Association Between Vitamin D and Risk of Colorectal Cancer: A Systematic Review of Prospective Studies

Purpose To conduct a systematic review of prospective studies assessing the association of vitamin D intake or blood levels of 25-hydroxyvitamin D [25(OH)D] with the risk of colorectal cancer using meta-analysis. Methods Relevant studies were identified by a search of MEDLINE and EMBASE databases before October 2010 with no restrictions. We included prospective studies that reported relative risk (RR) estimates with 95% CIs for the association between vitamin D intake or blood 25(OH) D levels and the risk of colorectal, colon, or rectal cancer. Approximately 1,000,000 participants from several countries were included in this analysis. Results Nine studies on vitamin D intake and nine studies on blood 25(OH) D levels were included in the meta-analysis. The pooled RRs of colorectal cancer for the highest versus lowest categories of vitamin D intake and blood 25(OH) D levels were 0.88 (95% CI, 0.80 to 0.96) and 0.67 (95% CI, 0.54 to 0.80), respectively. There was no heterogeneity among studies of vitamin D intake (P = .19) or among studies of blood 25(OH) D levels (P = .96). A 10 ng/mL increment in blood 25(OH) D level conferred an RR of 0.74 (95% CI, 0.63 to 0.89). Conclusion Vitamin D intake and blood 25(OH) D levels were inversely associated with the risk of colorectal cancer in this meta-analysis. J Clin Oncol 29: 3775-3782. (C) 2011 by American Society of Clinical Oncology