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Jenab, M.* ; Bueno-de-Mesquita, H.B.* ; Ferrari, P.* ; van Duijnhoven, F.J.* ; Norat, T.* ; Pischon, T.* ; Jansen, E.H.J.M.* ; Slimani, N.* ; Byrnes, G.* ; Rinaldi, S.* ; Tjonneland, A.* ; Olsen, A.* ; Overvad, K.* ; Boutron-Ruault, M.C.* ; Clavel-Chapelon, F.* ; Morois, S.* ; Kaaks, R.* ; Linseisen, J. ; Boeing, H.* ; Bergmann, M.M.* ; Trichopoulou, A.* ; Misirli, G.* ; Trichopoulos, D.* ; Berrino, F.* ; Vineis, P.* ; Panico, S.* ; Palli, D.* ; Tumino, R.* ; Ros, M.M.* ; van Gils, C.H.* ; Peeters, P.H.* ; Brustad, M.* ; Lund, E.* ; Tormo, M.J.* ; Ardanaz, E.* ; Rodriguez, L.* ; Sánchez, M.J.* ; Dorronsoro, M.* ; González, C.A.* ; Hallmans, G.* ; Palmqvist, R.* ; Roddam, A.* ; Key, T.J.* ; Khaw, K.T.* ; Autier, P.* ; Hainaut, P.* ; Riboli, E.*

Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: A nested case-control study.

BMJ:Br. Med. J. 340:b5500 (2010)
DOI PMC
OBJECTIVE: To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. DESIGN: Nested case-control study. Setting The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. PARTICIPANTS: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls MAIN OUTCOME MEASURES: Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders. RESULTS: 25-(OH)D concentration showed a strong inverse linear dose-response association with risk of colorectal cancer (P for trend <0.001). Compared with a pre-defined mid-level concentration of 25-(OH)D (50.0-75.0 nmol/l), lower levels were associated with higher colorectal cancer risk (<25.0 nmol/l: incidence rate ratio 1.32 (95% confidence interval 0.87 to 2.01); 25.0-49.9 nmol/l: 1.28 (1.05 to 1.56), and higher concentrations associated with lower risk (75.0-99.9 nmol/l: 0.88 (0.68 to 1.13); >or=100.0 nmol/l: 0.77 (0.56 to 1.06)). In analyses by quintile of 25-(OH)D concentration, patients in the highest quintile had a 40% lower risk of colorectal cancer than did those in the lowest quintile (P<0.001). Subgroup analyses showed a strong association for colon but not rectal cancer (P for heterogeneity=0.048). Greater dietary intake of calcium was associated with a lower colorectal cancer risk. Dietary vitamin D was not associated with disease risk. Findings did not vary by sex and were not altered by corrections for season or month of blood donation. CONCLUSIONS: The results of this large observational study indicate a strong inverse association between levels of pre-diagnostic 25-(OH)D concentration and risk of colorectal cancer in western European populations. Further randomised trials are needed to assess whether increases in circulating 25-(OH)D concentration can effectively decrease the risk of colorectal cancer.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Randomized-controlled-trials; colon-cancer; 25-hydroxyvitamin-D; D-receptor; D supplementation; calcium intake; dietary-intake; D metabolites; meta-analysis
ISSN (print) / ISBN 1756-1833
e-ISSN 0959-535X
Journal BMJ: British Medical Journal
Quellenangaben Volume: 340, Issue: , Pages: , Article Number: b5500 Supplement: ,
Publisher BMJ Publishing Group
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)