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Vitamin D Levels in Patients with Colorectal Cancer Before and After Treatment Initiation

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Abstract

Purpose

We aimed to described 25-hydroxyvitamin D [25(OH)D] levels in newly diagnosed colorectal cancer (CRC) patients and to re-evaluate levels after chemotherapy.

Methods

Permanent residents of the San Francisco Bay Area with a new CRC diagnosis of any stage were recruited prior to any non-surgical therapy. Serum 25(OH)D levels were measured at time of diagnosis and 6-month follow-up. Supplement use was not restricted. The primary endpoint was the frequency of vitamin D deficiency in patients with newly diagnosed CRC of all stages. The Kruskal-Wallis and Spearman correlation tests were used to evaluate associations of patient characteristics with 25(OH)D levels.

Results

Median 25(OH)D level at baseline was 27.0 ng/mL (range 7.2, 59.0); 65% of patients had insufficient levels (25(OH)D < 30 ng/mL) (n = 94). Race, disease stage, multivitamin use, vitamin D supplementation, and county of residence were associated with baseline 25(OH)D levels (P < 0.05). The median change in 25(OH)D from baseline to 6 months was − 0.7 ng/mL [− 19.4, 51.7] for patients treated with chemotherapy (n = 58) and 1.6 ng/mL [− 6.4, 33.2] for patients who did not receive chemotherapy (n = 19) (P = 0.26). For patients who received vitamin D supplementation during chemotherapy, the median 25(OH)D change was 8.3 ng/mL [− 7.6, 51.7] versus − 1.6 [− 19.4, 24.3] for chemotherapy patients who did not take vitamin D supplements (P = 0.02).

Conclusion

Among patients with a new diagnosis of CRC, most patients were found to have 25(OH)D levels consistent with either deficiency or insufficiency. In the subset of patients who received chemotherapy and took a vitamin D supplement, serum 25(OH)D levels increased, suggesting that vitamin D repletion is a feasible intervention during chemotherapy.

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Authors and Affiliations

  1. UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA

    Marissa B. Savoie, Alan Paciorek, Li Zhang, Erin L. Van Blarigan, Nilli Sommovilla, Donald Abrams, Chloe E. Atreya, Emily K. Bergsland, Hueylan Chern, Robin K. Kelley, Andrew Ko, Angela Laffan, Ankit Sarin, Madhulika G. Varma, Alan P. Venook & Katherine Van Loon

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    Alan Paciorek, Li Zhang & Erin L. Van Blarigan

  3. Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA

    Li Zhang, Donald Abrams, Chloe E. Atreya, Emily K. Bergsland, Robin K. Kelley, Andrew Ko, Alan P. Venook & Katherine Van Loon

  4. Department of Colorectal Surgery, University of California, San Francisco, CA, USA

    Hueylan Chern, Ankit Sarin & Madhulika G. Varma

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  1. Marissa B. Savoie
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Correspondence to Katherine Van Loon.

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This study was approved by the UCSF Committee for Human Research (IRB Number 10-03402), and all participants provided informed consent to participate.

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The authors declare that they have no competing interests.

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Savoie, M.B., Paciorek, A., Zhang, L. et al. Vitamin D Levels in Patients with Colorectal Cancer Before and After Treatment Initiation. J Gastrointest Canc 50, 769–779 (2019). https://doi.org/10.1007/s12029-018-0147-7

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