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Dr. Kathy J. Helzlsouer, Director, Prevention & Research at Mercy

National Study Indicates Vitamin D Status Not Associated With Risk For Less Common Cancers

Dr. Kathy J. Helzlsouer Chairs Study to Determine Vitamin D’s impact on 7 cancers

Despite hopes that higher blood levels of vitamin D might reduce cancer risk, a large study finds no protective effect against non-Hodgkin lymphoma or cancer of the endometrium, esophagus, stomach, kidney, ovary, or pancreas.

A large collaborative study was conducted by researchers representing 10 cohorts including the National Cancer Institute (NCI), part of the National Institutes of Health, and several other institutions, to study whether vitamin D levels were associated with cancer outcomes. Details of these analyses appear as a set of papers in the July 1, 2010 issue of the American Journal of Epidemiology.

“We did not see lower cancer risk in persons with high vitamin D blood concentrations compared to normal concentrations for any of these cancers,” said Demetrius Albanes, M.D., NCI, one of the study investigators. “And, at the other end of the vitamin D spectrum, we did not see higher cancer risk for participants with low levels.”

As part of a collaborative effort of the NCI Cohort Consortium, investigators from the Vitamin D Pooling Project of Rarer Cancers examined vitamin D levels in blood that had been collected from over 12,000 men and women before they received a cancer diagnosis. 25-hydroxyvitamin D (25(OH)D) concentrations, which is the major form of this vitamin in the bloodstream. Vitamin D concentrations were measured from blood that had been stored years before cancer developed.

Participants in these studies have been followed for up to 36 years for health outcomes after giving a blood sample. Investigators then compared the rates of among those with very low levels (less than 25 nmol/L or (you should also give ng/ml range) and those with high levels to with levels closer to the normal range of 75 nmol/L or about 30 ng/ml). Overall there was no dose – response association between vitamin D and the cancers studied.

Similar to prior reports, an increased risk of pancreatic cancer was observed among the small number of participants with vitamin D levels greater than 100 nmol/L. There was no trend across levels and this association requires more research.

Vitamin D is made naturally by the body when the skin is exposed to sunlight; it can also be obtained from a few foods in which it occurs naturally, from fortified foods, and from nutritional supplements. Vitamin D is essential for healthy bones, calcium absorption, and immune function.

Researchers and clinicians have looked to the possibility that vitamin D might be used for cancer prevention. Some evidence indicates that higher levels of vitamin D are associated with a lower risk of colorectal cancer, though the evidence is inconsistent.

Through the Vitamin D Pooling Project, researchers had access to a geographically and demographically diverse group of men and women, including participants from the United States, Finland, and China.

In this collection of groups of study participants, the proportion of the study population that was low in vitamin D varied from 3 percent to 36 percent, depending on geographical latitude, season during which the blood was collected, race, and other factors. The investigators had a wealth of other information on participants, including smoking history, lifestyle, and diet. As in other studies, individuals with higher 25(OH)D levels were more likely to be male, lean, and physically active. Those with higher levels also reported greater intake of multivitamins, calcium supplements, and foods rich in vitamin D.

“In this pooled analysis of cohort data, vitamin D was not associated with lower risk for these less common cancers, despite clear benefits for bone health,” concluded Albanes.

Many people in the United States and around the world have low concentrations of 25(OH)D. The current recommended daily intake of vitamin D to maintain bone health and normal calcium metabolism, according to the Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences, ranges from 200 IU (international units) to 600 IU, depending on age, with the highest dose recommendations being for the elderly.

In addition, the 2005 Dietary Guidelines for Americans recommends that older adults, people with dark skin, and those exposed to insufficient sunlight consume extra vitamin D from vitamin D-fortified foods and/or supplements. Since there are very few foods which naturally contain vitamin D (fatty fish, fish liver oil, and eggs), most dietary vitamin D comes from fortified foods such as milk, juice, yogurt, bread and breakfast cereals.

These recommendations are currently under review by the Institute of Medicine.

NCI’s Cohort Consortium (http://epi.grants.cancer.gov/Consortia/cohort.html) was established in 2000 to foster large collaborative studies, such as the Vitamin D Pooling Project, to investigate the causes of cancer, including interactions between genes, between genes and the environment, and between multiple environmental factors.

The Vitamin D Pooling Project realizes a major goal and advantage of the Cohort Consortium - - the study of rare cancer outcomes that no one cohort alone can examine effectively. The Project’s Steering Committee representing the 10 cohorts included researchers from NCI; the American Cancer Society; Brigham and Women’s Hospital, Harvard Medical School, and the Harvard School of Public Health, Boston; Mercy Medical Center and Johns Hopkins Bloomberg School of Public Health, Baltimore; New York University School of Medicine, New York City; University of Hawaii, Honolulu; and Vanderbilt University School of Medicine, Nashville.

EDITOR’S NOTE: Local/regional media seeking interviews, additional background, etc., should contact Dan Collins, Senior Director of Media Relations for Mercy Medical Center in Baltimore, to be placed in contact with study chair Dr. Kathy J. Helzlsouer, Director, Prevention & Research at Mercy, and/or study steering committee member and working group leader Dr. Lisa Gallicchio, Mercy Prevention & Research.

References:

Nine papers, all appearing in the American Journal of Epidemiology, July 1, 2010.

Overview of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Kathy J. Helzlsouer for the VDPP Steering Committee

Circulating 25-hydroxyvitamin D and Risk of Esophageal and Gastric Cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Abnet C.C., Chen Yu, et. al.

Circulating 25-hydroxyvitamin D and Risk of Pancreatic Cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Stolzenberg-Solomon R, Jacobs EJ, et.al.

Circulating 25-hydroxyvitamin D and Risk of Kidney Cancer: Cohort Consortium
Vitamin D Pooling Project of Rarer Cancers. Gallicchio L, Moore LE, et. al.

Circulating 25-hydroxyvitamin D and the Risk of Rarer Cancers: Cohort Consortium
Vitamin D Pooling Project of Rarer Cancers Design and Methods. Gallicchio L, Helzlsouer KJ, et. al.

Circulating 25-hydroxyvitamin D and Risk of Endometrial Cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Zeleniuch-Jacquotte A, Gallicchio L, et. al.

Circulating 25-hydroxyvitamin D and Risk of Epithelial Ovarian Cancer:
Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Zheng W, Danforth KN, et. al.

Circulating 25-hydroxyvitamin D and Risk of non-Hodgkin Lymphoma: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Purdue MP, Michal Freedman D, et. al.

Correlates of circulating 25-hydroxyvitamin D: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. McCullough ML, Weinstein SJ, et. al.

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

The Prevention & Research Center at Mercy Medical Center, part of the nationally renowned Weinberg Center for Women's Health & Medicine at Mercy and under the direction of Dr. Kathy J. Helzlsouer, seeks to improve the health of individuals through clinical programs and research into the prevention, early detection and treatment and long-term management of diseases. In addition to fostering integration of research into clinical care, the Center offers consultative services for assessing the risk of cancer and developing management strategies. For more information, visit Mercy online at www.mdmercy.com.