Serum 25-Hydroxyvitamin D and Cancer Risk in Older Adults: Results from a Large German Prospective Cohort Study

Abstract

Background: Several observational studies assessed the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of cancer but results were inconclusive.Methods: We measured 25(OH)D concentrations in a population-based cohort study of 9,949 men and women ages 50 to 74 years in Saarland, Germany. Comprehensively adjusted Cox regression models were applied to estimate HRs and 95% confidence intervals (CI) for the association between season-standardized 25 (OH)D concentrations and total and site-specific cancer incidence.Results: Overall, during a median of 8 years of follow-up, 873 subjects developed cancer; the most common being prostate (171), breast (137), lung (136), and colorectal (136) cancer. Low season-standardized 25(OH)D (<30, 35, 40, or 36 nmol/L in winter, spring, summer, and autumn, respectively) was neither significantly associated with total cancer incidence (HR, 1.10; 95% CI, 0.93-1.30) nor with site-specific cancer incidence. However, a significantly increased overall cancer risk was observed for low 25(OH)D among men, nonobese subjects and subjects reporting low fish consumption and for high 25(OH)D in nonsmokers and nonobese subjects. Accordingly, restricted cubic splines to investigate dose-response relationships curves showed an inverse association of 25(OH)D levels and total cancer risk in men but not in women.Conclusions: 25(OH)D concentrations were significantly associated with overall cancer incidence in subgroups of this large cohort from Germany. No significant association was observed with site-specific cancers but this could be due to a limited statistical power for these endpoints.Impact: Further research should clarify whether and to what extent specific risk groups might profit from vitamin D supplementation. Cancer Epidemiol Biomarkers Prev; 22(5); 905-16. Ó2013 AACR.

Levels of Serum 25-Hydroxy-Vitamin D in Benign and Malignant Breast Masses

“…There were 873 cases of cancer, 137 of them in the breast. Vitamin levels were lower in all cancers but not in site-specific tumors (Ordonez-Mena et al, 2013).…”

“…Again, results of 2 more recent large cohorts were against any association (Chlebowski et al, 2011). Ordonez-Mena et al (2013) followed 9949 people for eight years after the measurement of vitamin D levels in their sera. There were 873 cases of cancer, 137 of them in the breast.…”

Prospective Population-Based Study of the Association between Serum 25-Hydroxyvitamin-D Levels and the Incidence of Specific Types of Cancer

“…Ordonez-Mena and colleagues found no statistically significant association between vitamin D status and the incidence of total cancer in a general German population cohort, except in subgroup analyses (23). Thus, there was a significantly increased overall cancer risk for low vitamin D status among men, the non-obese, and individuals reporting low fish consumption, and for high vitamin D status among non-smokers and non-obese individuals (23).…”

Circulating Vitamin D Levels and Risk of Colorectal Cancer in Women

“…(32) Another recent meta-analysis review of 5 large prospective studies (including NHS and WHI(14)) has shown that 25(OH)D ≥ 33 ng/mL had a 51% reduction in risk of CRC compared to those with ≤ 12 ng/mL). (33) Prospective data on vitamin D status and total cancer remain limited(8, 34, 35) Yet, prospective observational studies of plasma 25(OH)D levels generally support an inverse association with risk of neoplasia. (32, 33, 36–44)…”