Dataset Information

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts.

ABSTRACT:

Background

Experimental and epidemiological studies suggest a protective role for vitamin D in colorectal carcinogenesis, but evidence is inconclusive. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations that minimize risk are unknown. Current Institute of Medicine (IOM) vitamin D guidance is based solely on bone health.

Methods

We pooled participant-level data from 17 cohorts, comprising 5706 colorectal cancer case participants and 7107 control participants with a wide range of circulating 25(OH)D concentrations. For 30.1% of participants, 25(OH)D was newly measured. Previously measured 25(OH)D was calibrated to the same assay to permit estimating risk by absolute concentrations. Study-specific relative risks (RRs) for prediagnostic season-standardized 25(OH)D concentrations were calculated using conditional logistic regression and pooled using random effects models.

Results

Compared with the lower range of sufficiency for bone health (50-<62.5 nmol/L), deficient 25(OH)D (<30 nmol/L) was associated with 31% higher colorectal cancer risk (RR = 1.31, 95% confidence interval [CI] = 1.05 to 1.62); 25(OH)D above sufficiency (75-<87.5 and 87.5-<100 nmol/L) was associated with 19% (RR = 0.81, 95% CI = 0.67 to 0.99) and 27% (RR = 0.73, 95% CI = 0.59 to 0.91) lower risk, respectively. At 25(OH)D of 100 nmol/L or greater, risk did not continue to decline and was not statistically significantly reduced (RR = 0.91, 95% CI = 0.67 to 1.24, 3.5% of control participants). Associations were minimally affected when adjusting for body mass index, physical activity, or other risk factors. For each 25 nmol/L increment in circulating 25(OH)D, colorectal cancer risk was 19% lower in women (RR = 0.81, 95% CI = 0.75 to 0.87) and 7% lower in men (RR = 0.93, 95% CI = 0.86 to 1.00) (two-sided Pheterogeneity by sex = .008). Associations were inverse in all subgroups, including colorectal subsite, geographic region, and season of blood collection.

Conclusions

Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non-statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM recommendations.

SUBMITTER: McCullough ML

PROVIDER: S-EPMC6376911 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts.

McCullough Marjorie L ML Zoltick Emilie S ES Weinstein Stephanie J SJ Fedirko Veronika V Wang Molin M Cook Nancy R NR Eliassen A Heather AH Zeleniuch-Jacquotte Anne A Agnoli Claudia C Albanes Demetrius D Barnett Matthew J MJ Buring Julie E JE Campbell Peter T PT Clendenen Tess V TV Freedman Neal D ND Gapstur Susan M SM Giovannucci Edward L EL Goodman Gary G GG Haiman Christopher A CA Ho Gloria Y F GYF Horst Ronald L RL Hou Tao T Huang Wen-Yi WY Jenab Mazda M Jones Michael E ME Joshu Corinne E CE Krogh Vittorio V Lee I-Min IM Lee Jung Eun JE Männistö Satu S Le Marchand Loic L Mondul Alison M AM Neuhouser Marian L ML Platz Elizabeth A EA Purdue Mark P MP Riboli Elio E Robsahm Trude Eid TE Rohan Thomas E TE Sasazuki Shizuka S Schoemaker Minouk J MJ Sieri Sabina S Stampfer Meir J MJ Swerdlow Anthony J AJ Thomson Cynthia A CA Tretli Steinar S Tsugane Schoichiro S Ursin Giske G Visvanathan Kala K White Kami K KK Wu Kana K Yaun Shiaw-Shyuan SS Zhang Xuehong X Willett Walter C WC Gail Mitchel H MH Ziegler Regina G RG Smith-Warner Stephanie A SA

Journal of the National Cancer Institute 20190201 2

<h4>Background</h4>Experimental and epidemiological studies suggest a protective role for vitamin D in colorectal carcinogenesis, but evidence is inconclusive. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations that minimize risk are unknown. Current Institute of Medicine (IOM) vitamin D guidance is based solely on bone health.<h4>Methods</h4>We pooled participant-level data from 17 cohorts, comprising 5706 colorectal cancer case participants and 7107 control participants with a wide range ...[more]

PMID: 29912394

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Project description:Background and aimsData on the relation of egg consumption with risk of type 2 diabetes (T2D) and coronary heart disease (CHD) are limited and inconsistent. Few studies have controlled for overall dietary patterns in egg-T2D or egg-CHD analyses, and it is unclear whether any observed elevated risks of T2D and CHD with frequent egg consumption is real or due to confounding by dietary habits. We tested the hypothesis that frequent egg consumption is associated with a higher risk of T2D and CHD risk after adjustment for overall dietary patterns among adults.DesignWe used prospective cohort design to complete time-to-event analyses.MethodsWe pooled de novo, harmonized, individual-level analyses from nine US cohorts (n = 103,811). Cox regression was used to estimate hazard ratios separately in each cohort adjusting for age, ethnicity, body mass index (BMI), exercise, smoking, alcohol intake, and dietary patterns. We pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks.ResultsMedian age ranged from 25 to 72 years. Median egg consumption was 1 egg per week in most of the cohorts. While egg consumption up to one per week was not associated with T2D risk, consumption of ≥2 eggs per week was associated with elevated risk [27% elevated risk of T2D comparing 7+ eggs/week with none (95% CI: 16%-37%)]. There was little evidence for heterogeneity across cohorts and we observed similar conclusions when stratified by BMI. Overall, egg consumption was not associated with the risk of CHD. However, in a sensitivity analysis, there was a 30% higher risk of CHD (95% CI: 3%-56%) restricted to older adults consuming 5-6 eggs/week.ConclusionsOur data showed an elevated risk of T2D with egg consumption of ≥2 eggs per week but not with <2 eggs/week. While there was no overall association of egg consumption with CHD risk, the elevated CHD observed with consumption of 5-6 eggs/week in older cohorts merits further investigation.

Dataset Information

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts.

Background

Methods

Results

Conclusions

Publications

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts.

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