The Impacts of Circulating 25-Hydroxyvitamin D Levels on Cancer Patient Outcomes: A Systematic Review and Meta-Analysis.
J Clin Endocrinol Metab. 2014 Apr 29:jc20134320.
Li M1, Chen P, Li J, Chu R, Xie D, Wang H.
1Key Laboratory of Food Safety Research (M.L., P.C., J.L., R.C., D.X., H.W.), Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of the Chinese Academy of Sciences, Shanghai 200031, China; Key Laboratory of Food Safety Risk Assessment (D.X., H.W.), Ministry of Health, Beijing 100021, China; and School of Life Science and Technology (D.X., H.W.), Shanghai Tech University, Shanghai, 200031, China.
Context: Circulating levels of 25-hydroxyvitamin D [25(OH)D] may affect the prognosis of cancer patients; however, the epidemiological results are not consistent.
Objective: To perform a meta-analysis of all published studies to assess the associations of circulating 25(OH)D levels measured at or near the time of diagnosis and outcomes for cancer patients.
Data Sources: Searches of the PubMed and MEDLINE databases were performed and updated to December 2013. Study Selection: Studies reporting an association between circulating 25(OH)D levels at or near the time of diagnosis and outcomes for the patients were included. Data Extraction: Data extraction was performed independently by two authors, and conflicts were resolved by a third investigator.
Data Synthesis: Included in the meta-analysis were 25 studies with 17 332 cases. Significant associations between circulating 25(OH)D levels at or near the time of diagnosis and the outcomes for cancer patients were found. The pooled hazard ratio for the highest vs the lowest quartile of circulating 25(OH)D levels was
- 0.55 (95% confidence interval [CI] = 0.33-0.91) for overall survival of colorectal cancer patients,
- 0.63 (95% CI = 0.51-0.77) for breast cancer patients, and
- 0.48 (95% CI = 0.36-0.64) for lymphoma patients.
Higher 25(OH)D levels were significantly associated with reduced cancer-specific mortality for patients with colorectal cancer (P = .005) and lymphoma (P < .001) and improved disease-free survival for patients with breast cancer (P < .001) or lymphoma (P < .05). A 10-nmol/L increment in circulating 25(OH)D levels conferred a hazard ratio of 0.96 (95% CI = 0.95-0.97) for overall survival of the cancer patients.
Conclusions: The results indicate that cancer patients with higher circulating 25(OH)D levels at or near the time of diagnosis have better outcomes.
Press Release April 29, 2014 Endocine Society
25 studies measured vitamin D levels at time of cancer diagnosis
Strongest association: breast cancer, lymphoma and colorectal cancer.
Less strong association: lung cancer, gastric cancer, prostate cancer, leukemia, melanoma or Merkel cell carcinoma,
"The Impacts of Circulating 25-Hydroxyvitamin D Levels on Cancer Patient Outcomes: A Systematic Review and Meta-Analysis,"
is scheduled to appear in the July issue of JCEM.
- Death due to breast cancer reduced 40 percent if high vitamin D – meta-analysis April 2014
- Vitamin D reduces risk of cause specific death, unless it is D2 – meta-analysis BMJ April 2014
- Colorectal and Breast Cancer – Vitamin D is associated with fewer deaths – meta-analysis Feb 2014
- Death of women from cancer 24% less likely if 20 ng more vitamin D – meta-analysis Sept 2013 very similar to current study of 4% per 4 ng
- Proof that Vitamin D Works 43 proofs as of April 2014: Vitamin D is more than association!
2 of the Random Controlled Trials showed less Cancer in those who happened to get the vitamin D
- Overview Cancer and vitamin D has the following chart
Previous graph overlaid with the slope shown in meta-analysis
Note: the base data is for INCIDENCE and the red arrow is for SURVIVAL