Page 86 - Vitamin D and Cancer

Chapter 4
The Epidemiology of Vitamin D
and Cancer Risk

Edward Giovannucci

Abstract Vitamin D status and cancer risk has been investigated in a number of
epidemiologic studies. The methods to estimate vitamin D status have included
direct measures of circulating 25(OH)vitamin D (25(OH)D) levels, surrogates or
determinants of 25(OH)D, including region of residence, intake, and sun exposure
estimates. For colorectal cancer, the evidence for an inverse association between
vitamin D status and risk is quite consistent. Evidence for breast cancer is intrigu-
ing, but prospective studies of 25(OH)D are sparse and conflicting. For prostate
cancer, the data on circulating 25(OH)D have suggested no association or a weak
inverse association, but studies of sun exposure on prostate cancer risk are more
suggestive. It is plausible that for prostate cancer, vitamin D level, much longer
before the time of diagnosis, is the most relevant exposure. Most of the epidemio-
logic studies to date have examined vitamin D status in relation to risk of cancer,
but emerging evidence suggests that vitamin D may also be an important factor for
cancer progression and mortality. Further study is needed to establish when in the
life span and on what stages of carcinogenesis vitamin D is relevant, the precise
intakes and levels required for benefit, and which cancer sites are most affected.

Keywords Epidemiology • Cancer risks • Vitamin D level • Vitamin D intake
• Colorectal cancer • Prostate cancer • Breast cancer • Pancreatic cancer • Ovarian
cancer • Esophageal cancer • Gastric cancer • Non-Hodgkin lymphoma • 25(OH)-
vitamin D • UV radiation

E. Giovannucci (*)
Department of Nutrition, 2–371, Harvard School of Public Health,
665 Huntington Avenue, Boston, MA 02115, USA
and
Department of Epidemiology, Harvard School of Public Health,
Boston, MA 02115, USA
and
Channing Laboratory, Department of Medicine,
Brigham and Women’s Hospital and Harvard Medical School,
181 Longwood Avenue, Boston, MA 02115, USA
e-mail: egiovann@hsph.harvard.edu

D.L. Trump and C.S. Johnson (eds.), Vitamin D and Cancer, 73
DOI 10.1007/978-1-4419-7188-3_4, © Springer Science+Business Media, LLC 2011