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The primary outcome was esophageal\/gastric cardia cancer mortality. The data were analyzed with Cox proportional hazards regression models. Subgroup analyses were performed by common characteristics such as age and gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cumulative total mortality was 83.5%. Multivitamin supplementation did not affect total or cause\u2010specific mortality in the participants as a whole (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.89\u20131.03). Subgroup analyses showed that no association between multivitamin supplementation and all\u2010cause mortality was observed in men (HR, 0.90; 95% CI, 0.81\u20131.01), women (HR, 1.01; 95% CI, 0.91\u20131.12), younger participants (HR, 0.97; 95% CI, 0.87\u20131.08), or older participants (HR, 0.94; 95% CI, 0.85\u20131.04). Significant reductions in heart disease mortality (HR, 0.64; 95% CI, 0.47\u20130.87) and cerebrovascular disease mortality (HR, 0.74; 95% CI, 0.56\u20131.00) were seen in older men. In a subgroup of younger men and a subgroup of moderate or severe dysplasia, subjects receiving multivitamin supplementation had a lower risk of esophageal\/cardia cancer mortality (HR for younger men, 0.76; 95% CI, 0.58\u20130.99; HR for moderate or severe dysplasia, 0.76; 95% CI, 0.58\u20131.00). No association between multivitamin supplementation and any cause\u2010specific mortality was observed in a mild dysplasia population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Multivitamin supplementation in a population with esophageal squamous dysplasia was not associated with the risk of total mortality in the 35\u2010year follow\u2010up of this randomized controlled trial. In light of this and previous trials, multivitamin supplements should be used thoughtfully to improve health status of populations with esophageal squamous dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Multivitamin supplementation is common, yet its effect on mortality is unclear.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The aim of this study was to update the long\u2010term effects of multivitamin supplementation on total and cause\u2010specific mortality during nearly 35\u2009years of follow\u2010up in the Linxian Dysplasia Nutrition Intervention Trial in China.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Multivitamin supplementation in a population with esophageal squamous dysplasia was not associated with the risk of total mortality in the 35\u2010year follow\u2010up of this randomized controlled trial, and this indicates that multivitamin supplements should be used thoughtfully to improve health status.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34344","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T04:06:33Z","timestamp":1654574793000},"page":"2939-2948","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality after multivitamin supplementation: Nearly 35\u2010year follow\u2010up of the randomized Linxian Dysplasia Nutrition Intervention Trial"],"prefix":"10.1002","volume":"128","author":[{"given":"Jin\u2010Hu","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Cancer Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing 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