TY - JOUR
T1 - Selenium supplementation for prevention of colorectal adenomas and risk of associated type 2 diabetes
AU - Thompson, Patricia A.
AU - Ashbeck, Erin L.
AU - Roe, Denise J.
AU - Fales, Liane
AU - Buckmeier, Julie
AU - Wang, Fang
AU - Bhattacharyya, Achyut
AU - Hsu, Chiu Hsieh
AU - Chow, H. H.Sherry
AU - Ahnen, Dennis J.
AU - Boland, C. Richard
AU - Heigh, Russell I.
AU - Fay, David E.
AU - Hamilton, Stanley R.
AU - Jacobs, Elizabeth T.
AU - Martinez, Maria Elena
AU - Alberts, David S.
AU - Lance, Peter
N1 - Publisher Copyright:
© The Author 2016. Published by Oxford University Press. All rights reserved.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: Selenium supplementation may help to prevent colorectal cancer; as precursors of colorectal cancer, colorectal adenomas are a surrogate for colorectal cancer. Selenium supplementation may increase risk of type 2 diabetes (T2D). Methods: The Selenium and Celecoxib (Sel/Cel) Trial was a randomized, placebo controlled trial of selenium 200 mg daily as selenized yeast and celecoxib 400mg once daily, alone or together, for colorectal adenoma prevention. Men and women between age 40 and 80 years were eligible following colonoscopic removal of colorectal adenomas. The primary outcome was adenoma development. Celecoxib was suspended because of cardiovascular toxicity in other trials, but accrual continued to selenium and placebo. A total of 1621 participants were randomly assigned to selenium or placebo, of whom 1374 (84.8%) were available for analysis. All statistical tests were two-sided. Results: In the respective placebo and selenium arms of 689 and 685 participants, adenoma detection after medians of 33.6 (range = 0.0-85.1 months) and 33.0 months (range = 0.0-82.6 months) were 42.8% and 44.1% (relative risk [RR] = 1.03, 95% confidence interval [CI] = 0.91 to 1.16, P = .68). In participants with baseline advanced adenomas, adenoma recurrence was reduced by 18% with selenium (RR=0.82, 95% CI=0.71 to 0.96, P = .01). In participants receiving selenium, the hazard ratio for new-onset T2D was 1.25 (95% CI=0.74 to 2.11, P = .41), with a statistically significantly increased risk of selenium-associated T2D among older participants (RR=2.21; 95% CI=1.04 to 4.67, P = .03). Conclusions: Overall, selenium did not prevent colorectal adenomas and showed only modest benefit in patients with baseline advanced adenomas. With limited benefit and similar increases in T2D to other trials, selenium is not recommended for preventing colorectal adenomas in selenium-replete individuals.
AB - Background: Selenium supplementation may help to prevent colorectal cancer; as precursors of colorectal cancer, colorectal adenomas are a surrogate for colorectal cancer. Selenium supplementation may increase risk of type 2 diabetes (T2D). Methods: The Selenium and Celecoxib (Sel/Cel) Trial was a randomized, placebo controlled trial of selenium 200 mg daily as selenized yeast and celecoxib 400mg once daily, alone or together, for colorectal adenoma prevention. Men and women between age 40 and 80 years were eligible following colonoscopic removal of colorectal adenomas. The primary outcome was adenoma development. Celecoxib was suspended because of cardiovascular toxicity in other trials, but accrual continued to selenium and placebo. A total of 1621 participants were randomly assigned to selenium or placebo, of whom 1374 (84.8%) were available for analysis. All statistical tests were two-sided. Results: In the respective placebo and selenium arms of 689 and 685 participants, adenoma detection after medians of 33.6 (range = 0.0-85.1 months) and 33.0 months (range = 0.0-82.6 months) were 42.8% and 44.1% (relative risk [RR] = 1.03, 95% confidence interval [CI] = 0.91 to 1.16, P = .68). In participants with baseline advanced adenomas, adenoma recurrence was reduced by 18% with selenium (RR=0.82, 95% CI=0.71 to 0.96, P = .01). In participants receiving selenium, the hazard ratio for new-onset T2D was 1.25 (95% CI=0.74 to 2.11, P = .41), with a statistically significantly increased risk of selenium-associated T2D among older participants (RR=2.21; 95% CI=1.04 to 4.67, P = .03). Conclusions: Overall, selenium did not prevent colorectal adenomas and showed only modest benefit in patients with baseline advanced adenomas. With limited benefit and similar increases in T2D to other trials, selenium is not recommended for preventing colorectal adenomas in selenium-replete individuals.
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U2 - 10.1093/jnci/djw152
DO - 10.1093/jnci/djw152
M3 - Article
C2 - 27530657
AN - SCOPUS:85016005029
SN - 0027-8874
VL - 108
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 12
M1 - djw152
ER -