Cancer with low Vitamin D increases Mortality by 13 percent – meta-analysis Feb 2019

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Vitamin D Supplements and Total Cancer Incidence and Mortality: a Meta-analysis - Feb 2019

Ann Oncol. 2019 Feb 22. pii: mdz059. doi: 10.1093/annonc/mdz059.
Keum N1,2, Lee DH1, Greenwood DC3, Manson JE4,5, Giovannucci E1,4,5.
1 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, U.S.A.
2 Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea.
3 Division of Biostatistics, University of Leeds, Leeds, UK.
4 Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, U.S.A.
5 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, U.S.A.

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BACKGROUND:
Previous meta-analyses of randomized controlled trials (RCTs) of vitamin D supplementation and total cancer incidence and mortality found inconsistent results, and most included trials administered generally low doses of vitamin D (≤ 1100 IU/day). We updated the meta-analysis by incorporating recent RCTs that have tested higher doses of vitamin D supplements.

MATERIALS AND METHODS:
PubMed and Embase were searched from the inception to November, 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a random-effects model.

RESULTS:
For total cancer incidence, 10 trials were included (6,547 cases; 3-10 years of follow-up; 54-135 nmol/L of attained levels of circulating 25(OH)vitamin D [25(OH)D] in the intervention group). The summary RR was 0.98 (95% CI, 0.93 to 1.03; P=.42; I2=0%). The results remained null across subgroups tested, including even when attained 25(OH)D levels exceeded 100 nmol/L (RR, 0.95; 95% CI, 0.83 to 1.09; P=.48; I2=26%).
For total cancer mortality, 5 trials were included (1,591 deaths; 3-10 years of follow-up; 54-135 nmol/L of attained levels of circulating 25(OH)D in the intervention group). The summary RR was 0.87 (95% CI, 0.79 to 0.96; P=.005; I2=0%), which was largely attributable to interventions with daily dosing (as opposed to infrequent bolus dosing). No statistically significant heterogeneity was observed by attained levels of circulating 25(OH)D (Pheterogeneity=.83), with RR being 0.88 (95% CI, 0.78 to 0.98; P=.02; I2=0%) for ≤ 100 nmol/L and 0.85 (95% CI, 0.70-1.03; P=.11; I2=0%) for > 100 nmol/L.

CONCLUSIONS:
In an updated meta-analysis of RCTs, vitamin D supplementation significantly reduced total cancer mortality but did not reduce total cancer incidence.

This study was presented as a poster in June 2019
People supplemented with Vitamin D had 13 percent fewer Cancer deaths – Meta-analysis of RCT June 2019

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If >28 ng of Vitamin D before Cancer diagnosis 2X more likely to survive - Feb 2019

Pre-diagnostic 25-hydroxyvitamin D levels and survival in cancer patients
Cancer Causes Control. 2019 Feb 25. doi: 10.1007/s10552-019-01143-9
Torfadottir JE1,2, Aspelund T3,4, Valdimarsdottir UA3,5,6, Cotch MF7, Tryggvadottir L8,9, Harris TB10, Gudnason V4,9, Adami HO6,11, Mucci LA5,12, Giovannucci EL5,12, Stampfer MJ5,12, Steingrimsdottir L13.

PURPOSE:
Our main aim was to explore whether pre-diagnostic circulating levels of 25-hydroxyvitamin D (25(OH)D) among older individuals with cancer were associated with overall and cancer-specific survival after diagnosis.

DESIGN:
We used data from the Reykjavik-AGES Study on participants (n = 4,619) without cancer at entry, when blood samples were taken for 25(OH)D standardized measurements. The association with cancer risk, all-cause- and cancer-specific mortality was assessed among those later diagnosed with cancer, comparing four 25(OH)D categories, using 50-69.9 nmol/L as the reference category.

RESULTS:
Cancer was diagnosed in 919 participants on average 8.3 years after blood draw. No association was observed between the reference group and other 25(OH)D groups and total cancer incidence. Mean age at diagnosis was 80.9 (± 5.7) years. Of those diagnosed, 552 died during follow-up, 67% from cancer. Low pre-diagnostic levels of 25(OH)D < 30 nmol/L were significantly associated with increased total mortality (HR: 1.39, 95% CI 1.03, 1.88) and non-significantly with cancer-specific mortality (HR: 1.33, 95% CI 0.93, 1.90).
Among patients surviving more than 2 years after diagnosis, higher pre-diagnostic 25(OH)D levels (≥ 70 nmol/L) were associated with lower risk of overall (HR: 0.68, 95% CI 0.46, 0.99) and cancer-specific mortality (HR: 0.47, 95% CI 0.26, 0.99).

CONCLUSIONS:Among elderly cancer patients, low pre-diagnostic serum 25(OH)D levels (< 30 nmol/L) were associated with increased overall mortality.