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Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Vitamin D and cancer mortality in elderly women

Authors: Germaine Wong, Wai Hon Lim, Joshua Lewis, Jonathan C Craig, Robin Turner, Kathy Zhu, Ee Mun Lim, Richard Prince

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

There is increasing evidence that vitamin D deficiency is a risk factor for cancer, however it remains uncertain whether vitamin D deficiency also predisposes to death from cancer. The aim of the study was to determine the association between serum 25-hydroxy-vitamin D (25 (OH) D) concentrations and cancer-specific mortality in a community-based cohort of older post-menopausal women.

Methods

Cox proportional regression analyses were conducted to examine the association between serum 25 (OH) D concentrations and the risk of overall and site-specific cancer mortality in a cohort of elderly women.

Results

Over a median follow-up time of 10 years, a total of 84 cancer deaths were observed. Women with lower serum 25 (OH) D concentrations were at an increased risk of cancer death, but not for incident cancer. The excess risk for cancer death was observed with serum 25 (OH) D concentration less than 64 nmol/L (the median value) [adjusted HR: 1.61 (95% CI: 1.02 - 2.54, p = 0.04]. For every 30 nmol/L reduction in serum 25 (OH) D concentrations, there was a 30% increase in the overall risk of cancer death [adjusted HR: 1.33; 95% CI: 1.03 – 1.72, p = 0.02]. The excess risk appeared to be site-specific and greatest in those with haematological cancers [adjusted HR: 2.13: 95% CI: 1.0 – 4.55, p = 0.05].

