The Associations of Multivitamin and Antioxidant Use With Mortality Among Women and Men Diagnosed With Colorectal Cancer

Jane C. Figueiredo, Mark A. Guinter, Christina C. Newton, Marjorie L. McCullough, Caroline Y. Um, Alpa V. Patel, Peter T. Campbell

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Colorectal cancer survivors often use multivitamins and other over-the-counter dietary supplements, but evidence is limited regarding their potential associations with mortality. Methods: This prospective analysis included women and men from the Cancer Prevention Study-II Nutrition Cohort who were cancer-free at baseline (1992 or 1993) and diagnosed with colorectal cancer through June 2015. Detailed information on multivitamin use, vitamin C supplements, and vitamin E supplements was self-reported on questionnaires at baseline, in 1997, and every 2 years thereafter. Pre- and postdiagnosis data were available for 3176 and 2006 colorectal cancer survivors, respectively, among whom 2116 (648 from colorectal cancer) and 1256 (242 from colorectal cancer) died. Multivariable-adjusted Cox proportional hazards regression models examined associations. All statistical tests were 2-sided. Results: Among colorectal cancer survivors, 49.7% and 58.5% reported multivitamin use before and after diagnosis, respectively (vitamin C use before and after diagnosis: 27.8% and 28.1%; vitamin E use before and after diagnosis: 27.5% and 29.4%, respectively). There were no statistically significant associations of pre- or postdiagnosis multivitamin use with all-cause, colorectal cancer-specific, or noncolorectal cancer mortality. Vitamin C was also not associated with any mortality outcomes. However, prediagnosis vitamin E use was associated with a non-statistically significant increased risk of all-cause mortality (multivariable adjusted hazard ratio ¼ 1.08, 95% confidence intervals ¼ 0.96 to 1.23) and all other noncolorectal cancer mortality (multivariable adjusted hazard ratio ¼ 1.13, 95% confidence intervals ¼ 0.97 to 1.31). Conclusions: These results suggest that multivitamin use before or after diagnosis is not associated with mortality in colorectal cancer survivors. However, vitamin E use may be associated with increased risk of mortality and merits further investigation.

Original languageEnglish (US)
Article numberpkac041
JournalJNCI Cancer Spectrum
Issue number4
StatePublished - Aug 1 2022

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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