Selenium and cancer prevention: observations and complexity.

Early case-control and intervention studies suggested that selenium (Se) species might reduce the risk of cancer and in a pre-diagnostic case-control study from 1986 [1] we found that the higher the serum Se concentration, the lower was the odds ratio of thyroid cancer. Our data showed, however, that this observation occurred late in the pre-diagnostic period indicating that low serum Se was simply a consequence of thyroid cancer. In 1986 we therefore concluded that the only way to get an indisputable and lasting answer to the question was to carry out properly designed intervention studies. Great was our frustration therefore when we in 2003 [2] discovered that thyroid cancer morbidity is a fractal variable powered by such complexity that we may never find a definite and enduring answer: Even the best, randomised, controlled trial comparing the incidence rate among exposed and controls can only produce temporary answers due to the complexity background. The only possible way to come up with a lasting solution seems to be by means of reductionist experiments, but they have to be tested on man and then one is back to square one.