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Multivitamin use and all-cause and cause-specific mortality in cancer survivors

British Journal of Cancer volume 130, pages 82–87 (2024)Cite this article

Subjects

Abstract

Background

Despite no sufficient evidence on benefits and harms of multivitamin use, cancer survivors use multivitamins as a self-care strategy to improve or maintain health. We examined if multivitamin use was associated with mortality in cancer survivors.

Methods

15,936 male and 7026 female cancer survivors in the NIH-AARP Diet and Health Study were included in the analysis. Types and frequency of multivitamin use at on average 4.6 years after cancer diagnosis were assessed. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression models.

Results

Multivitamin use was not associated with lower all-cause mortality risk in all female (RR = 0.94, 95% CI:0.87–1.01 daily vs. no use) or male cancer survivors (RR = 0.96, 95% CI:0.91–1.00); however, a modest inverse association for CVD mortality was observed in female survivors of reproductive cancers (RR = 0.75, 95% CI:0.61–0.92) and male survivors of non-reproductive cancers (RR = 0.81, 95% CI:0.70–0.94). Multivitamin use was also associated with a lower risk of cancer-specific mortality in survivors of skin (RR = 0.65, 95% CI:0.48–0.88) and breast (RR = 0.79, 95% CI:0.65–0.95) cancer.

Discussion

Multivitamin use may provide a modest survival benefit to some cancer survivors. Cancer care providers should talk with cancer survivors about potential benefits and harms of multivitamin use.

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Fig. 1: Multivariable-adjusteda relative risks and 95% confidence intervals of mortality for daily use of multivitamin vs. no use in survivors of specific cancer.

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Data availability

Data can be obtained on request. Requests should be directed to the NIH-AARP Diet and Health Study (https://dietandhealth.cancer.gov/), which has a protocol for approving data requests.

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Acknowledgements

Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. Cancer incidence data from California were collected by the California Cancer Registry, California Department of Public Health’s Cancer Surveillance and Research Branch, Sacramento, California. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, Lansing, Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System (Miami, Florida) under contract with the Florida Department of Health, Tallahassee, Florida. The views expressed herein are solely those of the authors and do not necessarily reflect those of the FCDC or FDOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, The Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry, Raleigh, North Carolina. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. Cancer incidence data from Arizona were collected by the Arizona Cancer Registry, Division of Public Health Services, Arizona Department of Health Services, Phoenix, Arizona. Cancer incidence data from Texas were collected by the Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas. Cancer incidence data from Nevada were collected by the Nevada Central Cancer Registry, Division of Public and Behavioral Health, State of Nevada Department of Health and Human Services, Carson City, Nevada.

We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. We also thank Sigurd Hermansen and Kerry Grace Morrissey from Westat for study outcomes ascertainment and management and Leslie Carroll at Information Management Services for data support and analysis.

Funding

The study was supported in part by the Intramural Research Program of the National Cancer Institute.

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Authors and Affiliations

  1. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Yikyung Park

  2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Zeinab Farhat, Linda M. Liao, Maki Inoue-Choi & Erikka Loftfield

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Contributions

YP designed and conceptualized study. YP and LML involved in the acquisition of the data. ZF performed data analysis. YP wrote the first draft of the manuscript. All authors contributed to the interpretation of results and critically reviewed the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yikyung Park.

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The study was approved by the US National Cancer Institute Special Studies Institutional Review Board. All participants gave informed consent by virtue of completing and returning the questionnaire.

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Park, Y., Farhat, Z., Liao, L.M. et al. Multivitamin use and all-cause and cause-specific mortality in cancer survivors. Br J Cancer 130, 82–87 (2024). https://doi.org/10.1038/s41416-023-02421-9

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