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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Article info
Publication history
Published online: March 03, 2014
Identification
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© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.