The Journal of Steroid Biochemistry and Molecular Biology
Vitamin D and prevention of breast cancer: Pooled analysis
Section snippets
Background
A wide range of ecological studies have linked low levels of sunlight or ultraviolet B irradiance with high breast cancer rates [1], [2], [3], [4], [5], [6], and studies of markers of ultraviolet B exposure individuals have supported this association [7]. However, until recently, it was not possible to estimate the dose–response relationship. Vitamin D status is assessed by the level of 25(OH)D in the serum. This is the predominant Vitamin D metabolite in the circulation because its half life
Methods
A PUBMED search for 1966–2006 was performed by two investigators studies. The search was performed by using the terms (“Vitamin D” or “cholecalciferol” or “calcidiol” or ”calcitriol”), and (“cohort” or “case–control” or “case–cohort” or “incidence” or “occurrence” or “epidemiology” or “clinical trial”) and “human” as medical subject heading (MeSH) terms and words in the abstract, combined with the subject term “breast neoplasms”. Articles were included if they were published in medical
Results
Both studies found lower risk of breast cancer in individuals with higher levels of 25(OH)D (Fig. 1, Fig. 2). When results of these studies were pooled, the odds ratios for the pooled serum 25(OH)D studies, from lowest to highest quintile, were 1.00, 0.90, 0.70, 0.70 and 0.50 (p trend < 0.001). The dose–response relationship is shown in Fig. 3. The serum 25(OH)D concentration accounted for 90% of the variation in risk of breast cancer (p < 0.001).
Discussion
A 50% lower risk of breast cancer was associated with a serum 25(OH)D level of 50 ng/ml, compared to ≤10 ng/ml. Since 25(OH)D increases by 10 ng per 1000 IU, this serum level would correspond to intake of 4000 IU/day, assuming baseline 25(OH)D of 10 ng/ml [10]. This exceeds the current National Academy of Sciences upper limit of 2000 IU/day [20]. However, a proposal has been made to establish an upper limit of 4000 IU/day [21], [22]. Given the low background levels of 25(OH)D in US women during the
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