The role of vitamin D supplementation for primary prevention of cancer: meta-analysis of randomized controlled trials

• Main Authors: Tarek Haykal (Author), Varun Samji (Author), Yazan Zayed (Author), Inderdeep Gakhal (Author), Harsukh Dhillon (Author), Babikir Kheiri (Author), Josiane Kerbage (Author), Vijaysai Veerapaneni (Author), Michele Obeid (Author), Rizwan Danish (Author), Ghassan Bachuwa (Author)
• Format: Book
• Published: Greater Baltimore Medical Center, 2019-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2000-9666; 10.1080/20009666.2019.1701839
• Keywords: vitamin d; cancer; primary prevention; mortality; incidence; Internal medicine; RC31-1245
• Source: Journal of Community Hospital Internal Medicine Perspectives, Vol 9, Iss 6, Pp 480-488 (2019)

Background: In the USA cancer is the second leading cause of mortality, as such, primary prevention of cancer is a major public health concern. Vitamin D supplementation has been studied as a primary prevention method for multiple diseases including cardiovascular disease, osteoporosis, diabetes mellitus and cancer. The role of Vitamin D as primary prevention of cancer is still controversial. With fast emergence of large randomized controlled trials (RCTs) in that regards, we aimed to evaluate the efficacy of Vitamin D supplementation as primary prophylaxis for cancer. Methods: A comprehensive electronic database search was conducted for all RCTs where comparison of Vitamin D supplementation versus placebo for the prevention of any type of disease with at least 3 years of Vitamin D supplementation was used and where cancer incidence or mortality was reported. The primary outcome was cancer-related mortality and cancer incidence. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) using a random-effects model at the longest follow-up. Results: We included 10 RCTs with 79,055 total patients, mean age of 68.07 years, a female percentage of 78.02% and a minimum follow-up of 4 years and more. Vitamin D was associated with significant reduction of cancer-related mortality compared with placebo (RR 0.87; 95% CI: 0.79-0.96; P = 0.05: I2 = 0%). Compared with placebo, Vitamin D was not associated with significant reduction of cancer incidence (RR: 0.96; 95% CI: 0.86-1.07; P = 0.46; I2 = 31%). Conclusion: With inclusion of studies, which did not primarily examine vitamin D for the purpose of preventing cancer or reducing cancer mortality our meta-analysis highlights that the use of vitamin D supplementation for primary prevention of cancer is encouraged as it does possibly decrease cancer-related mortality once cancer is diagnosed; however, it has no role or effect on cancer incidence.