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Female colorectal cancer 19 percent less likely for each additional 10 ng of vitamin D (17 studies) – June 2018

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts

Journal of the National Cancer Institute, https://doi.org/10.1093/jnci/djy087
Marjorie L McCullough Emilie S Zoltick Stephanie J Weinstein Veronika Fedirko Molin Wang Nancy R Cook A Heather Eliassen Anne Zeleniuch-Jacquotte Claudia Agnoli Demetrius JNCI:


Background
Experimental and epidemiological studies suggest a protective role for vitamin D in colorectal carcinogenesis, but evidence is inconclusive. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations that minimize risk are unknown. Current Institute of Medicine (IOM) vitamin D guidance is based solely on bone health.

Methods
We pooled participant-level data from 17 cohorts, comprising 5706 colorectal cancer case participants and 7107 control participants with a wide range of circulating 25(OH)D concentrations. For 30.1% of participants, 25(OH)D was newly measured. Previously measured 25(OH)D was calibrated to the same assay to permit estimating risk by absolute concentrations. Study-specific relative risks (RRs) for prediagnostic season-standardized 25(OH)D concentrations were calculated using conditional logistic regression and pooled using random effects models.

Results
Compared with the lower range of sufficiency for bone health (50–<62.5 nmol/L), deficient 25(OH)D (<30 nmol/L) was associated with 31% higher colorectal cancer risk (RR = 1.31, 95% confidence interval CI = 1.05 to 1.62); 25(OH)D above sufficiency (75–<87.5 and 87.5–<100 nmol/L) was associated with 19% (RR = 0.81, 95% CI = 0.67 to 0.99) and 27% (RR = 0.73, 95% CI = 0.59 to 0.91) lower risk, respectively. At 25(OH)D of 100 nmol/L or greater, risk did not continue to decline and was not statistically significantly reduced (RR = 0.91, 95% CI = 0.67 to 1.24, 3.5% of control participants).
Associations were minimally affected when adjusting for body mass index, physical activity, or other risk factors.
For each 25 nmol/L increment in circulating 25(OH)D, colorectal cancer risk was 19% lower in women (RR = 0.81, 95% CI = 0.75 to 0.87) and 7% lower in men (RR = 0.93, 95% CI = 0.86 to 1.00) (two-sided Pheterogeneity by sex = .008).
Associations were inverse in all subgroups, including colorectal subsite, geographic region, and season of blood collection.

Conclusions
Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non–statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM recommendations.

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Created by admin. Last Modification: Wednesday July 18, 2018 02:45:44 GMT-0000 by admin. (Version 3)

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10206 Colorectal Cancer sci-hub.pdf PDF 2018 admin 18 Jul, 2018 02:45 1,000.51 Kb 152
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