アブストラクト | BACKGROUND: There remains uncertainty in whether vitamin D status affects cancer survival. We investigated whether vitamin D (+/- calcium) supplementation affects cancer survival in women. METHODS: Participants were women aged >/=55 years identified from the UK Clinical Practice Research Datalink (CPRD) with a first diagnosis of breast, colorectal, lung, ovarian or uterine cancer between 2002 and 2009, and at least 5 years of CPRD data prior to diagnosis. Cox proportional hazards were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) of the relationship between pre-diagnostic vitamin D supplementation and all-cause mortality. To avoid confounding by indication, the primary analysis compared women with 3+ to 1-2 (but no more) vitamin D prescriptions. Models were adjusted for pre-diagnostic body mass index, smoking, alcohol and deprivation. A sensitivity analysis excluded supplements prescribed in the year prior to diagnosis. RESULTS: Exposure to 3 or more versus 1 to 2 prescriptions of vitamin D was not associated with survival from any of the cancers studied. Any vitamin D prescription, compared to never having been prescribed one, was associated with a better survival from breast cancer (HR 0.78, 95 % CI 0.70 to 0.88). The sensitivity analysis suggested a possible detrimental effect of vitamin D supplementation on lung cancer outcomes (HR for 3 versus 1 or 2 prescriptions 1.22 (95 % CI 0.94 to 1.57); HR for any versus no prescriptions 1.09 (0.98 to 1.22)). CONCLUSIONS: We found no evidence that vitamin D supplementation is associated with survival among women with cancer. Previous observational findings of beneficial effects of vitamin D supplementation on cancer survival may be confounded. |
組織名 | School of Social and Community Medicine, University of Bristol, Canynge Hall, 39;Whatley Road, Bristol, BS8 2PS, UK. Mona.Jeffreys@bristol.ac.uk.;Whatley Road, Bristol, BS8 2PS, UK. theresa.redaniel@bristol.ac.uk.;NIHR CLAHRC West, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.;theresa.redaniel@bristol.ac.uk.;Whatley Road, Bristol, BS8 2PS, UK. Richard.Martin@bristol.ac.uk.;Medical Research Council/University of Bristol Integrated Epidemiology Unit,;University of Bristol, Bristol, UK. Richard.Martin@bristol.ac.uk.;University of Bristol/University Hospitals Bristol NHS Foundation Trust National;Institute for Health Research Bristol Nutrition Biomedical Research Unit, |