Low Vitamin D Intake Associated With Early Onset Colorectal Cancer in Nurses’ Health Study
Douglas K. Rex, MD, MASGE, reviewing Kim H, et al. Gastroenterology 2021 Jul 6.
Many investigators are trying to understand the increasing risk of colorectal cancer (CRC) developing before age 50, or so-called early-onset CRC.
The Nurses’ Health Study tracks risk factors and health outcomes in mostly female nurses in the U.S. From 1991 to 2015, there were 111 incident cases of early-onset CRC in 1.3 million person-years of follow-up. The hazard ratio (HR) for early-onset CRC was 0.49 for vitamin D intake of ≥450 IU per day compared to <300 IU per day. The HR was 0.46 for each increase of 400 IU per day. There were also reductions in the diagnosis of conventional adenomas and serrated polyps associated with every increase of 400 IU per day, with odds ratios of 0.76 for adenomas and 0.85 for serrated polyps. Most of the benefit came from vitamin D in dietary sources, with an HR of 0.34 for each increase of 400 IU per day, whereas supplemental vitamin D had an HR of 0.77 that did not reach significance.
COMMENTSome of the factors recently associated with early-onset CRC include obesity, sedentary lifestyle, a high intake of sugary drinks during the teenage years, and, now, low intake of vitamin D, especially from dietary (dairy) sources. Overall, this study suggests that, among other things, declining milk intake over time in the U.S. could be a contributor to early-onset CRC.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Kim H, Lipsyc-Sharf M, Zong X, et al. Total vitamin D intake and risks of early-onset colorectal cancer and precursors. Gastroenterology 2021 Jul 6. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2021.07.002)
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