Is the inverse association between selenium and bladder cancer due to confounding by smoking?

American Journal of Epidemiology
Laura E Beane FreemanDebra T Silverman

Abstract

Selenium has been linked to a reduced risk of bladder cancer in some studies. Smoking, a well-established risk factor for bladder cancer, has been associated with lower selenium levels in the body. We investigated the selenium-bladder cancer association in subjects from Maine, New Hampshire, and Vermont in the New England Bladder Cancer Case-Control Study. At interview (2001-2005), participants provided information on a variety of factors, including a comprehensive smoking history, and submitted toenail samples, from which we measured selenium levels. We estimated odds ratios and 95% confidence intervals among 1,058 cases and 1,271 controls using logistic regression. After controlling for smoking, we saw no evidence of an association between selenium levels and bladder cancer (for fourth quartile vs. first quartile, odds ratio (OR) = 0.98, 95% confidence interval (CI): 0.77, 1.25). When results were restricted to regular smokers, there appeared to be an inverse association (OR = 0.76, 95% CI: 0.58, 0.99); however, when pack-years of smoking were considered, this association was attenuated (OR = 0.91, 95% CI: 0.68, 1.20), indicating potential confounding by smoking. Despite some reports of an inverse association between selenium...Continue Reading

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Citations

Jun 16, 2015·Journal of Environmental Science and Health. Part C, Environmental Carcinogenesis & Ecotoxicology Reviews·Ewa Jablonska, Marco Vinceti
Jul 30, 2015·American Journal of Epidemiology·L E Beane FreemanD Baris
Jun 28, 2016·Environmental Research·Marco VincetiPaolo Giorgi Rossi
Jul 7, 2017·International Journal of Cancer. Journal International Du Cancer·Malte Sandsveden, Jonas Manjer
Jan 30, 2018·The Cochrane Database of Systematic Reviews·Marco VincetiCatherine M Crespi

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