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In Reply: SELECT found that selenium as L-selenomethionine at 200 µg per day did not decrease the risk of prostate cancer in a large randomized group of men whose baseline selenium distribution represents that of the US population. Secondary analyses of selenium supplementation effects by baseline selenium status in the much smaller NPC study (1312 participants vs 35 533 in SELECT) may help understand this outcome: a population of men who are replete in selenium will not benefit from selenium supplementation and may have an increased risk of diabetes.¹

The design of SELECT does not address the contention of either Dr Rayman and colleagues or Drs Hurst and Fairweather-Tait regarding a potential benefit of selenium in men with low plasma levels of selenium. At present, the possibility that selenium may prevent prostate cancer in men with low plasma selenium levels is an unproved hypothesis that has not been tested as . . . [Full Text of this Article]

Scott M. Lippman, MD
slippman@mdanderson.org
University of Texas M. D. Anderson Cancer Center
Houston

Eric A. Klein, MD
Cleveland Clinic Lerner
Cleveland, Ohio

Phyllis J. Goodman, MS
Southwest Oncology Group Statistical Center
Seattle, Washington

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