Vitamin D and Cancer Risk and Survival
DCEG researchers in the Metabolic Epidemiology Branch (MEB) have been at the forefront of research into the association between vitamin D and cancer risk and survival. While experimental data demonstrate a range of anti-carcinogenic effects for vitamin D, the epidemiological evidence has been inconsistent. MEB research has included 1) prospective risk and survival association studies of vitamin D status, as measured by circulating 25-hydroxyvitamin D [25(OH)D], the accepted biomarker of vitamin D, and by vitamin D binding protein (DBP), the major vitamin D transporter in circulation; 2) vitamin D genetic score analyses of cancer risk as well as studies of DBP isotype modification of vitamin D-cancer survival associations; and 3) cell culture experiments of genomic biological mechanisms. In addition, MEB researchers have been examining vitamin D and prostate cancer risk in populations of African ancestry, an understudied group who are at particularly increased risk of both prostate cancer and vitamin D insufficiency. Our research has found that higher vitamin D status is associated with a reduced risk of colorectal cancer, and with higher risk of prostate cancer, with no association for most other cancer sites, including breast cancer.
MEB researchers have played integral roles in several large collaborative pooling projects investigating vitamin D-cancer associations which have led to conclusive findings. For example, the Vitamin D Pooling Project of Rarer Cancers showed no association between circulating 25(OH)D within 10 cohorts and risk of cancers of the endometrium, kidney, ovary, stomach, or esophagus, or non-Hodgkin lymphoma, but did show significantly elevated pancreatic cancer risk with circulating 25(OH)D greater than 100 nmol/L. The Lung Cancer Cohort Consortium found no association between 25(OH)D and lung cancer risk in 20 cohorts. MEB researchers are also involved with lead roles in the Circulating Biomarkers and Breast and Colorectal Cancer Consortium that showed 28% lower colorectal cancer risk for higher vitamin D status that was stronger in women than in men, as well as the Endogenous Hormones, Nutritional Biomarkers Prostate Cancer Consortium which observed 22% increased prostate cancer risk for men in the highest vitamin D category. Additionally with respect to cancer survival, MEB discoveries of improved prostate and overall cancer survival in persons with higher serum vitamin D and, for the latter, effect modification by DBP genetic isotypes, point to potential precision medicine applications in the vitamin D-cancer field being pursued in new G×E studies.
For more information, contact Demetrius Albanes.