USPSTF Recommends Against Vitamin E, Beta-Carotene Use for CVD and Cancer Prevention

The US Preventive Services Task Force (USPSTF) has released a final recommendation on the use of vitamin, mineral, and multivitamin supplements to prevent cardiovascular disease (CVD) and cancer.

To assess the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent CVD and cancer, the USPSTF reviewed 17,459 unique citations and 379 full-text articles that included randomized clinical trials as well as observational cohort studies. The USPSTF reviewed evidence from MEDLINE, PubMed, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviewed, and Embase between January 2013 and February 1, 2022.

The following recommendations apply to community-dwelling, nonpregnant adults:

The USPSTF recommends against the use of vitamin E or beta-carotene supplements for the prevention of heart disease, stroke, or cancer (Grade D). Based on available evidence, the Task Force concluded that there was no benefit associated with taking vitamin E. With regard to beta-carotene, an increased risk of CVD mortality and lung cancer (in high risk individuals) was observed in studies.
The USPSTF has concluded that the balance of benefits and harms of the use of single or paired nutrient supplements (other than vitamin E and beta carotene) or multivitamins for the prevention of CVD or cancer cannot be determined due to insufficient evidence (Grade I).
- Pooled analyses showed no association between multivitamins and all-cause mortality or CVD mortality. A small decrease in cancer incidence was found; however, studies were noted to have several limitations.
- The review included an assessment of vitamin D with or without calcium, calcium alone, folic acid (in nonpregnant adults) with or without vitamin B₁₂, vitamin C, vitamin B₃ and B₆, and selenium. Most studies showed no association with CVD or cancer outcomes, though the body of evidence was limited for some supplements.
- For most supplements, there was little to no evidence of serious harms.

“We all want ways to prevent heart disease, stroke, and cancer, so the Task Force again reviewed the evidence on whether taking vitamins and minerals helps prevent these diseases,” says Task Force member John Wong, MD. “Unfortunately, based on the existing evidence, the Task Force cannot recommend for or against the use of most vitamins and minerals and is calling for more research.”

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