagnostic multivitamin use among men with nonmetastatic prostate cancer was associated with better or worse survival in a well-nourished population.

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Data availability

Investigators wishing to use HPFS data are asked to submit a brief description of the proposed project (go to https://www.nurseshealthstudy.org/researchers (contact email: nhsaccess@channing.harvard.edu) and https://sites.sph.harvard.edu/hpfs/for-collaborators/ for details). Other data that support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

The authors would like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Central registries may also be supported by state agencies, universities, and cancer centers. Participating central cancer registries include the following: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Seattle SEER Registry, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming. We are grateful to the participants and research staff of the Health Professionals Follow-up Study and to the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA.

Funding

The Health Professionals Follow-up Study is supported by the National Cancer Institute (U01 CA167552 and administrative supplements). KHS and LAM are Prostate Cancer Foundation Young Investigators. EG is funded as an American Cancer Society Clinical Research Professor (grant CRP-23-1014041).

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Yiwen Zhang, Konrad H. Stopsack, Mingyang Song, Lorelei A. Mucci & Edward Giovannucci

  2. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Konrad H. Stopsack & Mingyang Song

  3. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Kana Wu, Mingyang Song & Edward Giovannucci

  4. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA

    Mingyang Song

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Contributions

YZ had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study conception and design: YZ and EG Acquisition of data: YZ, LM and EG Statistical analysis: YZ, KS and EG. Interpretation of data: all authors. Drafting of the paper: YZ Critical revision of the paper for important intellectual content: all authors. Administrative, technical, or material support: none. Supervision: EG.

Corresponding author

Correspondence to Yiwen Zhang.

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Competing interests

LAM received research funding from Astra Zeneca and Janssen; was a consultant to Bayer; serves on the SAB and has equity in Convergent Therapeutics. None of these activities were related to the work under review.

Ethics approval and consent to participate

Our study was approved by the institutional review boards of Harvard T.H. Chan School of Public Health, and those of participating registries as required. Completion of the questionnaire was considered to imply informed consent.

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Zhang, Y., Stopsack, K.H., Wu, K. et al. Multivitamin use after diagnosis and prostate cancer survival among men with nonmetastatic prostate cancer. Br J Cancer (2024). https://doi.org/10.1038/s41416-024-02651-5

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  • DOI: https://doi.org/10.1038/s41416-024-02651-5

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