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Back to Cancer

Vitamin D and Cancer

The Evidence

In 2009, a major systematic review of the evidence concluded the following regarding vitamin D and cancer:1

Cancer from all causes

  • Two randomized controlled trials and one analysis of the NHANES database (two publications) evaluated this association;
  • Both randomized controlled trials were conducted in older adults (one trial with postmenopausal women and one with people > 70 years). They found no significant effects for vitamin D supplementation on cancer (≈1500 mg/d or 100,000 IU every 4 months);
  • Analyses of NHANES III showed no significant association between baseline serum 25(OH)D concentrations and total cancer mortality.

Prostate cancer

  • Twelve nested case-control studies evaluated the association of baseline serum 25(OH)D concentrations and prostate cancer risk. No eligible randomized controlled trials were identified;
  • Eight of the twelve studies found no statistically significant dose-response relationship between serum 25(OH)D concentrations and the risk of prostate cancer;
  • One study found a significant association between lower baseline serum 25(OH)D concentrations (< 30 nmol/L compared to > 55 nmol/L) and higher risk of prostate cancer;
  • Another study suggested the possibility of a U-shaped association between baseline serum 25(OH)D concentrations and the risk of prostate cancer (i.e., lower and higher serum 25(OH)D concentrations were associated with an increased risk of prostate cancer, while the concentrations in between were associated with a decreased risk).

Breast cancer

  • One cohort study compared serum 25(OH)D concentrations and the risk of breast cancer mortality, and two nested case-control studies compared 25(OH)D concentrations and the incidence of breast cancer;
  • The NHANES III analysis reported a significant decrease in breast cancer mortality during 9 years of follow-up in those with a baseline serum 25(OH)D concentration > 62 nmol/L. However, during 7 to 12 years of follow-up, the nested case-control studies found no significant relationship between serum 25(OH)D concentration and risk of breast cancer diagnosis in either pre- or postmenopausal women

Colorectal cancer

  • One randomized controlled trial, one cohort study, and seven nested case-control studies evaluated the association between vitamin D exposure and colorectal cancer;
  • The randomized controlled trial, conducted on elderly individuals, reported no significant difference in colorectal cancer incidence or mortality with or without vitamin D3 supplements over 5 years of follow-up;
  • Most nested case-control studies found no significant associations between serum 25(OH)D concentrations and risk of colorectal cancer incidence or mortality. However, two of the three nested case-control studies in women found statistically significant trends between higher serum 25(OH)D concentrations and lower risk of colorectal cancer, but no individual quantile of serum 25(OH)D concentration had a significantly increased risk of colorectal cancer (compared to the reference quantile);
  • The cohort study on women also suggested an association between higher serum 25(OH)D concentrations (> 50 nmol/L) and lower risk of colorectal cancer mortality;
  • The studies on men or both sexes, and on specific cancers, did not consistently find associations.

Pancreatic cancer

  • Two nested case-control studies evaluated the association of serum 25(OH)D concentrations and pancreatic cancer. No relevant randomized controlled trials were identified;
  • One study of male smokers found a statistically significant relationship between increased serum 25(OH)D concentrations (> 65.5 vs. < 32 nmol/L) and higher risk for pancreatic cancer. A sub-analysis of the second study found an increased risk of pancreatic cancer among study participants with higher 25(OH)D concentrations (> 78.4 nmol/L) compared to those with lower concentrations (< 49.3 nmol/L), only in those living in residential areas with low UVB exposure.

Another systematic review of the evidence examined the burden of disease due to vitamin D deficiency in Canada and how this could change if the mean serum 25(OH)D concentration of Canadians were increased from 67 to 105 nmol/L, a value that would ensure that over half of the population has levels in the optimal range. This review found the following with respect to vitamin D and cancer:2

  • Increasing serum 25(OH)D concentration from about 75 to 105 nmol/L would reduce incidence rates of all cancers by about 25% (15–35%).

Learn more on the subject:

References

  1. Tufts Evidence-based Practice Center. Vitamin D and Calcium: A Systematic Review of Health Outcomes. Prepared for: Agency for Healthcare Research and Quality, 2009.
  2. Grant WB et al. An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada. Mo Nutr Food Res 2010;54(8):1172–81.

Keywords: cancer , vitamin D


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