Selenium dietary intake and survival among CRC patients
The prospective Cracow cohort study
Abstract
Abstract:Background: Despite advances in prevention and treatment, colorectal cancer remains the second most common cause of cancer death. To date, little is known about the role of prediagnostic selenium intake in colorectal cancer survival. Objective: The purpose of the study was to verify whether selenium intake in habitual diet before diagnosis is associated with survival in colorectal cancer patients. Study design: This was a prospective observation of patients primarily recruited for a case-control study between 2000 and 2012 in Cracow, Poland. A group of 671 incident cases of colorectal cancer was included. Habitual diet was assessed using a validated 148-item food questionnaire. 338 deaths were identified throughout 2017 by the Polish National Vital Registry. To evaluate the impact of dietary selenium on survival, the multivariable Cox regression model was used. Results: After standardization for several potential confounders (including key determinants, such as radical surgery, chemotherapy, tumor stage, and dietary factors), a decrease in the risk of death from colorectal cancer was observed in the group with higher dietary selenium intake (≥48.8 μg/day, group mean: 63.9 μg/day) compared to the group with lower dietary selenium intake (<48.8 μg/day, mean: 38.5 μg/day) (HR=0.73; 95% CI: 0.54–0.98) (the median was used for categorization). Conclusion: Our study suggests selenium as an additional dietary factor which may be associated with survival among colorectal cancer patients referred to surgery. Due to the observational nature of the study, the results should be taken with caution. These preliminary findings, however, provide the basis for well-structured clinical trials.
References
1 Global cancer statistics 2020: GLOBOCAN 279 estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
2 . World Health Organization, International Agency for Research on Cancer, Global Cancer Observatory: All cancers fact sheet. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/39-All-cancers-fact-sheet.pdf
3 . Nowotwory złośliwe w Polsce w 2017 roku
[Cancer in Poland in 2017] . Polish National Cancer Registry. 2019;29. Available from: http://onkologia.org.pl/wp-content/uploads/Nowotwory_2017.pdf4 . International Agency for Research on Cancer. ICBP SURVMARK-2. Available from: https://gco.iarc.fr/survival/survmark/visualizations/viz1/?groupby=%22country%22&period=%225%22&cancer_site=%22Colorectal%22&country=%22Australia%22&year=%222014%22&gender=%22All%22&sorting=%220%22
5 Prediagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study. BMC Med. 2015;13:107.
6 . Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009;22:191–97.
7 .
Chemoprewencja selenem (Se) w rakach tytoniozależnych . In: Lubiński J, editor. Genetyka kliniczna nowotworów. Szczecin: Szczecin Print Group; 2012. p. 287–98.8 . Rola selenu w organizmie człowieka. Post Nauk Med. 2016;29:929–33.
9 . Selenium, selenoproteins, and immunity. Nutrients. 2018;10:1203.
10 . Selenium and human health. Lancet. 2012;379:1256–68.
11 . Colorectal cancer-protective effects and the dietary micronutrients folate, methionine, vitamins B6, B12, C, E, selenium, and lycopene. Nutr Cancer. 2006;56:11–21.
12 Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer. Cancer Causes Control. 2010;21:1171–81.
13 Can selenium levels act as a marker of colorectal cancer risk? BMC Cancer. 2013;13:214.
14 . Selenium, folate, and colon cancer. Nutr Cancer. 2009;61:165–78.
15 Selenium status is associated with colorectal cancer risk in the European prospective investigation of cancer and nutrition cohort. Int J Cancer. 2015;136(5):1149–61.
16 Serum selenium, genetic variation in selenoenzymes, and risk of colorectal cancer: primary analysis from the Womenʼs Health Initiative Observational Study and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011;20(9):1822–30.
17 Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT). JAMA. 2009;301(1):39–51.
18 Selenium for preventing cancer. Cochrane Database Syst Rev. 2018;1(1):CD005195.
19 . Selenium and the regulation of cell signaling, growth, and survival: molecular and mechanistic aspects. Antioxid Redox Signal. 2002;4(2):339–51.
20 . Selenoproteins in colon cancer. Free Radic Biol Med. 2018;127:14–25.
21 Selenium and the 15kDa selenoprotein impact colorectal tumorigenesis by modulating intestinal barrier integrity. Int J Mol Sci. 2021;22(19):10651.
22 . Cancer mortality correlation studies–III: statistical associations with dietary selenium intakes. Bioinorg Chem. 1977;7(1):23–31.
23 . Selenium intake and breast cancer mortality in a cohort of Swedish women. Breast Cancer Res Treat. 2012;134(3):1269–77.
