Prediagnostic Selenium and Selenoprotein P and Survival in Colorectal Cancer Patients Public

Abstract

BACKGROUND: The dietary intake of selenium (Se) and blood concentrations of selenoprotein P (SePP), a biomarker of functional Se, varies significantly worldwide with lower levels observed in the European population. There is limited data on the association between Se and cancer survival and no studies on the association between Se, SePP and colorectal cancer (CRC) survival to our knowledge.

METHODS: To investigate whether pre-diagnostic circulating levels of Se and SePP are associated with overall and CRC-specific mortality after cancer diagnosis, we analyzed 1,021 patients (all deaths = 450, CRC deaths = 375) with CRC from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which included Western European populations that are historically Se deficient. Cox proportional hazards models were used to calculate the hazard ratios and 95% confidence intervals, adjusting for dietary and lifestyle factors.

RESULTS: Multivariable analyses suggested a statistically non-significant inverse association between total Se and overall (HR for the fifth quintile versus the first quintile = 0.82, 95% CI: 0.56 - 1.16) and CRC-specific mortality (HR for the fifth quintile versus the first quintile = 0.76, 95% CI: 0.52 - 1.11). Higher SePP levels were associated with a statistically significantly lower overall (HR for the fifth quintile versus the first quintile = 0.70, 95% CI: 0.50 - 0.98), but not CRC-specific mortality. No statistically significant interactions by potential modifying factors related to CRC and overall survival were identified.

CONCLUSION: Our study suggests that higher pre-diagnostic total serum Se and SePP protein concentrations may be associated with lower mortality among patients with CRC in Western Europe. Se intake/status might be a potential factor affecting survival in CRC patients, particularly from a population with low Se status, such as in Europe.

IMPACT: This study is the first and largest prospective analysis of the association between pre-diagnostic levels of Se and SePP with mortality among CRC patients.

Table of Contents

Table of Contents

CHAPTER I

BACKGROUND

Colorectal Cancer

Colorectal Carcinogenesis

Risk Factors in Colorectal Cancer

Prognostic Factors in Colorectal Cancer

Selenium (Se)

Dietary Selenium

Selenoprotein P (SePP)

Selenium, Selenoprotein P, and Colorectal Cancer

Selenium, Selenoprotein P, and Cancer Survival

CHAPTER II

ABSTRACT

INTRODUCTION

METHODS

Study population and data collection

Cancer incidence follow-up

Vital status follow-up

Case ascertainment and selection

Selenium and Selenoprotein P measurements

Covariates

Statistical Analyses

RESULTS

Characteristics of study participants

Selenium and mortality among colorectal cancer patients

Selenoprotein P and mortality among colorectal cancer patients

DISCUSSION

CHAPTER III

REFERENCES

TABLES

SUPPLEMENTARY TABLES AND FIGURES

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Mot-clé	Selenium Selenoprotein P Colorectal cancer
Committee Chair / Thesis Advisor	Fedirko, Veronika, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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