Evidence-based Complementary and Alternative Medicine for Cancer Prevention

Yu-Jin Paek

doi:10.5124/jkma.2008.51.5.411

J Korean Med Assoc > Volume 51(5); 2008 > Article

Paek: Evidence-based Complementary and Alternative Medicine for Cancer Prevention

Focused Issue of This Month

Evidence-based Complementary and Alternative Medicine for Cancer

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(5): 411-426.

Published online: May 31, 2008

DOI: http://dx.doi.org/10.5124/jkma.2008.51.5.411

Evidence-based Complementary and Alternative Medicine for Cancer Prevention

Yu-Jin Paek, MD

Department of Family Medicine, Hallym University College of Medicine, Korea. paek@hallym.ac.kr

Abstract

Cancer prevention with complementary and alternative medicine (CAM), especially based upon biologically-based practices, is a major concern among physicians, health care providers, and general population. Biologically-based practices include diet-based therapies, botanicals and herbs, vitamins and minerals, animal-derived extracts, and amino acids. We searched databases since the late 1990s and reviewed what have been done in the area of cancer prevention with specific CAM therapies to provide the most recent and updated materials and to be able to serve as a reference for physicians. Scottish Intercollegiate Guidelines Network (SIGN) and National Institute for Clinical Excellence (NICE) methodologies were adopted to classify the study design, study quality assessment, and determination of the evidence level. Some have more or less protective effects but there are conflicting evidences regarding the effectiveness of certain CAM therapies for the prevention of cancer, and most of them are epidemiologic studies, whereas clinical trials are relatively rare in the context of evidence-based medicine (EBM). More researches are mandatory to assess the effectiveness for the prevention of cancer by specific CAM therapies that allow the clinicians and health care providers to give EBM based advice to the patients and inspire them to study CAM therapies for cancer prevention.

Complementary & alternative medicine; Cancer prevention; Evidence-based medicine

Notes

This study was supported by a grant from the National R & D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (0720590).

References

1. Caraballoso M, Sacristan M, Serra C, Bonfill X. Drugs for preventing lung cancer in healthy people. Cochrane Database of Systematic Reviews 2003 Issue 2):Art. No.: CD002141. DOI: 10.1002/14651858.CD002141.

2. Virtamo J, Pietinen P, Huttunen JK, Korhonen P, Malila N, Virtanen MJ, Albanes D, Taylor PR, Albert P. ATBC Study Group. Incidence of cancer and mortality following alpha-tocopherol and beta-carotene supplementation: a postintervention follow-up. JAMA 2003;290:476-485.

3. Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers (Review). Cochrane Database of Systematic Reviews 2004 Issue 4):Art. No.: CD004183. DOI: 10.1002/14651858.CD004183 pub2.

4. Kubo A, Corley DA. Meta-analysis of antioxidant intake and the risk of esophageal and gastric cardia adenocarcinoma. Am J Gastroenterol 2007;102:2323-2330.

5. Baron JA, Cole BF, Mott L, Haile R, Grau M, Church TR, Beck GJ, Greenberg ER. Neoplastic and antineoplastic effects of beta-carotene on colorectal adenoma recurrence: results of a randomized trial. J Natl Cancer Inst 2003;95:717-722.

6. Malila N, Virtamo J, Virtanen M, Pietinen P, Albanes D, Teppo L. Dietary and serum alpha-tocopherol, beta-carotene and retinol, and risk for colorectal cancer in male smokers. Eur J Clin Nutr 2002;56:615-621.

7. Lee JE, Giovannucci E, Smith-Warner SA, Spiegelman D, Willett WC, Curhan GC. Intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and risk of renal cell cancer. Cancer Epidemiol Biomarkers Prev 2006;15:2445-2452.

8. García-Closas R, Castellsagué X, Bosch X, González CA. The role of diet and nutrition in cervical carcinogenesis: a review of recent evidence. Int J Cancer 2005;117:629-637.

9. McNaughton SA, Marks GC, Gaffney P, Williams G, Green AC. Antioxidants and basal cell carcinoma of the skin: a nested case-control study. Cancer Causes Control 2005;16:609-618.

10. Frieling UM, Schaumberg DA, Kupper TS, Muntwyler J, Hennekens CH. A randomized, 12-year primary-prevention trial of beta carotene supplementation for nonmelanoma skin cancer in the physician's health study. Arch Dermatol 2000;136:179-184.

