EFFECT OF NUTRITION INTERVENTION ON INTERMEDIATE END-POINTS IN ESOPHAGEAL AND GASTRIC CARCINOGENESIS

A nutrition intervention trial involving > 3000 participants was condu cted in Linxian, China, where the esophageal and stomach cancer mortal ity rates are among the highest in the world and suspicion exists that chronic deficiencies of multiple nutrients are etiologically involved . The trial was randomized, double-blind, and placebo-controlled and t ested the effect of multivitamin and multimineral supplements in reduc ing cancer incidence and mortality in adults with cytologically detect ed esophageal dysplasia. Endoscopic and cytologic examinations of samp les of trial participants during the intervention allowed evaluation o f intermediate endpoints in esophageal and gastric carcinogenesis, inc luding asymptomatic histologic precancerous lesions acid early invasiv e cancer, epithelial proliferation, and cytologic abnormalities. Resul ts from these ancillary studies suggest that multivitamin and multimin eral supplementation may decrease proliferation and enhance cytologic reversion to nondysplasia.