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      The Association of Dietary Intake of Calcium and Vitamin D to Colorectal Cancer Risk among Iranian Population

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          Abstract

          Background:

          Vitamin D and Calcium have a possible protective impact versus rectal neoplasm. Vitamin D, an important nutrient, is vital to regulate the absorption of calcium and bone mineralization; nevertheless, in a case-control study in Iran, we investigated the relationship among the dietary intake of vitamin D and calcium with the hazard of rectal neoplasm.

          Methods:

          363 subjects (162 cases and 201 controls) participated in the case- control Study from March 2017 to November 2018. Dietary intake of Calcium and Vitamin D was calculated using a 148-items food-frequency questionnaire.

          Results:

          Since altering the strong confounding agents, the multivariate risk proportion within the dietary vitamin D intake was OR=0.2, 95%CI 0.1-0.5, P-value <0.001 among cases. There was no association in case of calcium and rectal cancer.

          Conclusions:

          Taken together, a possible reduction in the hazard of rectal neoplasm with dietary intake of Vitamin D within Iranian patients was observed.

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          Calcium plus vitamin D supplementation and the risk of colorectal cancer.

          Jean Wactawski‐Wende, Jane Kotchen, Garnet Anderson … (2006)
          Higher intake of calcium and vitamin D has been associated with a reduced risk of colorectal cancer in epidemiologic studies and polyp recurrence in polyp-prevention trials. However, randomized-trial evidence that calcium with vitamin D supplementation is beneficial in the primary prevention of colorectal cancer is lacking. We conducted a randomized, double-blind, placebo-controlled trial involving 36,282 postmenopausal women from 40 Women's Health Initiative centers: 18,176 women received 500 mg of elemental calcium as calcium carbonate with 200 IU of vitamin D3 [corrected] twice daily (1000 mg of elemental calcium and 400 IU of vitamin D3) and 18,106 received a matching placebo for an average of 7.0 years. The incidence of pathologically confirmed colorectal cancer was the designated secondary outcome. Baseline levels of serum 25-hydroxyvitamin D were assessed in a nested case-control study. The incidence of invasive colorectal cancer did not differ significantly between women assigned to calcium plus vitamin D supplementation and those assigned to placebo (168 and 154 cases; hazard ratio, 1.08; 95 percent confidence interval, 0.86 to 1.34; P=0.51), and the tumor characteristics were similar in the two groups. The frequency of colorectal-cancer screening and abdominal symptoms was similar in the two groups. There were no significant treatment interactions with baseline characteristics. Daily supplementation of calcium with vitamin D for seven years had no effect on the incidence of colorectal cancer among postmenopausal women. The long latency associated with the development of colorectal cancer, along with the seven-year duration of the trial, may have contributed to this null finding. Ongoing follow-up will assess the longer-term effect of this intervention. (ClinicalTrials.gov number, NCT00000611.). Copyright 2006 Massachusetts Medical Society.
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            Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies.

            Peng Zhang, Yanlei Ma, Jianjun Yang … (2011)
            To conduct a systematic review of prospective studies assessing the association of vitamin D intake or blood levels of 25-hydroxyvitamin D [25(OH)D] with the risk of colorectal cancer using meta-analysis. Relevant studies were identified by a search of MEDLINE and EMBASE databases before October 2010 with no restrictions. We included prospective studies that reported relative risk (RR) estimates with 95% CIs for the association between vitamin D intake or blood 25(OH)D levels and the risk of colorectal, colon, or rectal cancer. Approximately 1,000,000 participants from several countries were included in this analysis. Nine studies on vitamin D intake and nine studies on blood 25(OH)D levels were included in the meta-analysis. The pooled RRs of colorectal cancer for the highest versus lowest categories of vitamin D intake and blood 25(OH)D levels were 0.88 (95% CI, 0.80 to 0.96) and 0.67 (95% CI, 0.54 to 0.80), respectively. There was no heterogeneity among studies of vitamin D intake (P = .19) or among studies of blood 25(OH)D levels (P = .96). A 10 ng/mL increment in blood 25(OH)D level conferred an RR of 0.74 (95% CI, 0.63 to 0.89). Vitamin D intake and blood 25(OH)D levels were inversely associated with the risk of colorectal cancer in this meta-analysis.
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              Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies.

              E. Cho, S Smith-Warner, D Spiegelman … (2004)
              Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 individuals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95% confidence intervals (CIs) were calculated. All statistical tests were two-sided. Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake ( or =250 g/day) of milk intake were 0.94 (95% CI = 0.86 to 1.02), 0.88 (95% CI = 0.81 to 0.96), and 0.85 (95% CI = 0.78 to 0.94), respectively (P(trend)<.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95% CI = 0.78 to 0.95; P(trend) =.02) for dietary calcium and 0.78 (95% CI = 0.69 to 0.88; P(trend)<.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (P(trend)<.001) and rectum (P(trend) =.02). Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Asian Pac J Cancer Prev
                Journal ID (iso-abbrev): Asian Pac. J. Cancer Prev
                Journal ID (publisher-id): APJCP
                Title: Asian Pacific Journal of Cancer Prevention : APJCP
                Publisher: West Asia Organization for Cancer Prevention (Iran )
                ISSN (Print): 1513-7368
                ISSN (Electronic): 2476-762X
                Publication date (Print): 2019
                Volume: 20
                Issue: 9
                Pages: 2825-2830
                Affiliations
                [1 ] Gastrointestinal and Liver Diseases Research Center (GILDRC),
                [3 ] Firoozgar Hospital, FCRDC, Iran University of Medical Sciences (IUMS),
                [2 ] Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran,
                [4 ] Noncommunicable Diseases Research Center,
                [5 ] Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran.
                Author notes
                [* ]For Correspondence: zamani.farhad@gmail.com
                Article
                DOI: 10.31557/APJCP.2019.20.9.2825
                PMC ID: 6976838
                PubMed ID: 31554383
                SO-VID: 9866818c-3049-41c8-a693-a855a91512fc
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 July 2019
                Date accepted : 12 September 2019
                Categories
                Subject: Research Article

                Keywords: cancer,vitamin d,calcium,rectal
                Data availability:
                Keywords: cancer, vitamin d, calcium, rectal

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