Dietary Vitamin D and Calcium and Risk of Colorectal Cancer: A 19-Year Prospective Study in Men

Garland, Cedric F.; Barrett‐Connor, Elizabeth; Rossof, ArthurH.; Shekelle, R. B.; Criqui, M H; Paul, Oglesby

doi:10.1016/s0140-6736(85)91082-7

Cited by 630 publications

(278 citation statements)

References 10 publications

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“…The association was not modified when controlling for fruit intake which was the only other food associated with a reduced risk of large adenomas (Bostick et al, 1993). A protective effect of calcium, not always statistically significant, was suggested in five of nine case-control and in three of five cohort studies (Garland et al, 1985;Stemmermann et al, 1990;Bostick et al, 1993). In a later study in the Netherlands (Kampman et al, 1994b), calcium was even positively, although not significantly, associated with cancer risk, as in our own study.…”

Section: Datamentioning

confidence: 83%

Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case - control study

Boutron

Faivre²,

Marteau³

et al. 1996

Br J Cancer

133

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Summary A protective effect of calcium against colorectal cancer has been described in Anglo-Saxon but not in Latin communities, and no such effect has been observed regarding adenomas. We investigated the relationship between calcium, dairy products and the adenoma-carcinoma sequence in a French region by comparing small adenoma (< 10 mm, n = 154), large adenoma (n = 208) and polyp-free (n = 426) subjects, and cancer cases (n = 171) with population controls (n = 309). There was no protective effect of calcium against colorectal tumours except for low fat calcium and large adenomas in men (OR for highest quintile= 0.3, P for trend = 0.06). There was even a trend towards an increased risk of cancer with dairy calcium in men and nondairy calcium in women. Vitamin D was inversely related to the risk of small adenomas in women (OR for highest quintile = 0.4, P for trend = 0.04). Regarding dairy products, only consumption of yoghurt displayed an inverse relationship with risk of large adenomas, in both men and women. These data failed to demonstrate a protective effect of calcium against colorectal carcinogenesis. They suggest that the type of dairy product might be the important factor with regard to prevention of colorectal tumours. (Benito et al., 1991;Tuyns et al., 1988; Negri et al., 1990). Dairy products have also been studied not only because they are the main source of dietary calcium, but also because other components may be of interest, such as the lactose content or the bacteria in fermented dairy products. To date, no significant association has been described between calcium intake and colorectal adenomas (Kampman et al., 1994a). This finding is all the more important since certain of the current intervention studies with calcium supplements use adenoma recurrence as an end point.France has a tradition of high calcium intake, mainly in the form of cheese. In order to define further the effect of calcium, phosphate, vitamin D and dairy product intake on the adenoma-carcinoma sequence, we carried out a casecontrol study in a French community of the relationship between these nutrients, as well as calcium-containing foods and the different macroscopic steps of colorectal carcinogenesis, namely small adenoma, large adenoma and cancer. Materials and methodsCases and controls A case-control study was set up between 1985 and 1990 to investigate risk factors for the different macroscopic steps of the adenoma-carcinoma sequence. Its general design has already been described Sample size calculations were based on fat intake, one of the suspected major risk factors for colorectal cancer. Considering the proportion of the population exposed to a high-fat diet, with a power of 80% to demonstrate a relative risk of 2.0 at the 5% level of significance, it was calculated that at least 140 cases and 280 controls were needed in each group.Two groups of patients with adenomas and polyp-free controls were selected from the endoscopy lists of all gastroenterologists in the area, whether in private or public practice. Adeno...

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Section: Datamentioning

confidence: 83%

Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case - control study

Boutron

Faivre²,

Marteau³

et al. 1996

Br J Cancer

133

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“…Consistent with the findings of several previous studies (Bergsma-Kadijk et al, 1996;Jain, 1998;Martinez & Willett, 1998), dietary calcium was not significantly related to risk of colon cancer or cancers of the colon and rectum combined. The two previous cohort studies that reported a significant inverse relationship between calcium intake and colorectal cancer risk based their findings in men with high average intake level of calcium (Garland et al, 1985;Pietinen et al, 1999). In the present study, calcium intake in men was clearly higher than that in women; however, due to the small number of colon cancer cases we were not able to carry out analyses separately in men and women.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the epidemiological evidence does not suggest an important effect of calcium intake on the risk of colorectal cancers (BergsmaKadijk et al, 1996;Jain, 1998;Martinez & Willett, 1998). Nevertheless, two previous prospective studies presented significant reduced risks of colorectal cancers with high calcium intake levels (Garland et al, 1985;Pietinen et al, 1999), and suggestive inverse relationships between calcium intake and colon cancer risk have been reported in other prospective studies (Bostick et al, 1993;Kato et al, 1997).…”

