A few trials have suggested that selenium supplementation may have a protective effect on liver cancer in high-risk groups living in low-selenium areas. The provision of selenium-fortified salt to a town in

Qidong, China, with high rates of primary liver cancer, reduced the incidence of this cancer by 35% compared with towns that did not receive this intervention (Table 3). Trials have also demonstrated the incidence of liver cancer to be significantly reduced in subjects with hepatitis B and among members of families with a history of liver cancer receiving a daily supplement of 200 mg of selenium for 4 and 2 years, respectively.

The Nutritional Prevention of Cancer Trial in the United States also supported a possible protective role of selenium (Table 4): 1312 patients (mostly men) with a previous history of skin cancer were supplemented with either placebo or 200 mg selenium per day for 4| years and those receiving selenium demonstrated significant reductions in the risk of cancer incidence (37%) and mortality (50%). Although selenium was not found to have a protective effect against recurrent skin cancer, the selenium-treated group had substantial reductions in the incidence of lung, colorectal, and prostate cancers of 46, 58, and 63%, respectively. Further analysis showed the protective effect on prostate cancer to be confined to those with lower baseline prostate-specific antigen and plasma selenium levels. Although these data need confirmation, they suggest that adequate selenium intake may be important for cancer prevention.

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