Toenail selenium status and the risk of Barrett's esophagus: the Netherlands Cohort Study

• Published in: Cancer causes & control 2010-12, Vol.21 (12), p.2259-2268
• Main Authors: Steevens, Jessie, Schouten, Leo J, Driessen, Ann L. C, Huysentruyt, Clément J. R, Keulemans, Yolande C. A, Goldbohm, R. Alexandra, van den Brandt, Piet A
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Aged; Algorithms; Barrett esophagus; Barrett Esophagus - epidemiology; Barrett Esophagus - etiology; Biomarkers; Biomedical and Life Sciences; Biomedicine; Body mass index; Cancer; Cancer Research; Cell cycle; Cigarette smoking; Cohort analysis; Cohort Studies; Developmental biology; Diet; DNA methylation; Epidemiology; Esophagus; Feeding Behavior - physiology; Female; Follow-Up Studies; Health Status Indicators; Hematology; Humans; Incidence; Life Style; Male; Metaplasia; Middle Aged; Nails - chemistry; Nails - metabolism; Netherlands - epidemiology; Oncology; Original Paper; Pathology; Public Health; Questionnaires; Risk Factors; Selenium; Selenium - analysis; Selenium - metabolism; Toenails; Women
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-010-9651-1

Objective To investigate the association between selenium and the risk of Barrett's esophagus (BE), the precursor lesion of esophageal adenocarcinoma. Methods Data from the prospective Netherlands Cohort Study were used. This cohort study was initiated in 1986, when 120,852 subjects aged 55-69 years completed a questionnaire on dietary habits and lifestyle, and provided toenail clippings for the determination of baseline selenium status. After 16.3 years of follow-up, 253 BE cases (identified through linkage with the nationwide Dutch pathology registry) and 2,039 subcohort members were available for case-cohort analysis. Cox proportional hazards models were used to calculate incidence rate ratios (RR). Results The multivariable-adjusted RR for the highest versus the lowest quartile of toenail selenium was 1.06 (95% CI 0.71-1.57). No dose-response trend was seen (p trend = 0.99). No association was found in subgroups defined by sex, smoking status, body mass index (BMI), or intake of antioxidants. For BE cases that later progressed to high-grade dysplasia or adenocarcinoma, the RR for a selenium level above the median vs. below the median was 0.64 (95% CI 0.24-1.76). Conclusions In this large prospective cohort study, we found no evidence of an association between selenium and risk of BE.