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      Vitamin D3 Intake Dose and Common Cancer: A Population-Based Case Control Study in a Chinese Population

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          Abstract

          Objectives: Epidemiological studies suggest that vitamin D status is associated inversely with risk of common cancers in western populations. This study aimed to investigate whether vitamin D is associated with risk of common cancers in Chinese population.

          Methods: A population-based retrospective case-control study was conducted analyzing data retrieved from the Catastrophic Illness Patient Databases (CIPD) and longitudinal health insurance database (LHID) from January 1, 2010 to December 31, 2011and January 1, 2000 to December 31, 2011, respectively. Cases were identified as subjects diagnosed with site-specific cancers (International Classification of Diseases, Ninth Revision,) and frequency matched to select controls. Use of vitamin D3 was compared between two groups. Odds ratios (ORs) were employed to quantify the risk associated with exposure to vitamin D3 by logistic regression.

          Results: There were 1.21% (1961/161806) patients in cases and 0.67 % (1092/161806) patients in controls identified were vitamin D3 users. Overall risk of cancers associated with vitamin D3 users was 1.67 (95% CI:1.55 -1.81). Among these, the risk of kidney cancer and bladder cancer associated with intakes of vitamin D3 were significant (OR 2.59; 95% CI 1.81-3.70; OR 4.97; 95% CI 4.40-5.60) in an adjusted model. In further stratification analysis, we found a statistically significant risk of bladder cancer associated with high intake of vitamin D3. Except this, no statistically significant risk of other site-specific cancers associated with high intake of vitamin D3.

          Conclusion: Except bladder cancer in stratification analysis, we observed no statistically significant association between high intake of vitamin D3 and other site-specific cancers.

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          World Health Organization.

          Ala Alwan (2007)
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            Meta-analysis of observational studies of serum 25-hydroxyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma.

            Sara Gandini, Mary Jane Sneyd, Philippe Autier … (2011)
            Epidemiological studies have suggested a reduced risk of several cancers associated with high vitamin D status. We performed a systematic review with meta-analyses of observational studies of serum 25-hydroxyvitamin D level and colorectal, breast and prostate cancer and colonic adenoma. The literature of December 2009 was searched without language restriction. The meta-regression analysis was done to compute dose-response effects. Because in case-control studies, serum 25-hydroxyvitamin D level is measured after the diagnosis of cancer, separate analyses for case-control and prospective studies were done. We identified 35 independent studies. The seven studies on colorectal adenomas were heterogeneous in terms of endpoint and control for major confounding factors, and we did not perform a meta-analysis of these data. The summary relative risk (SRR) and (95% confidence interval) for a 10 ng/ml increase in serum 25-hydroxyvitamin D was 0.85 (0.79; 0.91) for colorectal cancer (2,630 cases in 9 studies); 0.89 (0.81;0.98) for breast cancer (6,175 cases in 10 studies); and 0.99 (0.95;1.03) for prostate cancer (3,956 cases in 11 studies). For breast cancer, case-control studies (3,030 cases) had major limitations and obtained SRR of 0.83 (0.79; 0.87) whereas SRR of prospective studies (3,145 cases) was 0.97 (0.92; 1.03). For colorectal and breast cancer, differences between cases and controls in the season of blood draw or in overweight/obesity or physical inactivity could not explain the results. In conclusion, a consistent inverse relationship between serum 25-hydroxyvitamin D levels and colorectal cancer was found. No association was found for breast and prostate cancer. Copyright © 2010 UICC.
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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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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cancer
                Journal ID (iso-abbrev): J Cancer
                Journal ID (publisher-id): jca
                Title: Journal of Cancer
                Publisher: Ivyspring International Publisher (Sydney )
                ISSN (Electronic): 1837-9664
                Publication date Collection: 2016
                Publication date (Electronic): 21 October 2016
                Volume: 7
                Issue: 14
                Pages: 2028-2034
                Affiliations
                [1 ]Department of Radiation Therapy, An-Nan Hospital, China Medical University, Tainan, Taiwan;
                [2 ]Department of Nursing, Min-Hwei College of Health Care management, Tainan City 736, Taiwan;
                [3 ]Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan;
                [4 ]Department of Information Management, Chia Nan University of Pharmacy & Science, Tainan City 71710, Taiwan;
                [5 ]Department of Pharmacy, An-Nan Hospital, China Medical University, Tainan, Taiwan.
                Author notes
                ✉ Corresponding authors: Agnes LF Chan, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, Taiwan. Tel: +886-6-3553111, e-mail: agnes.lf@ gmail.com. Chung-Feng Liu, No. 60, Sec 1, Erren Rd., Rende Dist, Tainan City 71710, Taiwan. Tel: +886-6-2664911-5301. email: fredliu@ 123456mail.cnu.edu.tw .

                Competing Interests: The authors have declared that no competing interest exists.

                Article
                Publisher ID: jcav07p2028
                DOI: 10.7150/jca.16505
                PMC ID: 5118666
                SO-VID: c6e3d0e6-fd60-466e-8076-ed4012e8f309
                Copyright © © Ivyspring International Publisher. Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. See http://ivyspring.com/terms for terms and conditions.
                History
                Date received : 16 June 2016
                Date accepted : 18 September 2016
                Categories
                Subject: Research Paper

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: site-specific cancer,population-based study,vitamin d,odds ratio,incidence.
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: site-specific cancer, population-based study, vitamin d, odds ratio, incidence.

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