11. Cho E, Hunter DJ, Spiegelman D, Albanes D, Beeson WL, van den Brandt PA, Colditz GA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Miller AB, Rohan TE, Sellers TA, Virtamo J, Willett WC, Smith-Warner SA. Intakes of vitamins A, C and E and folate and multivitamins and lung cancer: a pooled analysis of 8 prospective studies. Int J Cancer 2006;118:970-978.

12. Bjelakovic G, Nagorni A, Nikolova D, Simonetti RG, Bjelakovic M, Gluud C. Meta-analysis: antioxidant supplements for primary and secondary prevention of colorectal adenoma. Aliment Pharmacol Ther 2006;24:281-291.

13. Lee IM, Cook NR, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women's Health Study: a randomized controlled trial. JAMA 2005;294:56-65.

14. Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais GR. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-1347.

15. Zhuo H, Smith AH, Steinmaus C. Selenium and lung cancer: A quantitative analysis of heterogeneity in the current epidemiological literature. Cancer Epidemiol Biomarkers Prev 2004;13:771-778.

16. Duffield-Lillico AJ, Dalkin BL, Reid ME, Turnbull BW, Slate EH, Jacobs ET, Marshall JR, Clark LC. Nutritional Prevention of Cancer Study Group. Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: an analysis of the complete treatment period of the Nutritional Prevention of Cancer Trial. BJU Int 2003;91:608-612.

17. Brinkman M, Reulen RC, Kellen E, Buntinx F, Zeegers MP. Are men with low selenium levels at increased risk of prostate cancer? Eur J Cancer 2006;42:2463-2471.

18. Li H, Li HQ, Wang Y, Xu HX, Fan WT, Wang ML, Sun PH, Xie XY. An intervention study to prevent gastric cancer by micro-selenium and large dose of allitridum. Chin Med J (Engl) 2004;117:1155-1160.

19. Duffield-Lillico AJ, Slate EH, Reid ME, Turnbull BW, Wilkins PA, Combs GF Jr, Park HK, Gross EG, Graham GF, Stratton MS, Marshall JR, Clark LC. Nutritional Prevention of Cancer Study Group. Selenium supplementation and secondary prevention of nonmelanoma skin cancer in a randomized trial. J natl Cancer Inst 2003;95:1477-1481.

20. Reid ME, Duffield-Lillico AJ, Sunga A, Fakih M, Alberts DS, Marshall JR. Selenium supplementation and colorectal adenomas: An analysis of the nutritional prevention of cancer trial. Int J Cancer 2006;118:1777-1781.

21. Jacobs ET, Jiang R, Alberts DS, Greenberg ER, Gunter EW, Karagas MR, Lanza E, Ratnasinghe L, Reid ME, Schatzkin A, Smith-Warner SA, Wallace K, Martínez ME. Selenium and colorectal adenoma: results of a pooled analysis. J Natl Cancer Inst 2004;96:1669-1675.

22. Kamangar F, Qiao YL, Yu B, Sun XD, Abnet CC, Fan JH, Mark SD, Zhao P, Dawsey SM, Taylor PR. Lung cancer chemoprevention: a randomized, double-blind trial in Linxian, China. Cancer Epidemiol Biomarkers Prev 2006;15:1562-1564.

23. Qu CX, Kamangar F, Fan JH, Yu B, Sun XD, Taylor PR, Chen BE, Abnet CC, Qiao YL, Mark SD, Dawsey SM. Chemoprevention of primary liver cancer: a randomized, double-blind trial in Linxian, China. J Natl Cancer Inst 2007;99:1240-1247.

24. Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med 2004;164:2335-2342.

25. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2008;1:CD003548.

26. Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, Margolis KL, Ockene JK, Phillips L, Pottern L, Prentice RL, Robbins J, Rohan TE, Sarto GE, Sharma S, Stefanick ML, Van Horn L, Wallace RB, Whitlock E, Bassford T, Beresford SA, Black HR, Bonds DE, Brzyski RG, Caan B, Chlebowski RT, Cochrane B, Garland C, Gass M, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Jackson RD, Johnson KC, Judd H, Kooperberg CL, Kuller LH, LaCroix AZ, Lane DS, Langer RD, Lasser NL, Lewis CE, Limacher MC, Manson JE. Women's Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684-696.

