Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials

Previous meta-analyses of randomized controlled trials (RCTs) of vitamin D supplementation and total cancer incidence and mortality found inconsistent results, and most included trials administered generally low doses of vitamin D (≤1100 IU/day). We updated the meta-analysis by incorporating recent...

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Bibliographic Details
Published in:Annals of oncology Vol. 30; no. 5; p. 733
Main Authors: Keum, N, Lee, D H, Greenwood, D C, Manson, J E, Giovannucci, E
Format: Journal Article
Language:English
Published: England 01.05.2019
Subjects:
Dietary Supplements - statistics & numerical data
Humans
Incidence
Neoplasms - drug therapy
Neoplasms - epidemiology
Neoplasms - mortality
Randomized Controlled Trials as Topic - statistics & numerical data
United States - epidemiology
Vitamin D - administration & dosage
Vitamin D - therapeutic use
Vitamins - administration & dosage
United States
meta-analysis
vitamin D supplements
circulating 25(OH)D
cancer incidence
cancer mortality
randomized controlled trial
ISSN:1569-8041, 1569-8041
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Summary:Previous meta-analyses of randomized controlled trials (RCTs) of vitamin D supplementation and total cancer incidence and mortality found inconsistent results, and most included trials administered generally low doses of vitamin D (≤1100 IU/day). We updated the meta-analysis by incorporating recent RCTs that have tested higher doses of vitamin D supplements. PubMed and Embase were searched from the inception to November 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. For total cancer incidence, 10 trials were included [6537 cases; 3-10 years of follow-up; 54-135 nmol/l of attained levels of circulating 25(OH) vitamin D [25(OH)D] in the intervention group]. The summary RR was 0.98 (95% CI, 0.93-1.03; P = 0.42; I2 = 0%). The results remained null across subgroups tested, including even when attained 25(OH)D levels exceeded 100 nmol/l (RR, 0.95; 95% CI, 0.83-1.09; P = 0.48; I2 = 26%). For total cancer mortality, five trials were included [1591 deaths; 3-10 years of follow-up; 54-135 nmol/l of attained levels of circulating 25(OH)D in the intervention group]. The summary RR was 0.87 (95% CI, 0.79-0.96; P = 0.005; I2 = 0%), which was largely attributable to interventions with daily dosing (as opposed to infrequent bolus dosing). No statistically significant heterogeneity was observed by attained levels of circulating 25(OH)D (Pheterogeneity = 0.83), with RR being 0.88 (95% CI, 0.78-0.98; P = 0.02; I2 = 0%) for ≤100 nmol/l and 0.85 (95% CI, 0.70-1.03; P = 0.11; I2 = 0%) for >100 nmol/l. In an updated meta-analysis of RCTs, vitamin D supplementation significantly reduced total cancer mortality but did not reduce total cancer incidence.
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ISSN:1569-8041
1569-8041
DOI:10.1093/annonc/mdz059