Conclusions

In elderly women, lower serum 25 (OH) D concentrations appear to be an independent risk factor for cancer-specific mortality, but not a risk factor for the development of cancer.
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Literature
1.
go back to reference Arnson Y, Gringauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM. 2012;105(7):633–9.CrossRefPubMed Arnson Y, Gringauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM. 2012;105(7):633–9.CrossRefPubMed
2.
go back to reference Fan C, Nieto FJ, Bautista LE, Fine JP. Vitamin D intake and cardiovascular mortality in the NHANES I epidemiological follow-up study cohort. J Dietary Supplements. 2012;9(2):79–89.CrossRef Fan C, Nieto FJ, Bautista LE, Fine JP. Vitamin D intake and cardiovascular mortality in the NHANES I epidemiological follow-up study cohort. J Dietary Supplements. 2012;9(2):79–89.CrossRef
3.
go back to reference Eaton CB, Young A, Allison MA, Robinson J, Martin LW, Kuller LH, et al. Prospective association of vitamin D concentrations with mortality in postmenopausal women: results from the women’s health initiative (WHI). Am J Clin Nutr. 2011;94(6):1471–8.CrossRefPubMedPubMedCentral Eaton CB, Young A, Allison MA, Robinson J, Martin LW, Kuller LH, et al. Prospective association of vitamin D concentrations with mortality in postmenopausal women: results from the women’s health initiative (WHI). Am J Clin Nutr. 2011;94(6):1471–8.CrossRefPubMedPubMedCentral
4.
go back to reference Formiga F, Ferrer A. Low Serum Vitamin D is Not Associated with an Increase in Mortality in Oldest Old Subjects: The Octabaix Three-Year Follow-Up Study. Gerontology. 2014;60(1):10–5.CrossRefPubMed Formiga F, Ferrer A. Low Serum Vitamin D is Not Associated with an Increase in Mortality in Oldest Old Subjects: The Octabaix Three-Year Follow-Up Study. Gerontology. 2014;60(1):10–5.CrossRefPubMed
5.
go back to reference Cui Y, Rohan TE. Vitamin D, calcium, and breast cancer risk: a review. [Review] [105 refs]. Cancer Epidemiol Biomark Prev. 2006;15(8):1427–37.CrossRef Cui Y, Rohan TE. Vitamin D, calcium, and breast cancer risk: a review. [Review] [105 refs]. Cancer Epidemiol Biomark Prev. 2006;15(8):1427–37.CrossRef
6.
go back to reference Mizoue T, Kimura Y, Toyomura K, Nagano J, Kono S, Mibu R, et al. Calcium, dairy foods, vitamin D, and colorectal cancer risk: the Fukuoka colorectal cancer study. Cancer Epidemiol Biomark Prev. 2008;17(10):2800–7.CrossRef Mizoue T, Kimura Y, Toyomura K, Nagano J, Kono S, Mibu R, et al. Calcium, dairy foods, vitamin D, and colorectal cancer risk: the Fukuoka colorectal cancer study. Cancer Epidemiol Biomark Prev. 2008;17(10):2800–7.CrossRef
7.
go back to reference Robien K, Cutler GJ, Lazovich D. Vitamin D intake and breast cancer risk in postmenopausal women: the Iowa women’s health study. Cancer Causes Control. 2007;18(7):775–82.CrossRefPubMed Robien K, Cutler GJ, Lazovich D. Vitamin D intake and breast cancer risk in postmenopausal women: the Iowa women’s health study. Cancer Causes Control. 2007;18(7):775–82.CrossRefPubMed
8.
go back to reference Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: circulating vitamin D and ovarian cancer risk. [review]. Gynecol Oncol. 2011;121(2):369–75.CrossRefPubMed Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: circulating vitamin D and ovarian cancer risk. [review]. Gynecol Oncol. 2011;121(2):369–75.CrossRefPubMed
9.
go back to reference Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009;30(2):113–25.CrossRefPubMed Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009;30(2):113–25.CrossRefPubMed
10.
go back to reference LaCroix AZ, Kotchen J, Anderson G, Brzyski R, Cauley JA, Cummings SR, et al. Calcium plus vitamin D supplementation and mortality in postmenopausal women: the women’s health initiative calcium-vitamin D randomized controlled trial. J Gerontol Series A-Biol Sci Med Sci. 2009;64(5):559–67.CrossRef LaCroix AZ, Kotchen J, Anderson G, Brzyski R, Cauley JA, Cummings SR, et al. Calcium plus vitamin D supplementation and mortality in postmenopausal women: the women’s health initiative calcium-vitamin D randomized controlled trial. J Gerontol Series A-Biol Sci Med Sci. 2009;64(5):559–67.CrossRef
11.
go back to reference Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85(6):1586–91. Erratum appears in Am J Clin Nutr. 2008 Mar;87 (3):794.PubMed Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85(6):1586–91. Erratum appears in Am J Clin Nutr. 2008 Mar;87 (3):794.PubMed
12.
go back to reference Giovannucci E, Liu Y, Willett WC. Cancer incidence and mortality and vitamin D in black and white male health professionals. Cancer Epidemiol Biomark Prev. 2006;15(12):2467–72.CrossRef Giovannucci E, Liu Y, Willett WC. Cancer incidence and mortality and vitamin D in black and white male health professionals. Cancer Epidemiol Biomark Prev. 2006;15(12):2467–72.CrossRef
13.
go back to reference Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006;98(7):451–9.CrossRefPubMed Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006;98(7):451–9.CrossRefPubMed
14.
go back to reference Freedman D, Fuhrman B, Graubard BI, Chang SC. Vitamin D and cancer mortality. Cancer Epidemiol Biomark Prev. 2009;18(1):359–60.CrossRef Freedman D, Fuhrman B, Graubard BI, Chang SC. Vitamin D and cancer mortality. Cancer Epidemiol Biomark Prev. 2009;18(1):359–60.CrossRef
15.
go back to reference Schottker B, Haug U, Schomburg L, Kohrle J, Perna L, Muller H, et al. Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study. Am J Clin Nutr. 2013;97(4):782–93.CrossRefPubMed Schottker B, Haug U, Schomburg L, Kohrle J, Perna L, Muller H, et al. Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study. Am J Clin Nutr. 2013;97(4):782–93.CrossRefPubMed
