Journal
EPIDEMIOLOGY
Volume 33, Issue 1, Pages 37-47Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EDE.0000000000001413
Keywords
vitamin D; breast cancer; supplement use
Categories
Funding
- Office of Dietary Supplement Research Scholars Program Grant
- Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences [Z01-ES044005, ES103332, Z1AES103325, Z01-ES049033]
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The use of vitamin D supplements, particularly recent use, is inversely associated with breast cancer risk, especially for ductal carcinoma in situ.
Background: Vitamin D has anticarcinogenic properties, but a relationship between vitamin D supplement use and breast cancer is not established. Few studies have accounted for changes in supplement use over time or evaluated racial-ethnic differences. Methods: The Sister Study is a prospective cohort of 50,884 women with 35-74 years of age who had a sister with breast cancer, but no breast cancer themselves at enrollment (2003-2009). We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between vitamin D supplement use and incident breast cancer (3,502 cases; median follow-up 10.5 years). Results: Vitamin D supplement use was common, with 64% reporting ever use (at least once per month) in the year before enrollment. Considering supplement use over time, ever use of vitamin D supplements was not meaningfully associated with breast cancer (HR = 0.96, 95% CI = 0.88, 1.0), relative to never use. However, after adjusting for prior use, recent use of vitamin D supplements >= 1/month was inversely associated with breast cancer (HR = 0.88, 95% CI = 0.78, 1.0), relative to nonrecent use. The inverse association was stronger for ductal carcinoma in situ (HR = 0.67, 95% CI = 0.52, 0.87) than invasive breast cancer (HR = 0.94, 95% CI = 0.72, 1.1, p-for-heterogeneity = 0.02). Supplement use was less common among African American/Black (56%) and non-Black Hispanic/Latina (50%) women than non-Hispanic White women (66%), but there was limited evidence of racial-ethnic differences in HRs (p-for-heterogeneity = 0.16 for ever use, P = 0.55 for recent). Conclusions: Our findings are consistent with the hypothesis that recent vitamin D use is inversely associated with breast cancer risk.
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