Prediagnostic Blood Selenium Status and Mortality among Patients with Colorectal Cancer in Western European Populations.

Jacqueline Baker ,Guri Skeie,Gianluca Severi,Alicia K Heath,Theron Johnson,Anne Tjønneland,Giovanna Masala,Heinz Freisling,Anja Olsen,David J Hughes,Elisabete Weiderpass,Bethany Van Guelpen,Veronika Fedirko,Catalina Bonet,José María Houerta,Inger Torhild Gram,Claudia Agnoli,H Bas Bueno-De-Mesquita,Rosario Tumino,Joseph A Rothwell,Björn Gylling,Vittorio Simeon,Verena Katzke,Matthias B Schulze,Amanda J Cross,Mazda Jenab,Lutz Schomburg,Miguel Rodríguez-Barranco ,S Umesh ,Marie‐Christine Boutron‐Ruault ,Elom K Aglago ,Aurora Perez‐Cornago

doi:10.3390/biomedicines9111521

Abstract

A higher selenium (Se) status has been shown to be associated with lower risk for colorectal cancer (CRC), but the importance of Se in survival after CRC diagnosis is not well studied. The associations of prediagnostic circulating Se status (as indicated by serum Se and selenoprotein P (SELENOP) measurements) with overall and CRC-specific mortality were estimated using multivariable Cox proportional hazards regression among 995 CRC cases (515 deaths, 396 from CRC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Se and SELENOP serum concentrations were measured on average 46 months before CRC diagnosis. Median follow-up time was 113 months. Participants with Se concentrations in the highest quintile (≥100 µg/L) had a multivariable-adjusted hazard ratio (HR) of 0.73 (95% CI: 0.52–1.02; Ptrend = 0.06) for CRC-specific mortality and 0.77 (95% CI: 0.57–1.03; Ptrend = 0.04) for overall mortality, compared with the lowest quintile (≤67.5 µg/L). Similarly, participants with SELENOP concentrations in the highest (≥5.07 mg/L) compared with the lowest quintile (≤3.53 mg/L) had HRs of 0.89 (95% CI: 0.64–1.24; Ptrend = 0.39) for CRC-specific mortality and 0.83 (95% CI: 0.62–1.11; Ptrend = 0.17) for overall mortality. Higher prediagnostic exposure to Se within an optimal concentration (100–150 µg/L) might be associated with improved survival among CRC patients, although our results were not statistically significant and additional studies are needed to confirm this potential association. Our findings may stimulate further research on selenium’s role in survival among CRC patients especially among those residing in geographic regions with suboptimal Se availability.

Highlights

Despite advances in prevention, screening, and treatment, colorectal cancer (CRC)remains the second most common cause of cancer death in Europe [1]
We explored whether the association between Se or SELENOP and risk for CRC-specific and overall mortality is non-linear using non-parametric restricted cubic splines [38,39] fitted to a Cox proportional hazards model using the SAS macro “lgtphcurv9” [40]
The distribution of selected baseline characteristics of CRC cases according to quintiles of serum Se are shown in Table 1

Summary

Introduction

Despite advances in prevention, screening, and treatment, colorectal cancer (CRC)remains the second most common cause of cancer death in Europe [1]. Despite advances in prevention, screening, and treatment, colorectal cancer (CRC). Little is known about the effects of pre- and postdiagnostic dietary or lifestyle factors in CRC survival, with the only recognized prognostic factors of survival being tumor stage and grade. Research is limited especially on dietary micronutrients, including selenium. Selenium (Se), an essential micronutrient, is a trace element that is involved in several major metabolic pathways and is thought to have anticarcinogenic properties [4]. The effects of Se are primarily mediated by selenoproteins, which have a variety of biological roles including modulation of redox homeostasis, antioxidant activity, thyroid metabolism, immune function, and inhibition of cell proliferation and angiogenesis [5,6,7].

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Results

Conclusion