27. Cho E, Smith-Warner SA, Spiegelman D, Beeson WL, van den Brandt PA, Colditz GA, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Miller AB, Pietinen P, Potter JD, Rohan TE, Terry P, Toniolo P, Virtanen MJ, Willett WC, Wolk A, Wu K, Yaun SS, Zeleniuch-Jacquotte A, Hunter DJ. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. J Natl Cancer Inst 2004;96:1015-1022.

28. Gao X, LaValley MP, Tucker KL. Prospective studies of dairy product and calcium intakes and prostate cancer risk: a meta-analysis. J Natl Cancer Inst 2005;97:1768-1777.

29. Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-210.

30. Park Y, Mitrou PN, Kipnis V, Hollenbeck A, Schatzkin A, Leitzmann MF. Calcium, dairy foods, and risk of incident and fatal prostate cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol 2007;166:1270-1279.

31. Kesse E, Bertrais S, Astorg P, Jaouen A, Arnault N, Galan P, Hercberg S. Dairy products, calcium and phosphorus intake, and the risk of prostate cancer: results of the French prospective SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) study. Br J Nutr 2006;95:539-545.

32. Ahn J, Albanes D, Peters U, Schatzkin A, Lim U, Freedman M, Chatterjee N, Andriole GL, Leitzmann MF, Hayes RB. Prostate, Lung, Colorectal, and Ovarian Trial Project Team. Dairy products, calcium intake, and risk of prostate cancer in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev 2007;16:2623-2630.

33. Baron JA, Beach M, Wallace K, Grau MV, Sandler RS, Mandel JS, Heber D, Greenberg ER. Risk of prostate cancer in a randomized clinical trial of calcium supplementation. Cancer Epidemiol Biomarkers Prev 2005;14:586-589.

34. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85:1586-1591.

35. Larsson SC, Giovannucci E, Wolk A. Folate intake, MTHFR polymorphisms, and risk of esophageal, gastric, and pancreatic cancer: a meta-analysis. Gastroenterology 2006;131:1271-1283.

36. Sanjoaquin MA, Allen N, Couto E, Roddam AW, Key TJ. Folate intake and colorectal cancer risk: a meta-analytical approach. Int J Cancer 2005;113:825-828.

37. Zhang SM, Moore SC, Lin J, Cook NR, Manson JE, Lee IM, Buring JE. Folate, vitamin B6, multivitamin supplements, and colorectal cancer risk in women. Am J Epidemiol 2006;163:108-115.

38. Kune G, Watson L. Colorectal cancer protective effects and the dietary micronutrients folate, methionine, vitamins B6, B12, C, E, selenium, and lycopene. Nutr Cancer 2006;56:11-21.

39. Cole BF, Baron JA, Sandler RS, Haile RW, Ahnen DJ, Bresalier RS, McKeown-Eyssen G, Summers RW, Rothstein RI, Burke CA, Snover DC, Church TR, Allen JI, Robertson DJ, Beck GJ, Bond JH, Byers T, Mandel JS, Mott LA, Pearson LH, Barry EL, Rees JR, Marcon N, Saibil F, Ueland PM, Greenberg ER. Polyp Prevention Study Group. Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. JAMA 2007;297:2351-2359.

40. Larsson SC, Giovannucci E, Wolk A. Folate and risk of breast cancer: a meta-analysis. J Natl Cancer Inst 2007;99:64-76.

41. Bunker CH, McDonald AC, Evans RW, de la Rosa N, Boumosleh JM, Patrick AL. A randomized trial of lycopene supplementation in Tobago men with high prostate cancer risk. Nutr Cancer 2007;57:130-137.

42. Etminan M, Takkouche B, Caamaño-Isorna F. The role of tomato products and lycopene in the prevention of prostate cancer: a meta-analysis of observational studies. Cancer epidemiology, biomarkers & preventio 2004;13:340-345.

43. Kirsh VA, Mayne ST, Peters U, Chatterjee N, Leitzmann MF, Dixon LB, Urban DA, Crawford ED, Hayes RB. A prospective study of lycopene and tomato product intake and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:92-98.

44. Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC. Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int J Cancer 2007;21:1571-1578.

45. Peters U, Leitzmann MF, Chatterjee N, Wang Y, Albanes D, Gelmann EP, Friesen MD, Riboli E, Hayes RB. Serum lycopene, other carotenoids, and prostate cancer risk: a nested case-control study in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev 2007;16:962-968.

