Vitamin B Increases Risk Of Lung Cancer, Especially Among Men

Lung CA seen on CXR

What was less surprising was that increased risks of lung cancer were found in current cigarette smokers. Results found that men obtaining vitamins from a single supplement were 30-40% more likely to develop lung cancer versus using a multivitamin. For smokers takin B12, the risk was almost fourfold higher. We observed no increased risk for any of the supplements - B6, B12, or folic acid - with lung cancer risk in women or women who smoked.

Their combined work is the first prospective, observational study to examine links between long-term high doses of B-6 and B-12 supplements and lung cancer risk.

The risk almost tripled (HR, 2.93; 95% CI, 1.50-5.72; P =.04) and quadrupled (HR, 3.71; 95% CI, 1.77-7.74; P .01) in men who were current smokers who took vitamin B6 and B12 at the highest levels, respectively (P .01), compared to male smokers who did not take B6 or B12 supplements. It found all men who took high-dose vitamin B supplements for a decade had about double the risk of developing lung cancer. Smoking is one of the single biggest risk factors for lung cancer, which makes up more than 13% of all new cancer diagnoses and more than one in four cancer deaths in the U.S. Male smokers taking B6 at this dose were three times more likely to develop lung cancer. "This is certainly a concern worthy of further evaluation". There also has been speculation that these vitamins may reduce cancer risk.

Current smokers who reported 10-year use of vitamin B12 at doses greater than 55 µg per day appeared almost four times as likely to develop lung cancer as nonusers (HR = 3.71; 95% CI, 1.77-7.74). But the effect seemed to be driven by current smokers who far exceeded the recommended daily amounts of the vitamins, according to study author Theodore Brasky, an epidemiologist in the division of cancer prevention and control at the Ohio State University College of Medicine.

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Increased vitamin B intake is hypothesized to interfere with the one-carbon metabolism pathway, a process that is thought to be important for gene expression regulation and DNA integrity maintenance, thereby increasing carcinogenic risk.

It's also possible that this action from the B vitamins simply hastens the development of an underlying lung tumor already caused by smoking, Brasky says. We were unable to address whether lung cancer patients had improved or worsened prognosis if they took these supplements.

Disclosures: The NCI, NIH and Office of Dietary Supplements funded this study.

Although the associations weakened among recent and former smokers who reported the highest usage of both vitamins, the HRs for lung cancer risk in both groups remained greater than 1. The researchers report no relevant financial disclosures.

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