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Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: Systematic review and meta-analysis of prospective cohort studies

  • Author Footnotes
    1 Equally contributed as first authors.
    Haifa Maalmi
    Footnotes
    1 Equally contributed as first authors.
    Affiliations
    German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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  • Author Footnotes
    1 Equally contributed as first authors.
    José Manuel Ordóñez-Mena
    Footnotes
    1 Equally contributed as first authors.
    Affiliations
    German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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  • Ben Schöttker
    Affiliations
    German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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  • Hermann Brenner
    Correspondence
    Corresponding author at: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, TP4, 1. OG, Room S 1.207, D-69120 Heidelberg, Germany. Tel.: +49 6221 42 1300; fax: +49 6221 42 1302.
    Affiliations
    German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany

    German Cancer Consortium (DKTK), Heidelberg, Germany
    Search for articles by this author
  • Author Footnotes
    1 Equally contributed as first authors.
Published:March 03, 2014DOI:https://doi.org/10.1016/j.ejca.2014.02.006

      Abstract

      Aim

      To estimate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and survival among colorectal and breast cancer patients.

      Methods

      We performed a comprehensive literature search of prospective cohort studies assessing the association of serum 25(OH)D levels with survival in colorectal and breast cancer patients. Study characteristics and results were extracted and dose–response relationships were graphically displayed in a standardised manner. Meta-analyses using random effects models were performed to estimate pooled hazard ratios.

      Results

      The systematic search yielded five studies including 2330 colorectal cancer patients and five studies including 4413 breast cancer patients all of which compared mortality across two to five categories of 25(OH)D levels. Among colorectal cancer patients, pooled hazard ratios (95% confidence intervals) comparing highest with lowest categories were 0.71 (0.55–0.91) and 0.65 (0.49–0.86) for overall and disease-specific mortality, respectively. For breast cancer patients, the corresponding pooled estimates were 0.62 (0.49–0.78) and 0.58 (0.38–0.84), respectively. No significant evidence of heterogeneity between studies was observed.

      Conclusion

      Higher 25(OH)D levels (>75 nmol/L) were associated with significantly reduced mortality in patients with colorectal and breast cancer. Randomised controlled trials are needed to evaluate whether vitamin D supplementation can improve survival in colorectal and breast cancer patients with low vitamin D status (25(OH)D < 50 nmol/L) at diagnosis and before treatment.

      Keywords

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