Associations of circulating and dietary vitamin D with prostate cancer risk: a systematic review and dose–response meta-analysis
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We systematically reviewed and meta-analyzed literature examining associations of vitamin D (dietary intake, circulating 25-hydroxy-vitamin-D (25(OH)D), and 1,25-dihydroxy-vitamin-D (1,25(OH)2D) concentrations) with prostate cancer.
We searched over 24,000 papers from seven electronic databases (to October 2010) for exposures related to vitamin D. We conducted dose–response random-effects meta-analyses pooling the log odds ratio (OR) and 95% confidence intervals (CI) per change in natural units of each exposure. The I2 statistic quantified between-study variation due to heterogeneity.
Twenty-five papers were included. In prospective studies, the OR per 1,000 IU increase in dietary intake was 1.14 (6 studies; CI: 0.99, 1.31; I 2 = 0%) for total prostate cancer and 0.93 (3 studies; 0.63, 1.39; I 2 = 25%) for aggressive prostate cancer. Five case–control studies examined dietary intake, but there was a high degree of inconsistency between studies (I 2 = 49%). The OR per 10 ng/mL increase in 25(OH)D was 1.04 (14 studies; 0.99, 1.10; I 2 = 0%) for total prostate cancer and 0.98 (6 studies; 0.84, 1.15; I 2 = 32%) for aggressive prostate cancer. The OR per 10 pg/mL increase in 1,25(OH)2D was 1.00 (7 studies; 0.87, 1.14; I 2 = 41%) for total prostate cancer and 0.86 (2 studies; 0.72, 1.02; I 2 = 0%) for aggressive prostate cancer.
Published literature provides little evidence to support a major role of vitamin D in preventing prostate cancer or its progression.
KeywordsVitamin D Prostatic neoplasms Review Meta-analysis Epidemiology
We would like to thank Margaret Burke, dedicated information specialist, for carrying out the systematic literature review in the electronic databases. This work was supported by Cancer Research UK (C31211/A10095 to RG, RMM, CM, WDF) and the World Cancer Research Fund (2006/15 to RMM, CM and WDF). The original Expert Report was funded by the World Cancer Research Fund (Davey Smith, G., Sterne, J.A.C., Bain, C. Burke, M., Donovan, J., Ebrahim, S., Egger, M., Emmett, P., Gunnell, D., Hooper, L., Ness, A. and Oliver, S. Systematic review of associations between diet, nutrition, physical activity and bladder, prostate and kidney cancer. World Cancer Research Fund. 1 September 2003–30 June 2006.).
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