46. Nouraie M, Pietinen P, Kamangar F, Dawsey SM, Abnet CC, Albanes D, Virtamo J, Taylor PR. Fruits, vegetables, and antioxidants and risk of gastric cancer among male smokers. Cancer Epidemiol Biomarkers Prev 2005;14:2087-2092.

47. Männistö S, Smith-Warner SA, Spiegelman D, Albanes D, Anderson K, van den Brandt PA, et al. Dietary carotenoids and risk of lung cancer in a pooled analysis of seven cohort studies. Cancer Epidemiol Biomarkers Prev 2004;13:40-48.

48. Nöthlings U, Wilkens LR, Murphy SP, Hankin JH, Henderson BE, Kolonel LN. Vegetable intake and pancreatic cancer risk: the multiethnic cohort study. Am J Epidemiol 2007;65:138-147.

49. Männistö S, Yaun SS, Hunter DJ, Spiegelman D, Adami HO, Albanes D, van den Brandt PA, Buring JE, Cerhan JR, Colditz GA, Freudenheim JL, Fuchs CS, Giovannucci E, Goldbohm RA, Harnack L, Leitzmann M, McCullough ML, Miller AB, Rohan TE, Schatzkin A, Virtamo J, Willett WC, Wolk A, Zhang SM, Smith-Warner SA. Dietary carotenoids and risk of colorectal cancer in a pooled analysis of 11 cohort studies. Am J Epidemiol 2007;65:246-255.

50. Koushik A, Hunter DJ, Spiegelman D, Anderson KE, Buring JE, Freudenheim JL, Goldbohm RA, Hankinson SE, Larsson SC, Leitzmann M, Marshall JR, McCullough ML, Miller AB, Rodriguez C, Rohan TE, Ross JA, Schatzkin A, Schouten LJ, Willett WC, Wolk A, Zhang SM, Smith-Warner SA. Intake of the major carotenoids and the risk of epithelial ovarian cancer in a pooled analysis of 10 cohort studies. Int J Cancer 2006;19:2148-2154.

51. Zhang M, Holman CD, Binns CW. Intake of specific carotenoids and the risk of epithelial ovarian cancer. Br J Nutr 2007;98:187-193.

52. Prentice RL, Caan B, Chlebowski RT, Patterson R, Kuller LH, Ockene JK, Margolis KL, Limacher MC, Manson JE, Parker LM, Paskett E, Phillips L, Robbins J, Rossouw JE, Sarto GE, Shikany JM, Stefanick ML, Thomson CA, Van Horn L, Vitolins MZ, Wactawski-Wende J, Wallace RB, Wassertheil-Smoller S, Whitlock E, Yano K, Adams-Campbell L, Anderson GL, Assaf AR, Beresford SA, Black HR, Brunner RL, Brzyski RG, Ford L, Gass M, Hays J, Heber D, Heiss G, Hendrix SL, Hsia J, Hubbell FA, Jackson RD, Johnson KC, Kotchen JM, LaCroix AZ, Lane DS, Langer RD, Lasser NL, Henderson MM. Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295:629-642.

53. Saadatian-Elahi M, Norat T, Goudable J, Riboli E. Biomarkers of dietary fatty acid intake and the risk of breast cancer: a meta-analysis. Int J Cancer 2004;11:584-591.

54. Boyd NF, Stone J, Vogt KN, Connelly BS, Martin LJ, Minkin S. Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature. Br J Cancer 2003;89:1672-1685.

55. Lanza E, Yu B, Murphy G, Albert PS, Caan B, Marshall JR, Lance P, Paskett ED, Weissfeld J, Slattery M, Burt R, Iber F, Shike M, Kikendall JW, Brewer BK, Schatzkin A. Polyp Prevention Trial Study Group. The polyp prevention trial continued follow-up study: no effect of a low-fat, high-fiber, high-fruit, and -vegetable diet on adenoma recurrence eight years after randomization. Cancer Epidemiol Biomarkers Prev 2007;16:1745-1752.

