Vitamin D in Cancer Prevention: Global Perspective
Just a few months prior to the conference mentioned above, Dr. Garland published an extensive review of recent data on the role of Vitamin D in cancer prevention and treatment in Annals of Epidemiology. This publication reviewed the data on many different types of cancer but only the data on breast cancer is presented here.
Results of recent Observational Studies:
Women in the NHANES III Study with Vitamin D levels higher than 25ng/ml (62nmol/L) had only one fourth of the mortality rate from breast cancer compared to those with levels less than 25ng/ml (relative risk 0.28, p<0.05). (1)
A recent pooled analysis of two studies of breast cancer showed that women with Vitamin D levels greater than 38ng/ml (95nmol/L) had a 58% lower risk of developing breast cancer compared to those with a Vitamin D level less than 15ng/ml. In this study patients were put into four groups depending on their Vitamin D levels. The incidence of breast cancer across these groups demonstrated a dose response that is a strong indicator of cause and effect. (p trend >0.02) (2,3)
Findings from a further case control study found similar statistically significant trends for premenopausal (4) and postmenopausal women (5).
Serum Vitamin D Levels and Survival of Breast Cancer Patients
Breast cancer patients with Vitamin D levels higher than 29ng/ml (72nmol/L) at diagnosis had a 42% lower 15-year death rate compared to those with Vitamin D levels less than 20ng/ml (50 nmol/L).
The incidence of metastases was 50% less in women with levels greater than 29ng/ml compared to those with levels less than 20ng/ml. Both of these findings were statistically significant p<0.02. (6)
Dr Garlands Conclusions:
2000IU of Vitamin D3 per day would lead to significant reductions in the incidence of breast cancer. A dose of 2000IU is the present upper limit suggested by the National Academy of Sciences. Approximately 250,000 new cases of breast cancer would be prevented each year by raising serum levels of Vitamin D to approximately 40-60ng/ml.
The preventive effects of higher Vitamin D3 intake have led 16 Vitamin D scientists and physicians in the US and Canada to disseminate a call to action recommending universal daily intake of 2000IU Vitamin D3. In the "call to action" distributed in July 2008, they conclude: Delays in taking reasonable preventive action on cancer by ensuring nearly universal oral intake of vitamin D3 in the range of 2000IU/day is costing thousands of lives unnecessarily each year that are lost due to fractures, cancer, diabetes, multiple sclerosis and other diseases for which Vitamin D deficiency plays a major role.
(1) Freedman DM, Looker AC, Chang SC, Graubard BI. Prospective study of
serum vitamin D and cancer mortality in the United States. J Natl
Cancer Inst. 2007;99:1594-1602.
(2) Lowe LC, Guy M, Mansi JL, Peckitt C, Bliss J, Wilson RG, et al. Plasma
25-hydroxy vitamin D concentrations, vitamin D receptor genotype and
breast cancer risk in a UK Caucasian population. Eur J Cancer.
(3) Bertone-Johnson ER, Chen WY, Holick MF, Hollis BW, Colditz GA,
Willett WC, et al. Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin
D and risk of breast cancer. Cancer Epidemiol Biomarkers Prev.
(4) Abbas S, Chang-Claude J, Linseisen J. Plasma 25-hydroxyvitamin D and
premenopausal breast cancer risk in a German case-control study. Int J
(5) Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-
Janys D, et al. Serum 25-hydroxyvitamin D and risk of post-menopausal
breast cancerdresults of a large case-control study. Carcinogenesis.
(6) Goodwin P, Ennis M, Pritchard K, Koo J, Hood N, Lunenfeld S, et al.
Vitamin D deficiency is common at breast cancer diagnosis and is
associated with a significantly higher risk of distant recurrence and death
in a prospective cohort study of T1-3, N0-1, M0 BC. J Clin Oncol.
2008;26(Suppl): Abstract 511