Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer

  • Marwan G. FakihEmail author
  • Donald L. Trump
  • Candace S. Johnson
  • Lili Tian
  • Josephia Muindi
  • Annette Y. Sunga
Original Article



Preclinical and clinical evidence support an association between vitamin D deficiency and an increased risk of colorectal cancer. Normal vitamin D status has been linked to favorable health outcomes ranging from decreased risk of osteoporosis to improved cancer mortality. We performed a retrospective study to assess the impact of metastatic disease and chemotherapy treatment on vitamin D status in patients with colorectal cancer residing in Western New York.

Materials and methods

Patients, 315, with colorectal cancer treated in a single institute were assayed for 25-OH vitamin D. The association of age, gender, primary disease site and stage, body mass index, and chemotherapy with vitamin D status was investigated.


Vitamin D deficiency was common among participants with a median 25-OH vitamin D level of 21.3 ng/ml (optimal range 32–100 ng/ml). Primary site of disease and chemotherapy status were associated with very low 25-OH vitamin D levels (≤15 ng/ml) on multivariate analysis. Patients receiving chemotherapy and patients with a rectal primary were 3.7 and 2.6-fold more likely to have severe vitamin D deficiency on multivariate analysis than nonchemotherapy patients and colon cancer primary patients, respectively.


Chemotherapy is associated with a significant increase in the risk of severe vitamin D deficiency. Patients with colorectal cancer, especially those receiving chemotherapy, should be considered for aggressive vitamin D replacement strategies.


Colorectal cancer Vitamin D 25-hydroxy vitamin D Chemotherapy 



This study was partly supported by a Mentored Scholar Award Grant by the American Cancer Society to MGF.

There are no financial conflicts to report.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Marwan G. Fakih
    • 1
    • 5
    Email author
  • Donald L. Trump
    • 1
  • Candace S. Johnson
    • 2
  • Lili Tian
    • 3
  • Josephia Muindi
    • 1
  • Annette Y. Sunga
    • 4
  1. 1.Department of MedicineRoswell Park Cancer Institute and the University at BuffaloBuffaloUSA
  2. 2.Department of PharmacologyRoswell Park Cancer InstituteBuffaloUSA
  3. 3.Department of BiostatisticsRoswell Park Cancer Institute and the University at BuffaloBuffaloUSA
  4. 4.Cancer Prevention and Population ScienceRoswell Park Cancer InstituteBuffaloUSA
  5. 5.Department of MedicineRoswell Park Cancer InstituteBuffaloUSA

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