56. Beresford SA, Johnson KC, Ritenbaugh C, Lasser NL, Snetselaar LG, Black HR, Anderson GL, Assaf AR, Bassford T, Bowen D, Brunner RL, Brzyski RG, Caan B, Chlebowski RT, Gass M, Harrigan RC, Hays J, Heber D, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Jackson RD, Kotchen JM, Kuller LH, LaCroix AZ, Lane DS, Langer RD, Lewis CE, Manson JE, Margolis KL, Mossavar-Rahmani Y, Ockene JK, Parker LM, Perri MG, Phillips L, Prentice RL, Robbins J, Rossouw JE, Sarto GE, Stefanick ML, Van Horn L, Vitolins MZ, Wactawski-Wende J, Wallace RB, Whitlock E. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295:643-654.

57. Prentice RL, Thomson CA, Caan B, Hubbell FA, Anderson GL, Beresford SA, Pettinger M, Lane DS, Lessin L, Yasmeen S, Singh B, Khandekar J, Shikany JM, Satterfield S, Chlebowski RT. Low-fat dietary pattern and cancer incidence in the Women's Health Initiative Dietary Modification Randomized Controlled Trial. J Natl Cancer Inst 2007;99:1534-1543.

58. Genkinger JM, Hunter DJ, Spiegelman D, Anderson KE, Beeson WL, Buring JE, Colditz GA, Fraser GE, Freudenheim JL, Goldbohm RA, Hankinson SE, Koenig KL, Larsson SC, Leitzmann M, McCullough ML, Miller AB, Rodriguez C, Rohan TE, Ross JA, Schatzkin A, Schouten LJ, Smit E, Willett WC, Wolk A, Zeleniuch-Jacquotte A, Zhang SM, Smith-Warner SA. A pooled analysis of 12 cohort studies of dietary fat, cholesterol and egg intake and ovarian cancer. Cancer Causes Control 2006;17:273-285.

59. Huncharek M, Kupelnick B. Dietary fat intake and risk of epithelial ovarian cancer: a meta-analysis of 6,689 subjects from 8 observational studies. Nutr Cancer 2001;40:87-91.

60. Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML. Dietary lipids and endometrial cancer: the current epidemiologic evidence. Cancer Causes Control 2007;18:687-703.

61. Steinmaus CM, Nuñez S, Smith AH. Diet and bladder cancer: a meta-analysis of six dietary variables. Am J Epidemiol 2000;51:693-702.

62. Wallström P, Bjartell A, Gullberg B, Olsson H, Wirfält E. A prospective study on dietary fat and incidence of prostate cancer (Malmö, Sweden). Cancer Causes Control 2007;18:1107-1121.

63. Park SY, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. Fat and meat intake and prostate cancer risk: the multiethnic cohort study. Int J Cancer 2007;21:1339-1345.

64. Smith-Warner SA, Ritz J, Hunter DJ, Albanes D, Beeson WL, van den Brandt PA, Colditz G, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Rohan TE, Speizer FE, Virtamo J, Willett WC. Dietary fat and risk of lung cancer in a pooled analysis of prospective studies. Cancer Epidemiol Biomarkers Prev 2002;11(10 Pt 1):987-992.

65. Saadatian-Elahi M, Norat T, Goudable J, Riboli E. Biomarkers of dietary fatty acid intake and the risk of breast cancer: a meta-analysis. Int J Cancer 2004;11:584-591.

66. Shannon J, King IB, Moshofsky R, Lampe JW, Gao DL, et al. Erythrocyte fatty acids and breast cancer risk: a case-control study in Shanghai, China. Am J Clin Nutr 2007;85:1090-1097.

67. Engeset D, Alsaker E, Lund E, Welch A, Khaw KT, Clavel-Chapelon F, Thiébaut A, Chajès V, Key TJ, Allen NE, Amiano P, Dorronsoro M, Tjønneland A, Stripp C, Peeters PH, van Gils CH, Chirlaque MD, Nagel G, Linseisen J, Ocké MC, Bueno-de-Mesquita HB, Sacerdote C, Tumino R, Ardanaz E, Sánchez MJ, Panico S, Palli D, Trichopoulou A, Kalapothaki V, Benetou V, Quirós JR, Agudo A, Overvad K, Bjerregaard L, Wirfält E, Schulz M, Boeing H, Slimani N, Riboli E. The European Prospective Investigation into Cancer and Nutrition (EPIC). Fish consumption and breast cancer risk. Int J Cancer 2006;19:175-182.

68. Brouwer IA, Katan MB, Zock PL. Dietary-Linolenic Acid Is Associated with Reduced Risk of Fatal Coronary Heart Disease, but Increased Prostate Cancer Risk: A Meta-Analysis. Nutr 2004;34:919-922.

