Abstract
BackgroundThere 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.MethodsCox 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.ResultsOver 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].ConclusionsIn 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1112-5) contains supplementary material, which is available to authorized users.
Highlights
There is increasing evidence that vitamin D deficiency is a risk factor for cancer, it remains uncertain whether vitamin D deficiency predisposes to death from cancer
The median age, body mass index (BMI), and baseline serum 25 (OH) D concentrations of those included in the study were 75.1 (Interquartile range (IQR): 73 to 77) years, 26.5 (IQR: 23.8 to 29.7) kg/m2 and 64 (IQR: 46.2 to 83.2) nmol/L, respectively
In conclusion, lower baseline serum 25 (OH) D concentrations were independently associated with an increased risk of overall cancer mortality
Summary
There is increasing evidence that vitamin D deficiency is a risk factor for cancer, it remains uncertain whether vitamin D deficiency 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. Two controlled trials have assessed the impact of vitamin D supplementation and the incidence of cancer with conflicting results. The largest trial involved over 36,000 women randomized to combination calcium and vitamin D supplementation and matching placebo and found no significant effects on the incidence of cancer in postmenopausal women after an average of 7 years of follow up [10]. The other randomized controlled trial found a significant reduction in overall cancer risk by 60% with calcium and vitamin D supplementation in 1,179 healthy post-menopausal women with high baseline serum 25 (OH) D concentrations over a follow-up period of 4 years [11]
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