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=== Medication === Medications can be used to prevent cancer in a few circumstances.<ref>Holland Chp.33</ref> In the general population, [[Non-steroidal anti-inflammatory drug|NSAIDs]] reduce the risk of [[colorectal cancer]]; however, due to cardiovascular and gastrointestinal side effects, they cause overall harm when used for prevention.<ref name="pmid17339623">{{cite journal |vauthors=Rostom A, DubΓ© C, Lewin G, Tsertsvadze A, Barrowman N, Code C, Sampson M, Moher D |title=Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force |journal=Annals of Internal Medicine |volume=146 |issue=5 |pages=376β89 |date=March 2007 |pmid=17339623 |doi=10.7326/0003-4819-146-5-200703060-00010|doi-access=free }}</ref> [[Aspirin]] has been found to reduce the risk of death from cancer by about 7%.<ref name="pmid21144578">{{cite journal |vauthors=Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW |s2cid=22950940 |title=Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials |journal=Lancet |volume=377 |issue=9759 |pages=31β41 |date=January 2011 |pmid=21144578 |doi=10.1016/S0140-6736(10)62110-1}}</ref> [[COX-2 inhibitor]]s may decrease the rate of [[polyp (medicine)|polyp]] formation in people with [[familial adenomatous polyposis]]; however, it is associated with the same adverse effects as NSAIDs.<ref name="pmid20594533">{{cite journal |vauthors=Cooper K, Squires H, Carroll C, Papaioannou D, Booth A, Logan RF, Maguire C, Hind D, Tappenden P |title=Chemoprevention of colorectal cancer: systematic review and economic evaluation |journal=Health Technology Assessment |volume=14 |issue=32 |pages=1β206 |date=June 2010 |pmid=20594533 |doi=10.3310/hta14320|doi-access=free }}</ref> Daily use of [[tamoxifen]] or [[raloxifene]] reduce the risk of breast cancer in high-risk women.<ref name="pmid19020189">{{cite journal |vauthors=Thomsen A, Kolesar JM |title=Chemoprevention of breast cancer |journal=American Journal of Health-System Pharmacy |volume=65 |issue=23 |pages=2221β28 |date=December 2008 |pmid=19020189 |doi=10.2146/ajhp070663}}</ref> The benefit versus harm for [[5-alpha-reductase inhibitor]] such as [[finasteride]] is not clear.<ref name="pmid18425978">{{cite journal |vauthors=Wilt TJ, MacDonald R, Hagerty K, Schellhammer P, Kramer BS |title=Five-alpha-reductase Inhibitors for prostate cancer prevention |veditors=Wilt TJ |journal=The Cochrane Database of Systematic Reviews |issue=2 |pages=CD007091 |date=April 2008 |pmid=18425978 |doi=10.1002/14651858.CD007091|pmc=11270836 }}</ref> [[Vitamin]] supplementation does not appear to be effective at preventing cancer.<ref name="pmid20939459">{{cite journal |title=Vitamins and minerals: not for cancer or cardiovascular prevention |journal=Prescrire International |volume=19 |issue=108 |page=182 |date=August 2010 |pmid=20939459 |url=http://english.prescrire.org/en/81/168/46461/0/2010/ArchiveNewsDetails.aspx?page=2 |url-status=live |archive-url=https://web.archive.org/web/20120525134048/http://english.prescrire.org/en/81/168/46461/0/2010/ArchiveNewsDetails.aspx?page=2 |archive-date=25 May 2012}}</ref> While low blood levels of [[vitamin D]] are correlated with increased cancer risk,<ref name="pmid16595781">{{cite journal |vauthors=Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, Willett WC |title=Prospective study of predictors of vitamin D status and cancer incidence and mortality in men |journal=Journal of the National Cancer Institute |volume=98 |issue=7 |pages=451β59 |date=April 2006 |pmid=16595781 |doi=10.1093/jnci/djj101 |citeseerx=10.1.1.594.1654}}</ref><ref>{{cite web |title=Vitamin D Has Role in Colon Cancer Prevention |url=http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Vitamin_D_Has_Role_in_Colon_Cancer_Prevention.asp |access-date=27 July 2007 |archive-url=https://web.archive.org/web/20061204052746/http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Vitamin_D_Has_Role_in_Colon_Cancer_Prevention.asp |archive-date=4 December 2006 }}</ref><ref>{{cite journal |vauthors=Holick MF |title=Vitamin D, sunlight and cancer connection |journal=Anti-Cancer Agents in Medicinal Chemistry |volume=13 |issue=1 |pages=70β82 |date=January 2013 |pmid=23094923 |doi=10.2174/187152013804487308}}</ref> whether this relationship is causal and vitamin D supplementation is protective is not determined.<ref name="pmid16595770">{{cite journal |vauthors=Schwartz GG, Blot WJ |title=Vitamin D status and cancer incidence and mortality: something new under the sun |journal=Journal of the National Cancer Institute |volume=98 |issue=7 |pages=428β30 |date=April 2006 |pmid=16595770 |doi=10.1093/jnci/djj127|doi-access=free }}</ref><ref name=Futil2014>{{cite journal |vauthors=Bolland MJ, Grey A, Gamble GD, Reid IR |title=The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis |journal=The Lancet. Diabetes & Endocrinology |volume=2 |issue=4 |pages=307β320 |date=April 2014 |pmid=24703049 |doi=10.1016/S2213-8587(13)70212-2}}</ref> One 2014 review found that supplements had no significant effect on cancer risk.<ref name=Futil2014/> Another 2014 review concluded that vitamin D<sub>3</sub> may decrease the risk of death from cancer (one fewer death in 150 people treated over 5 years), but concerns with the quality of the data were noted.<ref>{{cite journal |vauthors=Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C |s2cid=205189615 |title=Vitamin D supplementation for prevention of mortality in adults |journal=The Cochrane Database of Systematic Reviews |volume=1 |issue=1 |pages=CD007470 |date=January 2014 |pmid=24414552 |doi=10.1002/14651858.cd007470.pub3|pmc=11285307 }}</ref> [[Beta-Carotene]] supplementation increases lung cancer rates in those who are high risk.<ref name="pmid21738614">{{cite journal | vauthors = Fritz H, Kennedy D, Fergusson D, Fernandes R, Doucette S, Cooley K, Seely A, Sagar S, Wong R, Seely D | title = Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis | journal = PLOS ONE | volume = 6 | issue = 6 | pages = e21107 | year = 2011 | pmid = 21738614 | pmc = 3124481 | doi = 10.1371/journal.pone.0021107 | bibcode = 2011PLoSO...621107F | veditors = Minna JD | doi-access = free }}</ref> [[Folic acid]] supplementation is not effective in preventing colon cancer and may increase colon polyps.<ref name="pmid17551129">{{cite journal | vauthors = 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 | title = Folic acid for the prevention of colorectal adenomas: a randomized clinical trial | journal = JAMA | volume = 297 | issue = 21 | pages = 2351β2359 | date = June 2007 | pmid = 17551129 | doi = 10.1001/jama.297.21.2351 | doi-access = free }}</ref> Selenium supplementation has not been shown to reduce the risk of cancer.<ref>{{cite journal | vauthors = Vinceti M, Filippini T, Del Giovane C, Dennert G, Zwahlen M, Brinkman M, Zeegers MP, Horneber M, D'Amico R, Crespi CM | title = Selenium for preventing cancer | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD005195 | date = January 2018 | pmid = 29376219 | pmc = 6491296 | doi = 10.1002/14651858.CD005195.pub4 }}</ref>
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