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A Clinical Trial of Beta Carotene to Prevent Basal-Cell and Squamous-Cell Cancers of the Skin
Open accessAbstract
BACKGROUND: Beta carotene has been associated with a decreased risk of human cancer in many studies employing dietary questionnaires or blood measurements, and it has had protective effects in some animal models of carcinogenesis. METHODS: We tested the possible cancer-preventing effects of beta carotene by randomly assigning 1805 patients who had had a recent nonmelanoma skin cancer to receive either 50 mg of beta carotene or placebo per day and by conducting annual skin examinations to determine the occurrence of new nonmelanoma skin cancer. RESULTS: Adherence to the prescribed treatment was good, and after one year the actively treated group's median plasma beta carotene level (3021 nmol per liter) was much higher than that of the control group (354 nmol per liter). After five years of follow-up, however, there was no difference between the groups in the rate of occurrence of the first new nonmelanoma skin cancer (relative rate, 1.05; 95 percent confidence interval, 0.91 to 1.22). In subgroup analyses, active treatment showed no efficacy either in the patients whose initial plasma beta carotene level was in the lowest quartile or in those who currently smoked. There was also no significant difference between treated and control groups in the mean number of new nonmelanoma skin cancers per patient-year. CONCLUSIONS: In persons with a previous nonmelanoma skin cancer, treatment with beta carotene does not reduce the occurrence of new skin cancers over a five-year period of treatment and observation.
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“In other research, treatment with β-carotene did not significantly reduce the occurrence of new skin cancers in persons with previous non-melanoma skin cancer [242].”
From Bioactive Compounds for Skin Health: A Review (2021) · cites this paper as [242]
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“However, randomised trials testing b-carotene supplementation, alone or in combination with other supplements, have not supported this (Greenberg et al, 1990; Blot et al, 1993; Li et al, 1993; The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group, 1994; Hennekens et al, 1996; Omenn et…”
Comprehensive Cancer Centres and the war on cancer
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“Anderson Cancer Centre has advanced the notion of chemoprevention of cancer, and several chemopreventive agents, such as carotenoids, are now in clinical trial”
BackgroundPRIMARY CANCER PREVENTION TRIALS
Hawk, E. T., & Lippman, S. M. (2000) · Hematology/Oncology Clinics of North America · doi:10.1016/s0889-8588(05)70313-0 · Cited by 12
Systemic photoprotection Dietary intervention and therapy
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Isotretinoin Does Not Prevent Basal Cell Carcinoma
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Free radicals as carcinogens and their quenchers as anticarcinogens
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Comparison of Markov chains via weak Poincaré inequalities with application to pseudo-marginal MCMC
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“…limit arguments [34], two approaches have proved particularly successful for characterizing the properties of MCMC algorithms [4]: Lyapunov drift/minorization conditions [30, 33, 16], and functional-analytic tools on Hilbert spaces, in particular in the reversible setup [27, 16, Chapter 22].”
BackgroundMethodInfluentialModel selection in the weighted generalized estimating equations for longitudinal data with dropout
Gosho, M. (2015) · Biometrical Journal · doi:10.1002/bimj.201400045 · Cited by 11
“…of selecting the correct mean model based on all the criteria shown in Table 3 and Table A.2 in the Supporting Information were lower than those shown in Table 1 and The skin cancer prevention study was conducted by Greenberg et al. (1990) to test the cancer-preventing effects of beta carotene.”
BackgroundMethodResultInfluentialThe Role of Dietary Antioxidants in Melanoma and Nonmelanoma Skin Cancer
Sable, K. A. (2023) · Cutis · doi:10.12788/cutis.0672 · Cited by 12
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[10] Assessing variability in quantitation of carotenoids in human plasma: Variance component model
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Beta Carotene to Prevent Skin Cancer
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“To this end, skin in contrast to blood serves as a reservoir for carotenoids.(48,51) The latter findings could explain the fact that even in adipose cattle, no close correlation was observed between dermal carotenoid concentrations and blood levels of beta carotene.”
BackgroundOn Dynamic Generalized Linear Models with Applications
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“This leads to the conclusion that the treatment does not have any significant effect over the number of new skin cancers, which commensurate with the same conclusion as Greenberg et al. (1990). Interestingly, the analysis for ‘δ less than one’ is similar to that of ‘δ equals to one’.”
ResultA novel mechanism of filaggrin induction and sunburn prevention by β-damascenone in Skh-1 mice
Uddin, A., Labuda, I., & Burns, F. J. (2012) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2012.08.035 · Cited by 10
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“MATERIALS AND METHODS Patient population and parent study design We derived our study group from the Skin Cancer Prevention Study – a multicenter, randomized clinical trial conducted in the United States from 1980 to 1989 to test the efficacy of oral β-carotene supplementation in the prevention of KC among persons wit…”
MethodChemoprevention of Keratinocyte Carcinomas: An Updated Review
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“Retinol [23], [30], [32], [33], [34] [19], [20], [22], [24], [25], [26], [27], [28], [29], [31] Oral vitamin A does not prevent BCC, but may prevent SCC in non-organ transplant patients.”
Dutta, S., Surapaneni, B. K., & Bansal, A. (2018) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2018.19.11.3251 · Cited by 8
“(Greenberg et al., 1990), lung cancer (Greenwald, 2003) and various other malignancies.”
BackgroundChemopreventive opportunities to control basal cell carcinoma: Current perspectives
Tilley, C., Deep, G., & Agarwal, R. (2015) · Molecular Carcinogenesis · doi:10.1002/mc.22348 · Cited by 8
“administered 50mgdose ofb-carotene daily for 5 years to patients with a recent NMSC, and resulted in no significant effect on the incidenceofnewNMSC[5,59].”
