Circulating 25-hydroxyvitamin D up to 3 decades prior to diagnosis in relation to overall and organ-specific cancer survival

Abstract

While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. We examined the accepted biomarker of vitamin D status, serum 25-hydroxyvitamin D [25(OH)D], and cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up and 1732 survived or died of other causes. Proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnostic 25(OH)D and overall and site-specific survival. Serum 25(OH)D was significantly lower among cases who subsequently died from their malignancy compared with those who did not (medians 34.7 vs. 36.5 nmol/L, respectively; p = 0.01). Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76, 95% CI 0.67-0.85 for highest vs. lowest quintile, p-trend < 0.0001). Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74, 95% CI 0.55-1.01, p-trend = 0.005), kidney (HR = 0.59, 95% CI 0.35-0.98, p-trend = 0.28), and melanoma (HR = 0.39, 95% CI 0.20-0.78, p-trend = 0.01), but increased mortality from lung cancer (HR = 1.28, 95% CI 1.02-1.61, p-trend = 0.19). Improved survival was also suggested for head and neck, gastric, pancreatic, and liver cancers, though not statistically significantly, and case numbers for the latter two organ sites were small. Higher 25(OH)D status years prior to diagnosis was related to improved survival for overall and some site-specific cancers, associations that should be examined in other prospective populations that include women and other racial-ethnic groups.

Serum Bioavailable, Rather Than Total, 25‐hydroxyvitamin D Levels Are Associated With Hepatocellular Carcinoma Survival

“…(13) The other study using data from 206 Finnish male smokers, who received a diagnosis of liver cancer during the follow-up of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, showed a suggestive improvement in LCSS among participants with higher total 25OHD levels up to 28 years before cancer diagnosis, albeit not statistically significant. (12) Of note, the existing studies were both carried out in European populations living at latitudes higher than 50°N. As opposed to the aforementioned studies, no significant associations of serum total 25OHD with either LCSS or OS were observed in our study population.…”

“…(10) However, evidence linking vitamin D status to organ-specific cancer survival is sparse and has produced conflicting results between and within types of cancers. (10)(11)(12) Specific to liver cancer, few studies have been conducted. (12,13) The total 25-hydroxyvitamin D (25OHD) level in serum or plasma is used currently to assess vitamin D status in routine clinical practice.…”

“…(10)(11)(12) Specific to liver cancer, few studies have been conducted. (12,13) The total 25-hydroxyvitamin D (25OHD) level in serum or plasma is used currently to assess vitamin D status in routine clinical practice. (14) Circulating 25OHD exists in three forms: (1) about 85%-90% is tightly bound to vitamin D-binding protein (DBP); (2) approximately 10%-15% is loosely bound to albumin; and (3) less than 0.03% is unbound and free.…”

Mikronährstoffe in der Onkologie: Risiko und Nutzen – Update 2020

“…Bei Lungenkarzinomen hingegen war das Risiko erhöht. Für Kopf-Hals-Tumoren, Magen-, Pankreas-und Leberkarzinome zeigte sich eine Tendenz, aber keine statistische Signifikanz für ein besseres Überleben [71].…”

Competing mortality risks analysis of prediagnostic lifestyle and dietary factors in colorectal cancer survival: the Norwegian Women and Cancer Study

“…However, there is still variability in the survival among people with similar stages of CRC and similar access to healthcare,7 which may be due to variations in lifestyle and dietary habits before and/or after CRC diagnosis 6–9. For instance, vitamin D status as much as three decades prior to diagnosis has been shown to be related to survival among patients with some organ-specific cancers 10. A recent review of the literature concluded that both prediagnostic and postdiagnostic lifestyle factors, including physical activity, obesity, and dietary habits, may play a critical role in improving CRC survival 8…”