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16 maart 2018: Bron: BMJ 2018; 360 (Published 07 March 2018)

Een hogere concentratie van 25-hydroxyvitamine D in het bloed wordt geassocieerd met een verlaagd risico op alle vormen van kanker en niet op 1 specifieke vorm van kanker. 

Sanjeev Budhathoki, MD, van het National Cancer Center in Tokio, en collega's onderzochten het verband tussen in bloed circulerende vitamine D-concentraties voor de diagnose van kanker werd geconstateerd en het risico op het krijgen van kanker. Ze voerden een zogeheten case-cohortstudie uit waarin bij 3.301 mensen met kanker en 4.044 willekeurig geselecteerde deelnemers hun bloedwaarden van 25-hydroxyvitamine D werden onderzocht.

Zij namen uiteindelijk 33 736 deelnemers op in de studie.

Fig 1

Fig 1

Selection of cases and subcohort participants in Japan Public Health Center-based Prospective (JPHC) Study. PHC=public health centre


De onderzoekers vonden dat er een verband was tussen hoge bloedwaarden van 25-hydroxyvitamine D-concentratie en het risico op het krijgen van kanker, Uit het onderzoek kwam niet naar voren dat dit voor 1 specifieke vorm van kanker zou gelden, maar die relatie was er voor alle vormen van kanker. Alleen leverkanker sprong er enigszins uit met een hoger risico tussen de laagste en hoogste waarden.

Table 3

Hazard ratios (HRs) for total and site specific* cancer according to quarters of plasma vitamin D

Quarters of plasma vitamin DP for trend
1 (low)2 (second)3 (third)4 (high)
All cancer
No of cases 840 792 795 874
HR (95% CI)† 1 (reference) 0.84 (0.73 to 0.97) 0.79 (0.68 to 0.91) 0.80 (0.69 to 0.93) 0.003
HR (95% CI)‡ 1 (reference) 0.81 (0.70 to 0.94) 0.75 (0.65 to 0.87) 0.78 (0.67 to 0.91) 0.001
Gastric cancer
No of cases 153 156 157 171
HR (95% CI)† 1 (reference) 0.98 (0.77 to 1.27) 0.97 (0.75 to 1.26) 1.04 (0.81 to 1.36) 0.78
HR (95% CI)‡ 1 (reference) 0.97 (0.75 to 1.25) 0.92 (0.71 to 1.20) 0.99 (0.76 to 1.29) 0.88
Colorectal cancer
No of cases 134 165 160 178
HR (95% CI)† 1 (reference) 1.11 (0.86 to 1.42) 0.98 (0.76 to 1.28) 0.97 (0.75 to 1.26) 0.59
HR (95% CI)‡ 1 (reference) 1.08 (0.84 to 1.39) 0.96 (0.74 to 1.26) 0.95 (0.73 to 1.23) 0.48
Colon cancer
No of cases 89 115 115 133
HR (95% CI)† 1 (reference) 1.12 (0.83 to 1.51) 1.00 (0.73 to 1.36) 1.01 (0.74 to 1.37) 0.80
HR (95% CI)‡ 1 (reference) 1.09 (0.80 to 1.47) 0.97 (0.71 to 1.33) 0.98 (0.72 to 1.33) 0.68
Rectal cancer
No of cases 46 50 47 47
HR (95% CI)† 1 (reference) 1.08 (0.71 to 1.64) 0.99 (0.64 to 1.54) 0.93 (0.60 to 1.46) 0.68
HR (95% CI)‡ 1 (reference) 1.07 (0.70 to 1.64) 1.00 (0.63 to 1.56) 0.92 (0.58 to 1.46) 0.66
Liver cancer
No of cases 47 43 41 34
HR (95% CI)† 1 (reference) 0.72 (0.46 to 1.13) 0.65 (0.41 to 1.04) 0.45 (0.27 to 0.77) 0.004
HR (95% CI)‡ 1 (reference) 0.70 (0.44 to 1.13) 0.65 (0.40 to 1.06) 0.45 (0.26 to 0.79) 0.006
Lung cancer
No of cases 109 87 88 112
HR (95% CI)† 1 (reference) 0.70 (0.51 to 0.96) 0.65 (0.47 to 0.89) 0.75 (0.55 to 1.03) 0.08
HR (95% CI)‡ 1 (reference) 0.63 (0.45 to 0.87) 0.56 (0.40 to 0.79) 0.72 (0.52 to 1.00) 0.06
Prostate cancer
No of cases 67 65 69 62
HR (95% CI)† 1 (reference) 0.81 (0.54 to 1.22) 0.79 (0.53 to 1.20) 0.64 (0.41 to 1.00) 0.06
HR (95% CI)‡ 1 (reference) 0.81 (0.53 to 1.23) 0.81 (0.53 to 1.25) 0.64 (0.41 to 1.02) 0.07
Breast cancer
No of cases 72 59 46 62
HR (95% CI)† 1 (reference) 0.82 (0.57 to 1.18) 0.61 (0.41 to 0.92) 0.75 (0.51 to 1.11) 0.08
HR (95% CI)§ 1 (reference) 0.98 (0.66 to 1.47) 0.69 (0.45 to 1.05) 0.78 (0.51 to 1.21) 0.12
Premenopausal:
 No of cases 35 27 12 12
 HR (95% CI)** 1 (reference) 1.14 (0.62 to 2.09) 0.42 (0.20 to 0.90) 0.56 (0.25 to 1.24) 0.03
Postmenopausal:
 No of cases 29 28 31 40
 HR (95% CI)** 1 (reference) 0.91 (0.51 to 1.60) 0.94 (0.54 to 1.64) 0.97 (0.56 to 1.71) 0.98