BackgroundCarotenoids, Cigarette Smoking, and Mortality Riska
Greenberg, E. R. (1993) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1993.tb26163.x · Cited by 8
Self-citationAntioxidants and cardiovascular disease
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Chemoprevention of Human Cancer:A Reasonable Strategy?
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Lung cancer chemoprevention: facts and hopes
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A joint model for longitudinal and survival data based on an AR(1) latent process
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“surrounding two articles in a current issue of the New England Journal of Medicine (4, 5), there is some concern that research results may be misinterpreted and claims of therapeutic effectiveness and/or safety exaggerated (6).”
BackgroundCurrent views on carotenoids: biology, epidemiology and trials
Krinsky, N. I., & Mayne, S. T. (2000) · Birkhäuser Basel eBooks · doi:10.1007/978-3-0348-8454-9_4 · Cited by 7
“In contrast to the lack of effect [ 50 ,49] and adverse effects [47,48] reported for ~-carotene in cancer prevention are the findings from the Linxian (China) cancer prevention trial [51].”
ResultEpidemiology and Risk Factors of Basal Cell Carcinoma
Shaikh, W. R., & Nawas, Z. Y. (2019) · Springer eBooks · doi:10.1007/978-3-030-26887-9_1 · Cited by 7
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“Since 1990, results from seven such trials testing vitamin and mineral supplements have been reported.(5-11) What have we learned from the first generation of cancer prevention trials? Most importantly, these trials have yielded a striking number of promising leads: vitamin E in prostate and colon cancer; β-carotene/v…”
BackgroundA carrot a day keeps cancer at bay?
(1991) · The Lancet · doi:10.1016/0140-6736(91)90740-g · Cited by 6
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Basal cell carcinoma: Epidemiology
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Hong, G., White, J. H., Zhong, L., & Carlson, L. E. (2015) · Integrative Cancer Therapies · doi:10.1177/1534735415572884 · Cited by 5
“Two other prospective randomized trial studies found no effect of β-carotene supplements on cancer risk, even though one included more than 22 000 participants.(42,43) Hence, the use of these”
BackgroundTaylor, J. H., & Rosen, C. F. (2020) · Current Dermatology Reports · doi:10.1007/s13671-020-00306-1 · Cited by 7
“Results from two other RCTs supported this finding [21, 22].”
ResultSquamous Cell Carcinoma of the Skin: Current Strategies for Treatment and Prevention
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“Chemoprevention trials involving selenium, -carotene, and isotretinoin showed that these compounds have no effect on decreasing NMSC incidence in patients with a history of SCC or BCC whereas patients receiving retinol had a 26% less risk of being diagnosed with SCC [26-28].”
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A CONCISE GUIDE TO TOPICAL SUNSCREENS: STATE OF THE ART
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“However, conflicting results were observed when three other clinical trials showed no association between β-carotene and incidences of cancer (Greenberg et al. 1990; Hennekens et al. 1996; Lee et al. 1999).”
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BackgroundPotential Adverse Effects of beta-Carotene Supplementation in Cigarette Smokers and Heavier Drinkers
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Micronutrients as Intermediate Biomarkers in Chemotherapy and Enhancement for Cancer Treatments
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Mahamat‐Saleh, Y., Savoye, I., Cervenka, I., Rahmoun, M. A., Cadeau, C., Boutron‐Ruault, M., & Kvaskoff, M. (2022) · European Journal of Nutrition · doi:10.1007/s00394-022-02861-8 · Cited by 3
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BackgroundDietary Supplements and Cancer Risk: Epidemiologic Research and Recommendations
Sedjo, R. L., Neuhouser, M. L., & Rock, C. L. (2015) · Springer eBooks · doi:10.1007/978-3-319-22431-2_11 · Cited by 3
Nonmelanoma Skin Cancer of the Head and Neck
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Professional and consumer concerns about the environment, lifestyle, and cancer
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Poisson distribution to assess actinic keratoses in xeroderma pigmentosum
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Metadata
- Authors
- Greenberg, E. R., Baron, J. A., Stukel, T. A., Stevens, M. M., Mandel, J. S., Spencer, S. K., Elias, P. M., Lowe, N., Nierenberg, D. W., Bayrd, G., Vance, J. C., Freeman, D. H., Clendenning, W. E., & Kwan, T.
- Affiliations
- Dartmouth College (US)
- University of Minnesota (US)
- University of California, San Francisco (US)
- University of California, Los Angeles (US)
- Harvard University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1990-09-20
- Volume
- 323
- Issue
- 12
- Pages
- 789-795
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2313686482
- Cited by
- 482
- References
- 35
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 8 · 2022: 10 · 2021: 4 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 8 · 2015: 13 · 2014: 11 · 2013: 7 · 2012: 21
- FWCI
- 18.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01ca032934-10)
- National Cancer Institute (CA-32934, CA 23 108, P30CA023108)
- Topics
- Health Sciences › Medicine › Dermatology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- beta-carotene, non-melanoma skin cancer, basal cell carcinoma, squamous cell carcinoma, cancer prevention, chemoprevention, smoking, medication adherence
- MeSH terms
- Aged, Basal Cell Carcinoma, Carcinoma, Squamous Cell, Carotenoids, Drug Evaluation, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Recurrence, Skin Neoplasms, Randomized Controlled Trials as Topic, beta Carotene
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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