Low levels of vitamin D is associated with increased cancer risk and vice
versa. The full study is available also.
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Journal of the National Cancer Institute, Vol. 98, No. 7, 451-459, April 5,
2006
Prospective Study of Predictors of Vitamin D Status and Cancer Incidence and
Mortality in Men
Edward Giovannucci, Yan Liu, Eric B. Rimm, Bruce W. Hollis, Charles S.
Fuchs, Meir J. Stampfer, Walter C. Willett
Affiliations of authors: Channing Laboratory, Department of Medicine,
Harvard Medical School and Brigham and Women's Hospital, Boston, MA (EG,
EBR, CSF, MJS, WCW); Department of Nutrition (EG, YL, EBR, MJS, WCW),
Department of Epidemiology (EG, EBR, MJS, WCW), Harvard School of Public
Health, Boston, MA; Department of Pediatrics, Medical University of South
Carolina, Charleston, SC (BWH); Department of Adult Oncology, Dana-Farber
Cancer Institute, Boston, MA (CSF)
Correspondence to: Edward Giovannucci, MD, ScD, Harvard School of Public
Health, 665 Huntington Ave., Boston, MA 02115 (e-mail:
[email hidden]).
Background: Vitamin D has potent anticancer properties, especially against
digestive-system cancers. Many human studies have used geographic residence
as a marker of solar ultraviolet B and hence vitamin D exposure. Here, we
considered multiple determinants of vitamin D exposure (dietary and
supplementary vitamin D, skin pigmentation, adiposity, geographic residence,
and leisure-time physical activity-to estimate sunlight exposure) in
relation to cancer risk in the Health Professionals Follow-Up Study.
Methods: Among 1095 men of this cohort, we quantified the relation of these
six determinants to plasma 25-hydroxy-vitamin D [25(OH)D] level by use of a
multiple linear regression model. We used results from the model to compute
a predicted 25(OH)D level for each of 47 800 men in the cohort based on
these characteristics. We then prospectively examined this variable in
relation to cancer risk with multivariable Cox proportional hazards models.
Results: From 1986 through January 31, 2000, we documented 4286 incident
cancers (excluding organ-confined prostate cancer and nonmelanoma skin
cancer) and 2025 deaths from cancer. From multivariable models, an increment
of 25 nmol/L in predicted 25(OH)D level was associated with a 17% reduction
in total cancer incidence (multivariable relative risk [RR] = 0.83, 95%
confidence interval [CI] = 0.74 to 0.92), a 29% reduction in total cancer
mortality (RR = 0.71, 95% CI = 0.60 to 0.83), and a 45% reduction in
digestive-system cancer mortality (RR = 0.55, 95% CI = 0.41 to 0.74). The
absolute annual rate of total cancer was 758 per 100 000 men in the bottom
decile of predicted 25(OH)D and 674 per 100 000 men for the top decile;
these respective rates were 326 per 100 000 and 277 per 100 000 for total
cancer mortality and 128 per 100 000 and 78 per 100 000 for digestive-system
cancer mortality. Results were similar when we controlled further for body
mass index or physical activity level. Conclusions: Low levels of vitamin D
may be associated with increased cancer incidence and mortality in men,
particularly for digestive-system cancers. The vitamin D supplementation
necessary to achieve a 25(OH)D increment of 25 nmol/L may be at least 1500
IU/day.
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Juhana