Funded in part by Bio-Tech Pharmacal
Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort
McDonnell SL, Baggerly CA, French CB, Baggerly LL, Garland CF, Gorham ED, Hollis BW, Trump DL, Lappe JM
PloS one · 96 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Industry funded
- University or hospital
- Creighton University
- Company
- Bio-Tech Pharmacal
- Nonprofit
- Vitamin D Society
- University or hospital
- University of Texas MD Anderson Cancer Center
- Government
- National Cancer Institute
Based on 5 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2018-06-15 · PLoS One · vol. 13 · issue 6 · p. e0199265
- Publisher
- Public Library of Science
- Cited
- 118 citations · more than 99% of similar papers · 9.9× the field average
- Impact
- Top 10% most cited in its field
- References
- 49 works
- Access
- Open access (journal) · PUBLIC-DOMAIN
- Research areas
- Vitamin D Research Studies · Thyroid Disorders and Treatments · Estrogen and related hormone effects
- Keywords
- Breast cancer, Medicine, Prospective cohort study, Internal medicine, Proportional hazards model, Incidence (geometry), Cancer, Cohort, Cohort study, Gastroenterology, Gynecology
- MeSH
- humans, breast neoplasms, vitamin d, proportional hazards models, risk factors, prospective studies, aged, aged, 80 and over, middle aged, female, randomized controlled trials as topic
9 authors
From US
- Sharon L. McDonnell · correspondingGrassrootsHealth
- Carole A. BaggerlyGrassrootsHealth
- Christine FrenchGrassrootsHealth
- Leo L. BaggerlyGrassrootsHealth
- Cedric F. GarlandUniversity of California San Diego
- Edward Doerr GorhamUniversity of California San Diego
Abstract
Background
While numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml.
Objective
To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older.
Methods
Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements.
Results
Within the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20-39, 40-59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin.
Conclusions
Higher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC0).
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