Keum, N, Lee, DH, Greenwood, DC orcid.org/0000-0001-7035-3096 et al. (2 more authors) (2019) Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. Annals of Oncology, 30 (5). pp. 733-743. ISSN 0923-7534
Abstract
Background: 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.
Materials and methods: 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.
Results: 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.
Conclusions: In an updated meta-analysis of RCTs, vitamin D supplementation significantly reduced total cancer mortality but did not reduce total cancer incidence.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. This is a pre-copyedited, author-produced version of an article accepted for publication in Annals of Oncology following peer review. The version of record Keum, N, Lee, DH, Greenwood, DC et al. (2 more authors) (2019) Vitamin D Supplements and Total Cancer Incidence and Mortality: a Meta-analysis of randomized controlled trials. Annals of Oncology. mdz059. is available online at: https://doi.org/10.1093/annonc/mdz059. |
Keywords: | vitamin D supplements; circulating 25(OH)D; cancer incidence; cancer mortality; meta-analysis; randomized controlled trial |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Feb 2019 12:20 |
Last Modified: | 22 Feb 2020 01:38 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/annonc/mdz059 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:142423 |