This study by Lappe et al. (JAMA, 2017) sought to determine if Vitamin D3 and calcium supplements reduce cancer risk in older women.
Randomized Controlled Trial (RCT)
This four year, double-blind, placebo-controlled, population-based, randomized clinical trial included 2,303 healthy, postmenopausal women, 55 years or older (mean age, 65.2 years). 1,156 women were randomized to receive 2000 IU/d of D3 and 1500 mg/d of calcium, and 1,147 received a placebo. The average baseline serum 25-hydroxyvitamin D level was 32.8 ng/mL; after one year levels were 43.9 ng/mL and 31.6 ng/mL in the treatment and placebo group respectively. A new diagnosis of cancer was reported in 109 participants, 45 in the treatment group and 64 in the placebo group, a difference of 1.69% that was not found to be statistically significant ([95% CI, -0.06% to 3.46%]; P = .06). Adverse events were noted in the treatment group, including renal calculi and elevated serum calcium levels. The editorial on this paper points out that this paper is in keeping with previous research that has yet to demonstrate a clear benefit to vitamin D supplementation and cancer prevention. Limitations to this study include the fact that the average baseline serum 25-hydroxyvitamin D level was 32.8 ng/mL – a level well within normal and potentially high enough to be protective from the outset. The editorial also addresses the importance of research in diverse populations. For example, African Americans may be more prone to vitamin D insufficiency. Furthermore, the study of vitamin D supplementation on specific cancers (e.g. breast or colorectal cancer) also requires further research. Both the authors and editorial conclude that further trials, including larger datasets with longer follow up, are still required.
JAMA Editorial: Vitamin D, Calcium, and Cancer: Approaching Daylight?
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