Section: Introductionmentioning

confidence: 86%

Prospective study on milk products, calcium and cancers of the colon and rectum

et al. 2001

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Objective: To study the relationship between consumption of milk and milk products, calcium, lactose and vitamin D and occurrence of colorectal cancers. Design: Prospective cohort study. Subjects: A total of 9959 men and women aged 15 y or older without history of cancer at baseline. During a 24 y follow-up, 72 new cancers of the large bowel (38 in the colon and 34 in the rectum) were detected. Results: Consumption of milk and total milk products was suggested to be inversely related to colon cancer incidence, whereas no similar association was seen for rectal cancer. The relative risk between the highest and lowest quartiles of intake adjusted for potential confounding factors was 0.46 (95% confidence interval 0.14 -1.46, P for trend 0.09) for milk and 0.37 (95% CI ¼ 0.12 -1.39, P for trend 0.06) for total milk products. Lactose intake showed a similar inverse relationship with colon cancer: the relative risk was 0.31 (95% CI ¼ 0.08 -1.15, P for trend 0.03). Intake of vitamin D or total dietary calcium was not significantly related to colorectal cancer risk, whereas calcium provided by fermented milk products was associated with increased colorectal cancer incidence; in the highest quartile the multivariate adjusted relative risk for colorectal cancer was 2.07 (95% CI ¼ 1.00 -4.28). Conclusions: Our results indicate that individuals showing high consumption of milk have a potentially reduced risk of colon cancer; however, the association does not appear to be due to intake of calcium, vitamin D, or to specific effects of fermented milk. Sponsorship: This study was supported by a grant from the Swedish Cancer Foundation.

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“…Thus, over-expression of 24-hydroxylase may further abrogate growth control mediated by 1a,25(OH) 2 D 3 , via target cell inactivation of the hormone. It has therefore been proposed that breast cancer is associated with low circulating concentrations of 25OH-D, arising as a result of reduced exposure to sunlight, altered dietary patterns and impaired generation of 1a,25(OH) 2 D 3 within breast tissue (51,(117)(118)(119)(120)(121) .…”

Section: Epidemiological Evidencementioning

confidence: 99%

The vitamin D receptor in cancer

2008

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Over the last 25 years roles have been established for vitamin D receptor (VDR) in influencing cell proliferation and differentiation. For example, murine knock-out approaches have revealed a role for the VDR in controlling mammary gland growth and function. These actions appear widespread, as the enzymes responsible for 1a,25-dihydroxycholecalciferol generation and degradation, and the VDR itself, are all functionally present in a wide range of epithelial and haematopoietic cell types. These findings, combined with epidemiological and functional data, support the concept that local, autocrine and paracrine VDR signalling exerts control over cell-fate decisions in multiple cell types. Furthermore, the recent identification of bile acid lithocholic acid as a VDR ligand underscores the environmental sensing role for the VDR. In vitro and in vivo dissection of VDR signalling in cancers (e.g. breast, prostate and colon) supports a role for targeting the VDR in either chemoprevention or chemotherapy settings. As with other potential therapeutics, it has become clear that cancer cells display de novo and acquired genetic and epigenetic mechanisms of resistance to these actions. Consequently, a range of experimental and clinical options are being developed to bring about more targeted actions, overcome resistance and enhance the efficacy of VDR-centred therapeutics. The cancer burdenThe impact of cancer continues to be one of the greatest burdens in the developed world and is also increasingly impacting on the developing world. Approximately 1 . 5 million individuals will die from breast, colon or prostate cancer this year, and the total number of deaths from cancer accounts for 13 % of all deaths worldwide and for one in every four deaths in the UK and USA (1) . The impact is also economic; $280 · 10 9 is spent annually worldwide on the treatment of patients. Many cancers are however preventable, and through lifestyle choices such as smoking, diet and exercise the worldwide incidence of cancer could be cut by 40 % (2,3) . Major risk factors for cancer DietRecently, the appreciation of the impact of diet on cancer has come to the fore, with a number of studies establishing unequivocal relationships between diet and cancer initiation and progression. Reflecting the accumulation of these data, the WHO has now stated that diet forms the secondmost preventable cause of cancer (after smoking) (3) . This impact will rise further as a result of demographic factors, and quite possibly because of changing dietary habits worldwide, which will contribute further to the projected increase in cancer incidence in developing nations. Highprofile malignancies such as breast, prostate, and colon cancer typify this scenario, in which the aetiology of the disease reflects the cumulative impact of dietary factors over an individual's lifetime (4)(5)(6) . The relationship between diet and disease is already exploited clinically, e.g. in the Selenium and Vitamin E Cancer Prevention Trial to assess the chemoprevention potential of vitamin E ...

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Dietary Vitamin D and Calcium and Risk of Colorectal Cancer: A 19-Year Prospective Study in Men

Cited by 630 publications

References 10 publications

Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case - control study

Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case - control study

Prospective study on milk products, calcium and cancers of the colon and rectum

The vitamin D receptor in cancer

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