16.
go back to reference Freedman DM, Looker AC, Abnet CC, Linet MS, Graubard BI. Serum 25-hydroxyvitamin D and cancer mortality in the NHANES III study (1988–2006). Cancer Res. 2010;70(21):8587–97.CrossRefPubMedPubMedCentral Freedman DM, Looker AC, Abnet CC, Linet MS, Graubard BI. Serum 25-hydroxyvitamin D and cancer mortality in the NHANES III study (1988–2006). Cancer Res. 2010;70(21):8587–97.CrossRefPubMedPubMedCentral
17.
go back to reference Tomson J, Emberson J, Hill M, Gordon A, Armitage J, Shipley M, et al. Vitamin D and risk of death from vascular and non-vascular causes in the Whitehall study and meta-analyses of 12 000 deaths. Eur Heart J. 2013;34(18):1365–74.CrossRefPubMed Tomson J, Emberson J, Hill M, Gordon A, Armitage J, Shipley M, et al. Vitamin D and risk of death from vascular and non-vascular causes in the Whitehall study and meta-analyses of 12 000 deaths. Eur Heart J. 2013;34(18):1365–74.CrossRefPubMed
18.
go back to reference Lazzeroni M, Serrano D, Pilz S, Gandini S. Vitamin D supplementation and cancer: review of randomized controlled trials. [review]. Current Med Chem Anti-Cancer Agents. 2013;13(1):118–25.CrossRef Lazzeroni M, Serrano D, Pilz S, Gandini S. Vitamin D supplementation and cancer: review of randomized controlled trials. [review]. Current Med Chem Anti-Cancer Agents. 2013;13(1):118–25.CrossRef
19.
go back to reference Lewis JR, Calver J, Zhu K, Flicker L, Prince RL. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up. J Bone Mineral Res. 2011;26(1):35–41.CrossRef Lewis JR, Calver J, Zhu K, Flicker L, Prince RL. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up. J Bone Mineral Res. 2011;26(1):35–41.CrossRef
20.
go back to reference Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94:496–509.CrossRef Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94:496–509.CrossRef
21.
go back to reference Lim HS, Roychoudhuri R, Peto J, Schwartz G, Baade P, Moller H. Cancer survival is dependent on season of diagnosis and sunlight exposure. Int J Cancer. 2006;119(7):1530–6.CrossRefPubMed Lim HS, Roychoudhuri R, Peto J, Schwartz G, Baade P, Moller H. Cancer survival is dependent on season of diagnosis and sunlight exposure. Int J Cancer. 2006;119(7):1530–6.CrossRefPubMed
22.
go back to reference Vrieling A, Hein R, Abbas S, Schneeweiss A, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study. Breast Cancer Res. 2011;13(4):R74.CrossRefPubMedPubMedCentral Vrieling A, Hein R, Abbas S, Schneeweiss A, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study. Breast Cancer Res. 2011;13(4):R74.CrossRefPubMedPubMedCentral
23.
go back to reference Michaelsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundstrom J, et al. Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr. 2010;92(4):841–8.CrossRefPubMed Michaelsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundstrom J, et al. Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr. 2010;92(4):841–8.CrossRefPubMed
24.
go back to reference Pilz S, Tomaschitz A, Obermayer-Pietsch B, Dobnig H, Pieber TR. Epidemiology of vitamin D insufficiency and cancer mortality. [Review] [33 refs]. Anticancer Res. 2009;29(9):3699–704.PubMed Pilz S, Tomaschitz A, Obermayer-Pietsch B, Dobnig H, Pieber TR. Epidemiology of vitamin D insufficiency and cancer mortality. [Review] [33 refs]. Anticancer Res. 2009;29(9):3699–704.PubMed
25.
go back to reference Ren C, Qiu MZ, Wang DS, Luo HY, Zhang DS, Wang ZQ, et al. Prognostic effects of 25-hydroxyvitamin D levels in gastric cancer. J Transl Med. 2012;10:16.CrossRefPubMedPubMedCentral Ren C, Qiu MZ, Wang DS, Luo HY, Zhang DS, Wang ZQ, et al. Prognostic effects of 25-hydroxyvitamin D levels in gastric cancer. J Transl Med. 2012;10:16.CrossRefPubMedPubMedCentral
26.
go back to reference Salehi-Tabar R, Nguyen-Yamamoto L, Tavera-Mendoza LE, Quail T, Dimitrov V, An BS, et al. Vitamin D receptor as a master regulator of the c-MYC/MXD1 network. Proc Natl Acad Sci U S A. 2012;109(46):18827–32.CrossRefPubMedPubMedCentral Salehi-Tabar R, Nguyen-Yamamoto L, Tavera-Mendoza LE, Quail T, Dimitrov V, An BS, et al. Vitamin D receptor as a master regulator of the c-MYC/MXD1 network. Proc Natl Acad Sci U S A. 2012;109(46):18827–32.CrossRefPubMedPubMedCentral
27.
go back to reference Zheng W, Wong KE, Zhang Z, Dougherty U, Mustafi R, Kong J, et al. Inactivation of the vitamin D receptor in APC (min/+) mice reveals a critical role for the vitamin D receptor in intestinal tumor growth. Int J Cancer. 2012;130(1):10–9.CrossRefPubMed Zheng W, Wong KE, Zhang Z, Dougherty U, Mustafi R, Kong J, et al. Inactivation of the vitamin D receptor in APC (min/+) mice reveals a critical role for the vitamin D receptor in intestinal tumor growth. Int J Cancer. 2012;130(1):10–9.CrossRefPubMed
28.
go back to reference Zittermann A, Iodice S, Pilz S, Grant WB, Bagnardi V, Gandini S. Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies. Am J Clin Nutr. 2012;95(1):91–100.CrossRefPubMed Zittermann A, Iodice S, Pilz S, Grant WB, Bagnardi V, Gandini S. Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies. Am J Clin Nutr. 2012;95(1):91–100.CrossRefPubMed
Metadata
Title
Vitamin D and cancer mortality in elderly women
Authors
Germaine Wong
Wai Hon Lim
Joshua Lewis
Jonathan C Craig
Robin Turner
Kathy Zhu
Ee Mun Lim
Richard Prince
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1112-5

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