Selenium and Prostate Cancer: What the SELECT Trial Found

A man in his sixties reading a newspaper in an armchair with tea and a plain supplement bottle

For 2 decades selenium was sold on cancer prevention, and the reasoning came from real epidemiology. Then 1 randomized trial tested it directly.

SELECT found no reduction in prostate cancer risk from either supplement it tested.

Quick Answer: Does Selenium Prevent Prostate Cancer?

No, according to the trial designed to answer that question. The Selenium and Vitamin E Cancer Prevention Trial randomized relatively healthy men to selenium, vitamin E, both or placebo. The 2009 report found no reduction in prostate cancer risk with either supplement, and a statistically nonsignificant increase in risk with vitamin E. Longer follow-up in 2011 examined that vitamin E signal further.

Key Takeaways

  • SELECT was 1 large randomized and placebo-controlled cancer prevention trial.
  • It tested 4 arms: selenium, vitamin E, both, or neither, in healthy men.
  • The 2009 report found 0 reduction in prostate cancer risk.
  • It also found a nonsignificant risk increase in 1 arm, vitamin E.
  • 2 earlier meta-analyses of observational data had suggested a benefit.

Why Anyone Expected a Benefit

SELECT was not a fishing expedition. The reasoning behind it was genuinely strong, which is what makes the result instructive.

  • Source 1: Secondary analyses of 2 earlier randomized trials.
  • Source 2: Supportive epidemiological data.
  • Source 3: Preclinical work on selenium and tumour biology.
  • The question: Could either prevent prostate cancer with little toxicity.

The trial's own framing describes exactly that chain of reasoning.[1]Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT) — JAMA (2009) View source What the mineral does normally is in what selenium is for.

Four identical dishes in a row, each holding two identical capsules

What the Trial Found

The headline is simple and the detail matters.

Arm Result on prostate cancer risk
Selenium alone No reduction
Vitamin E alone No reduction, and a nonsignificant increase
Both together No reduction
Longer follow-up, 2011 The vitamin E signal examined further

The 2011 report set out to determine the relationship with more events and longer follow-up, after the initial finding of a statistically nonsignificant increase in risk with vitamin E.[2]Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT) — JAMA (2011) View source

Why the Observational Data Was Misleading

This is the part worth carrying to every other supplement you consider.

  • What observational studies showed: Lower selenium, more cancer.
  • What that could mean: Selenium protects, or illness lowers selenium.
  • What a trial does: Separates the 2 by randomising.
  • What SELECT concluded: The protection did not appear.

Where the mineral comes from in an ordinary diet is in selenium in food.

Earlier meta-analyses of intake and prostate cancer had reported conflicting results even before the trial ran.[3]Intake of selenium in the prevention of prostate cancer: a systematic review and meta-analysis — Cancer Causes and Control (2006) View source A later pooling described the relationship as inconsistent.[4]The association between Selenium and Prostate Cancer: a Systematic Review and Meta-Analysis — Asian Pacific Journal of Cancer Prevention (2018) View source

Hands with a pen resting on a stack of defocused printed pages

What This Means for Buying Selenium

The trial removed a reason, and it did not remove the mineral's actual role.

  • Removed: Cancer prevention as a reason to supplement.
  • Unchanged: Its role in thyroid hormone conversion.
  • Unchanged: That deficiency is a real thing in some regions.
  • Reinforced: That more is not better with this mineral.

The thyroid question is separate and still contested, and it sits in the thyroid evidence.

What We Will Not Say

Given a trial this size reached this result, some claims are simply off the table here.

  • We will not say: That selenium prevents cancer of any kind.
  • We will not say: That SELECT was flawed enough to ignore.
  • We will say: It is an essential mineral with a real role.
  • We will say: The upper limit matters more than the benefit.

Sold on those terms, our selenium capsule is a measured 200 mcg of an essential trace mineral.

Speak to a Clinician Before Taking Selenium If

  • You already eat Brazil nuts most days, which alone can exceed the upper limit
  • You take more than 1 supplement containing selenium, including a multivitamin
  • You have hair loss, brittle nails or a garlic-like breath odour while supplementing
  • You have thyroid disease and are considering selenium alongside levothyroxine
  • You are pregnant, where the upper limit matters more and the margin is smaller
A man in a shop aisle reading the back of a plain supplement bottle

Frequently Asked Questions

Does selenium prevent prostate cancer? +

No. SELECT randomized healthy men and found 0 reduction in prostate cancer risk from selenium.

What was the SELECT trial? +

1 randomized, placebo-controlled prevention trial testing selenium, vitamin E, both or neither in relatively healthy men.

Why was SELECT stopped? +

Because it was not showing benefit, and 1 arm, vitamin E, showed a nonsignificant increase in prostate cancer risk in the 2009 report.

Did vitamin E increase cancer risk? +

The 2009 report found a statistically nonsignificant increase. The 2011 follow-up examined that signal with more events.

Why did earlier studies suggest a benefit? +

They were observational, so 2 explanations fit the same data: selenium protects, or illness lowers selenium.

Should I stop taking selenium because of SELECT? +

It removed 1 reason to take it, cancer prevention. It did not change its role in thyroid hormone conversion.

Does selenium prevent any other cancer? +

SELECT looked at prostate cancer and other cancers. 0 prevention benefit was demonstrated for the supplement arms.

Is selenium bad for you then? +

No. It is an essential mineral, and the practical issue is the narrow 55 to 400 mcg window rather than harm at normal intakes.

What does this mean for supplements generally? +

That observational data and randomized trials can disagree. SELECT is 1 of the clearest examples of that in nutrition.

Related Reading