24 . Dietary factors and the survival of women with breast carcinoma. Cancer. 1999;86(5):826–35. Erratum in: Cancer. 1999;86(12):2707–8.
25 Dietary selenium intake and mortality in two population-based cohort studies of 133957 Chinese men and women. Public Health Nutr. 2016;19(16):2991–98.
26 . Blood selenium and glutathione peroxidase status in patients with colorectal cancer. Dis Colon Rectum. 1998;41(3):328–35.
27 Selenium status and survival from colorectal cancer in the European prospective investigation of cancer and nutrition. Revue d’Épidémiologie et de Santé Publique. 2018;66(Supplement 5):S290. https://doi.org/10.1016/j.respe.2018.05.142
28 . Correlations of colon cancer mortality with dietary factors, serum markers, and schistosomiasis in China. Nutr Cancer. 1993;20(1):13–20.
29 Prediagnostic blood selenium status and mortality among patients with colorectal cancer in Western European populations. Biomedicines. 2021;9(11):1521.
30 Serum selenium levels predict survival after breast cancer. Breast Cancer Res Treat. 2018;167(2):591–98.
31 . Prediagnostic serum selenium levels concerning breast cancer survival and tumor characteristics. Int J Cancer. 2020;147(9):2424–36.
32 Serum selenium level predicts 10-year survival after breast cancer. Nutrients. 2021;13(3):953.
33 Serum selenium, selenoprotein P and glutathione peroxidase 3 as predictors of mortality and recurrence following breast cancer diagnosis: a multicentre cohort study. Redox Biol. 2021;47:102145.
34 Selenoprotein P status correlates to cancer-specific mortality in renal cancer patients. PLoS One. 2012;7(10):e46644.
35 Serum selenium levels and the risk of progression of laryngeal cancer. PLoS One. 2018;13(1):e0184873. Erratum in: PLoS One. 2018;13(3):e0194469.
36 Influence of the selenium level on overall survival in lung cancer. J Trace Elem Med Biol. 2019;56:46–51.
37 . Does dietary calcium interact with dietary fiber against colorectal cancer? A case-control study in Central Europe. Nutr J. 2013;12:134.
38 . Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol. 1997;26(Suppl 1):59–70.
39 . Reproducibility and relative validity of energy and macronutrient intake of a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol. 1997;26(Suppl 1):71–81.
40 . Determination of selenium in the serum of healthy Swiss adults and correlation to dietary intake. J Trace Elem Med Biol. 1996;10(1):31–45.
41 . BRCA1 and BRCA2 mutations and the risk for colorectal cancer. Clinical Genetics. 2015;87(5):411–18.
42 . Selenium and selenocysteine: roles in cancer, health, and development. Trends Biochem Sci. 2014;39(3):112–20.
43 . Food-chain selenium and human health: emphasis on intake. Br J Nutr. 2008;100(2):254–68.
44 Expression of selenium-binding protein 1 characterizes intestinal cell maturation and predicts survival for patients with colorectal cancer. Mol Nutr Food Res. 2008;52(11):1289–99.
45 Suppression of human selenium-binding protein 1 is a late event in colorectal carcinogenesis and is associated with poor survival. Proteomics. 2006;6(11):3466–76.
46 . Expression of selenoprotein genes and association with selenium status in colorectal adenoma and colorectal cancer. Nutrients. 2018;10(11):1812.
47 . Monomethyl selenium-specific inhibition of MMP-2 and VEGF expression: implications for angiogenic switch regulation. Mol Carcinog. 2000;29(4):236–50.
48 . Osteopontin is a potential target gene in mouse mammary cancer chemoprevention by Se-methylselenocysteine. Breast Cancer Res. 2004;6(5):R586–92.
49 . Inhibitory effect of selenite on invasion of HT1080 tumor cells. J Biol Chem. 2001;276(23):20085–92.
50 Selenite inhibits glutamine metabolism and induces apoptosis by regulating GLS1 protein degradation via APC/C-CDH1 pathway in colorectal cancer cells. Oncotarget. 2017;8(12):18832–47.
51 . Selenoproteins in tumorigenesis and cancer progression. Adv Cancer Res. 2017;136:49–83.
52 . Validation of food-frequency questionnaire – FFQ. Reproducibility assessment. Bromat Chem Toksykol. 2005;38(1):27–33.
53 Significant changes in dietary intake and supplement use after breast cancer diagnosis in a UK multicentre study. Breast Cancer Res Treat. 2011;128(2):473–82.
54 . Colonoscopy as a method of choice in the diagnosis of colorectal cancer. Acta Inform Med. 2014;22(3):164–6.