  • ↵* Site specific cancers with case numbers of ≥130.

  • ↵† Adjusted for age and sex.

  • ↵‡ Adjusted for age, sex, body mass index, smoking, alcohol use, physical activity, family history of cancer, and reported history of diabetes.

  • ↵§ Adjusted for factors in ‡ (except sex) in addition to age at menarche, number of births, use of exogenous female hormones, and menopausal status and age at menopause.

  • ↵ Number of cases from first to fourth quarters are 63, 55, 43, and 51, respectively.

  • ↵** Adjusted for factors in ‡ (except sex) in addition to age at menarche, number of births, and use of exogenous female hormones.

vitamine D 2



"Deze bevindingen ondersteunen de hypothese dat vitamine D een beschermend effect heeft tegen nagenoeg alle vormen van kanker.", schrijven de auteurs.

Uit het studierapport:

What this study adds

  • In this population based prospective cohort study of a Japanese population, higher vitamin D concentration was associated with a reduced risk of overall cancer in both men and women

  • A decreased risk of liver cancer was also associated with a high vitamin D concentration

  • The results support the hypothesis that vitamin D might have beneficial effects in cancer prevention

Het volledige studierapport, gepubliceerd in BMJ International  Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort is gratis in te zien.

Hier het abstract van de studie:

higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites.

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k671 (Published 07 March 2018) Cite this as: BMJ 2018;360:k671

  1. Sanjeev Budhathoki, staff scientist1,
  2. Akihisa Hidaka, staff scientist1,
  3. Taiki Yamaji, section head,1,
  4. Norie Sawada, section head1,
  5. Sachiko Tanaka-Mizuno, associate professor2,
  6. Aya Kuchiba, section head3 4,
  7. Hadrien Charvat, staff scientist1,
  8. Atsushi Goto, section head1,
  9. Satoshi Kojima, manager5,
  10. Natsuki Sudo, researcher5,
  11. Taichi Shimazu, section head1,
  12. Shizuka Sasazuki, division chief1,
  13. Manami Inoue, division chief1,
  14. Shoichiro Tsugane, director1,
  15. Motoki Iwasaki, division chief1
  16. for the Japan Public Health Center-based Prospective Study Group
Author affiliations
  1. Correspondence to: T Yamaji tyamaji@ncc.go.jp
  • Accepted 1 February 2018

Abstract

Objective To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study.

Design Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort.

Setting Nine public health centre areas across Japan.

Participants 3301 incident cases of cancer and 4044 randomly selected subcohort participants.

Exposure Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference.

Main outcome measure Incidence of overall or site specific cancer.

Results Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios.

Conclusions In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites.

vitamine D, 25-hydroxyvitamine D, bloedwaarden, kans op kanker, preventie, kankersoorten, alle vormen van kanker


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