Total vitamin D intake and risks of early-onset colorectal cancer and precursors.

Jul 12, 2021

Contributor: Hanseul Kim,Marla Lipsyc-Sharf,Xiaoyu Zong,Xiaoyan Wang,Jinhee Hur,Mingyang Song,Molin Wang,Stephanie A Smith-Warner,Charles Fuchs,Shuji Ogino,Kana Wu,Andrew T Chan,Yin Cao,Kimmie Ng,Edward L Giovannucci

Total vitamin D intake and risks of early-onset colorectal cancer and precursors.

Vitamin D has been implicated in colorectal cancer (CRC) pathogenesis, but it remains unknown whether total vitamin D intake is associated with early-onset CRC and precursors diagnosed before age 50.
We prospectively examined the association between total vitamin D intake and risks of early-onset CRC and precursors among women enrolled in the Nurses’ Health Study II. Multivariable-adjusted hazard ratio (HR) and 95% confidence interval (CI) for early-onset CRC were estimated with Cox proportional hazards model. Multivariable-adjusted odds ratio (OR) and 95% CI for early-onset conventional adenoma and serrated polyp were estimated with logistic regression model.
We documented 111 incident cases of early-onset CRC during 1,250,560 person-years of follow-up (1991 to 2015). Higher total vitamin D intake was significantly associated with a reduced risk of early-onset CRC (HR for ≥450 IU/day vs <300 IU/day, 0.49; 95% CI, 0.26-0.93; P for trend = 0.01). The HR per 400 IU/day increase was 0.46 (95% CI, 0.26-0.83). The inverse association was significant and appeared more evident for dietary sources of vitamin D (HR per 400 IU/day increase, 0.34; 95% CI, 0.15-0.79) than supplemental vitamin D (HR per 400 IU/day increase, 0.77; 95% CI, 0.37-1.62). For CRC precursors, the ORs per 400 IU/day increase were 0.76 (95% CI, 0.65-0.88) for conventional adenoma (n = 1,439) and 0.85 (95% CI, 0.75-0.97) for serrated polyp (n = 1,878).
In a cohort of younger women, higher total vitamin D intake was associated with decreased risks of early-onset CRC and precursors.

Copyright © 2021 AGA Institute. Published by Elsevier Inc. All rights reserved.

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About The Expert

Hanseul Kim

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Marla Lipsyc-Sharf

Department of Internal Medicine, Brigham and Women’s Hospital, Boston, MA, USA.

Xiaoyu Zong

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.

Xiaoyan Wang

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.

Jinhee Hur

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Mingyang Song

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Molin Wang

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA.

Stephanie A Smith-Warner

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Charles Fuchs

Yale Cancer Center, Smilow Cancer Hospital, New Haven, CT, USA.

Shuji Ogino

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; Cancer Immunology Program and Cancer Epidemiology Program, Dana-Farber Harvard Cancer Center, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA.

Kana Wu

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Andrew T Chan

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Yin Cao

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, Washington University School of Medicine in St Louis, St Louis, MO, USA; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.

Kimmie Ng

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.

Edward L Giovannucci

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: egiovann@hsph.harvard.edu.

References

PubMed