182635 Vitamin D and prevention of colorectal adenoma: A meta-analysis

Monday, October 27, 2008: 8:50 AM

Melissa Y. Wei, MD, MPH , Department of Public Health and Preventive Medicine, Oregon Health & Science University School of Medicine, Portland, OR
Cedric F. Garland, DrPH, FACE , Dept of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
Edward D. Gorham, PhD , Dept of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
William B. Grant, PhD , SUNARC, San Francisco, CA
Sharif B. Mohr, MPH , Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
Edward C. Giovannnucci, MD ScD , Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA
     
Background: Vitamin D status is associated inversely with risk of colorectal cancer, but the association with adenoma risk is less clear. This meta-analysis examined the overall relationship between circulating (plasma or serum) 25(OH)D, vitamin D intake (dietary, supplemental, total) and colorectal adenoma incidence in published studies.

Methods: A meta-analysis comprised of seventeen epidemiological studies (one cross-sectional, nine case-control and seven cohort or nested case-control studies; seven on 25(OH)D and twelve on vitamin D intake) published before December 2007 was performed to examine the association between circulating 25(OH)D, vitamin D intake and colorectal adenomas. Summary Peto odds ratios (OR) were computed for overall and stratified analyses.

Results: Circulating 25(OH)D was inversely associated with colorectal adenomas: the OR was 0.70 (95% CI: 0.56-0.87) for high versus low circulating 25(OH)D. The highest quintile of vitamin D intake conferred an 11% marginally decreased risk of colorectal adenomas compared to low vitamin D intake (OR = 0.89; 95% CI: 0.78-1.02). For recurrent adenomas there was a decrease of 12% (95% CI: 0.72-1.07) among individuals with high versus low vitamin D intake. The inverse associations appeared stronger for advanced adenoma (OR = 0.71, 95% CI: 0.43-1.19 for serum 25(OH)D and OR = 0.75, 95% CI: 0.57-0.99 for vitamin D intake), but the number of studies was low.

Conclusions: Both circulating 25(OH)D and vitamin D intake were inversely associated with colorectal adenoma incidence and recurrent adenomas. This study further supports a role of vitamin D in prevention of colorectal adenoma incidence and recurrence.

Learning Objectives:
1. Appreciate the role of vitamin D in prevention of colorectal adenoma 2. Make recommendations for optimal vitamin D intake 3. Optimize vitamin D status for prevention of colorectal adenoma

Keywords: Cancer Prevention, Vitamins

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the analysis and prepared accompanying tables, figures, and manuscript for this study (with assistance from co-authors).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cancer Epidemiology
See more of: Epidemiology