69. Koralek DO, Peters U, Andriole G, Reding D, Kirsh V, Subar A, Schatzkin A, Hayes R, Leitzmann MF. A prospective study of dietary alpha-linolenic acid and the risk of prostate cancer (United States). Cancer Causes Control 2006;17:783-791.

70. Theodoratou E, McNeill G, Cetnarskyj R, Farrington SM, Tenesa A, Barnetson R, Porteous M, Dunlop M, Campbell H. Dietary Fatty Acids and Colorectal Cancer: A Case-Control Study. Am J Epidemiol 2007;166:181-195.

71. MacLean CH, Newberry SJ, Mojica WA, Khanna P, Issa AM, Suttorp MJ, Lim YW, Traina SB, Hilton L, Garland R, Morton SC. Effects of Omega-3 Fatty Acids on Cancer Risk: A Systematic Review. JAMA 2006;295:403-415.

72. Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE, Riemersma RA, Ebrahim SB, Davey Smith G. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ 2006;332:752-760.

73. Seely D, Millis EJ, Wu P, Verma S, Guyatt GHl. The effects of grean tea consumption on incidence of breast cancer and recurrence of breast cancer: a systematic review and meta-analysis. Integrative Cancer Therapy 2005;4:144-155.

74. Yang G, Shu XO, Li H, Chow WH, Ji BT, Zhang X, Gao YT, Zheng W. Prospective cohort study of green tea consumption and colorectal cancer risk in women. Cancer Epidemiol Biomarkers Prev 2007;16:1219-1223.

75. Sasazuki S, Inoue M, Hanaoka T, Yamamoto S, Sobue T, Tsugane S. Green tea consumption and subsequent risk of gastric cancer by subsite: the JPHC Study. Cancer Causes Control 2004;15:483-491.

76. Kurahashi N, Sasazuki S, Iwasaki M, Inoue M, Tsugane S. JPHC Study Group. Green tea consumption and prostate cancer risk in Japanese men: a prospective study. Am J Epidemiol 2008;67:71-77.

77. Steevens J, Schouten LJ, Verhage BA, Goldbohm RA, van den Brandt PA. Tea and coffee drinking and ovarian cancer risk: results from the Netherlands Cohort Study and a meta-analysis. Br J Cancer 2007;97:1291-1294.

78. Kuriyama S, Shimazu T, Ohmori K, Kikuchi N, Nakaya N, Nishino Y, Tsubono Y, Tsuji I. Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan. JAMA 2007;296:1255-1265.

79. Fleischauer AT, Poole C, Arab L. Garlic consumption and cancer prevention: Meta-analyses of colorectal and stomach cancers. American J Clinical Nutrition 2000;72:1047-1052.

80. González CA, Pera G, Agudo A, Bueno-de-Mesquita HB, Ceroti M, Boeing H, Schulz M, Del Giudice G, Plebani M, Carneiro F, Berrino F, Sacerdote C, Tumino R, Panico S, Berglund G, Simán H, Hallmans G, Stenling R, Martinez C, Dorronsoro M, Barricarte A, Navarro C, Quiros JR, Allen N, Key TJ, Bingham S, Day NE, Linseisen J, Nagel G, Overvad K, Jensen MK, Olsen A, Tjønneland A, Büchner FL, Peeters PH, Numans ME, Clavel-Chapelon F, Boutron-Ruault MC, Roukos D, Trichopoulou A, Psaltopoulou T, Lund E, Casagrande C, Slimani N, Jenab M, Riboli E. Fruit and vegetable intake and the risk of stomach and oesophagus adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Cancer 2006;18:2559-2566.

81. Tanaka S, Haruma K, Kunihiro M, Nagata S, Kitadai Y, Manabe N, Sumii M, Yoshihara M, Kajiyama G, Chayama K. Effects of aged garlic extract (AGE) on colorectal adenomas: a double-blinded study. Hiroshima J Med Sci 2004;53(3-4):39-45.

82. Lee YH, Lee CW, Lee HJ, Lee MY, Jeon JC, Shon SS. Stomach cancer related variables by case-control study in some Korean. J Korean Public Health Assoc 2000;26:484-496.

83. Schuurman AG, Goldbohm RA, Dorant E, van den Brandt PA. Vegetable and fruit consumption and prostate cancer risk: a cohort study in The Netherlands. Cancer Epidemiol Biomarkers Prev 1998;7:673-680.

