Dose-response of serum 25-hydroxyvitamin D in association with risk of colorectal cancer: A meta-analysis
The Journal of Steroid Biochemistry and Molecular Biology, Volume 168, April 2017, Pages 1–8, http://dx.doi.org/10.1016/j.jsbmb.2016.12.003
Cedric F. Garlanda, 1, ,email@example.com , Edward D. Gorhamb, 1
• Fifteen studies were performed in 14 countries.
• 50 ng/ml 25(OH)D level was associated with a 60% lower risk of colorectal cancer.
• 30 ng/ml 25(OH)D level was associated with a 33% lower risk of colorectal cancer.
• Target 25(OH)D ≥50 ng/ml would be desirable for prevention of colorectal cancer.
All Meta-analyses of many studies of COLON Cancer and Vitamin D are listed here:
- Colorectal cancer 60 percent less likely if have more than 50 ng of vitamin D (vs 5 ng) – meta-analysis April 2017
- Colorectal cancer 60 percent less likely: high vs low Vitamin D level – meta-analysis Dec 2016
- Colorectal Cancer recurrence not prevented by 1,000 IU of vitamin D – meta-analysis Dec 2016
- Risk of Cancer increased due to Vitamin D Receptor – meta-analysis of 73 studies Jan 2016
- Colon cancer 30 percent more likely if low vitamin D – 12th meta-analysis Aug 2015
- Colon cancer risk reduced by many vitamins – 13 percent reduction by Vitamin D – meta-analysis Jan 2015
- Cancer (colon, breast, lymph) survival about 2X better with high level vitamin D – meta-analysis July 2014
- Cancer survival 4 percent more likely with just a little more vitamin D (4 ng) - meta-analysis July 2014
- Colorectal and Breast Cancer – Vitamin D is associated with fewer deaths – meta-analysis Feb 2014
- 10 percent of colon cancer linked to Vitamin D Receptor – meta-analysis April 2012
- Meta-graphs of vitamin D and Cancer – Dec 2011
- Colon cancer probability increases with decreased vitamin D – Meta-analysis July 2011
- Non-cancer colon growths 7 percent less likely with each 10 ng increase in vitamin D – Oct 2011
- Colorectal cancer 26 percent less likely for every 10 ng of vitamin D – meta-analysis Aug 2011
- Colon polyps reduced 15 percent by increasing vitamin D by 20 ng – meta-analysis June 2011
- Meta-analysis of 3 cancers - 10 ng more vitamin D decrease colorectal by 15 percent– May 2010
- Meta-analysis found vitamin D association with colon but not prostate nor breast cancer May 2010
Fifteen nested case-control or cohort studies in 14 countries have examined the association between serum 25-hydroxyvitamin D [25(OH)D] and risk of colorectal cancer. A meta-analysis of these studies would provide a useful dose-response gradient curve based on pooling of the results of known studies to date. An up-to-date dose-response curve that combines the findings of these studies has not been reported, to our knowledge. This curve would help in designing interventions for future studies. A new meta-analysis would be more precise than any previous analysis due to its larger sample size. Therefore a search of PubMed and other resources was performed in May 2016 for all cohort or nested case-control observational studies that reported risk of colon or colorectal cancer by quantiles of 25(OH)D.
All but two of the 15 studies found a trend toward lower risk of colorectal cancer associated with higher serum 25(OH)D. There was a linear reduction in the odds ratio (OR) with each 10 ng/ml-increment in 25(OH)D concentration. The lowest quantile of the serum 25(OH)D concentration was generally < 20 ng/ml. The downward trend in ORs associated with higher serum 25(OH)D concentrations was statistically significant in 3 studies. The pooled OR from all studies comparing highest with lowest quantile of 25(OH)D was 0.67 (95% confidence interval [CI], 0.59–0.76), meaning there was a 33% lower risk associated with the highest compared with the lowest quantile of serum 25(OH)D.
A dose-response analysis revealed that a serum 25(OH)D of 50 ng/ml was associated with an OR of 0.4 (95% CI, 0.2–1.0) compared with a concentration of 5 ng/ml.
The formula for the linear relationship was OR = 0.008x. For example, individuals with a 25(OH)D concentration of 50 ng/ml had an approximately 60% lower risk of colorectal cancer than those with a concentration of 5 ng/ml. Those with a 25(OH)D concentration of 30 ng/ml had a 33% lower risk than those with a concentration of 5 ng/ml. The inverse association between serum 25(OH)D and risk of colorectal cancer overall was strong and statistically significant. There also was a mostly linear dose response relationship between serum 25(OH)D and risk of colorectal cancer when all studies were combined. No study reported significant adverse effects, and there was no evidence of publication bias. Misclassification in some studies could have influenced the association, causing it to appear weaker than the true association.
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