84. Galeone C, Pelucchi C, Levi F, Negri E, Franceschi S, Talamini R, Giacosa A, La Vecchia C. Onion and garlic use and human cancer. Am J Clin Nutr 2006;84:1027-1032.

85. Kirsh VA, Peters U, Mayne ST, Subar AF, Chatterjee N, Johnson CC, Hayes RB. Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Prospective study of fruit and vegetable intake and risk of prostate cancer. J Natl Cancer Inst 2007;99:1200-1209.

86. Ambrosini GL, de Klerk NH, Fritschi L, Mackerras D, Musk B. Fruit, vegetable, vitamin A intakes, and prostate cancer risk. Prostate Cancer Prostatic Dis 2008;11:61-66.

87. Brennan P, Hsu CC, Moullan N, Szeszenia-Dabrowska N, Lissowska J, Zaridze D, Rudnai P, Fabianova E, Mates D, Bencko V, Foretova L, Janout V, Gemignani F, Chabrier A, Hall J, Hung RJ, Boffetta P, Canzian F. Effect of cruciferous vegetables on lung cancer in patients stratified by genetic status: a mendelian randomisation approach. Lancet 2005;366:1558-1560.

88. Lin HJ, Probst-Hensch NM, Louie AD, Kau IH, Witte JS, Ingles SA, Frankl HD, Lee ER, Haile RW. Glutathione transferase null genotype, broccoli, and lower prevalence of colorectal adenomas. Cancer Epidemiol Biomarkers Prev 1998;7:647-652.

89. Hara M, Hanaoka T, Kobayashi M, Otani T, Adachi HY, Montani A, Natsukawa S, Shaura K, Koizumi Y, Kasuga Y, Matsuzawa T, Ikekawa T, Sasaki S, Tsugane S. Cruciferous vegetables, mushrooms, and gastrointestinal cancer risks in a multicenter, hospital-based case-control study in Japan. Nutr Cancer 2003;46:138-147.

90. Shin HR, Kim JY, Lee DH, Yun TK, Morgan G, Vainio H. The Cancer-preventive Potential of Panax ginseng: A Review of Human and Experimental Evidence. Korean J Prev Med 2000;33:383-392.

91. Byun JS, Ohrr H, Yi SW, Hong JS, Sohn TY. A Study on the Association Between Ginseng Intake and Incidences of Cancer: Kangwha Cohort Study. Korean J Prev Med 2003;36:367-372.

92. Kamangar F, Gao YT, Shu XO, Kahkeshani K, Ji BT, Yang G, Li HL, Rothman N, Chow WH, Zheng W. Ginseng intake and gastric cancer risk in the Shanghai Women's Health Study cohort. Cancer Epidemiol Biomarkers Prev 2007;16:629-630.

93. Ye B, Aponte M, Dai Y, Li L, Ho MC, Vitonis A, Edwards D, Huang TN, Cramer DW. Ginkgo biloba and ovarian cancer prevention: Epidemiological and biological evidence. Cancer Letters 2007;251:43-52.

94. Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Willett WC, Giovannucci EL. Fruit and vegetable intake and incidence of bladder cancer in a male prospective cohort. J Natl Cancer Inst 1999;91:605-613.

95. Radosavljevic V, Jankovic S, Marinkovic J, Dokic M. Diet and bladder cancer: a case-control study. Int Urol Nephrol 2005;37:283-289.

96. Akedo I, Ishikawa H, Nakamura T, Kimura K, Takeyama I, Suzuki T, Kameyama M, Sato S, Nakamura T, Matsuzawa Y, Kakizoe T, Otani T. Randomized trial of dietary fiber and Lactobacillus casei administration for prevention of colorectal tumors. Int J Cancer 2005;16:762-767.

97. Rafter J, Bennett M, Caderni G, Clune Y, Hughes R, Karlsson PC, Klinder A, O'Riordan M, O'Sullivan GC, Pool-Zobel B, Rechkemmer G, Roller M, Rowland I, Salvadori M, Thijs H, Van Loo J, Watzl B, Collins JK. Dietary synbiotics reduce cancer risk factors in polypectomized and colon cancer patients. Am J Clin Nutr 2007;85:488-496.

Table 1

Scientific evidence of complementary and alternative therapies for cancer prevention