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Meta-analysis of randomized controlled trials on vitamin D supplement and cancer incidence and mortality.

ABSTRACT: OBJECTIVES:We aimed to meta-analyze the results of published randomized controlled trials to test the hypothesis that low vitamin D supplement is associated with an increased risk of cancer incidence and mortality. METHODS:Randomized controlled trials that explored the association between vitamin D supplement and cancer incidence or mortality as primary outcomes were identified through searching the PubMed and EMBASE. Literature search and data extraction were performed independently and in duplicate. RESULTS:Ten randomized controlled trials pooled in 81362 participants. The incidence rate of cancer was 9.16% (3716 cases) and 9.29% (3799 cases) in vitamin D intervention group and placebo group, respectively, resulting in a nonsignificant relative risk (RR) (95% confidence interval (95% CI)) of 0.99 (0.94-1.03) (P=0.532). The mortality rate of cancer was 2.11% (821 cases) and 2.43% (942 cases) in vitamin D intervention group and placebo group, respectively, resulting in a significant reduction in risk (RR = 0.87, 95% CI: 0.79-0.95, P=0.003). There was no observable heterogeneity or publication bias. Subgroup analyses revealed that history of cancer, extra use of vitamin D and calcium supplement were potential sources of heterogeneity. CONCLUSIONS:Our findings support a beneficial effect of vitamin D supplement on lowering cancer mortality, especially in subpopulations with no history of cancer, extra use of vitamin D, or calcium supplement.

SUBMITTER: Zhang X

PROVIDER: S-EPMC6851517 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Meta-analysis of randomized controlled trials on vitamin D supplement and cancer incidence and mortality.

Zhang Xinran X Niu Wenquan W

Bioscience reports 20191101 11

<h4>Objectives</h4>We aimed to meta-analyze the results of published randomized controlled trials to test the hypothesis that low vitamin D supplement is associated with an increased risk of cancer incidence and mortality.<h4>Methods</h4>Randomized controlled trials that explored the association between vitamin D supplement and cancer incidence or mortality as primary outcomes were identified through searching the PubMed and EMBASE. Literature search and data extraction were performed independen ...[more]

PMID: 31696224

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Project description:BackgroundRandomized controlled trials (RCTs) have yielded varying estimates of the benefit of flexible sigmoidoscopy (FS) screening for colorectal cancer (CRC). Our objective was to more precisely estimate the effect of FS-based screening on the incidence and mortality of CRC by performing a meta-analysis of published RCTs.Methods and findingsMedline and Embase databases were searched for eligible articles published between 1966 and 28 May 2012. After screening 3,319 citations and 29 potentially relevant articles, two reviewers identified five RCTs evaluating the effect of FS screening on the incidence and mortality of CRC. The reviewers independently extracted relevant data; discrepancies were resolved by consensus. The quality of included studies was assessed using criteria set out by the Evidence-Based Gastroenterology Steering Group. Random effects meta-analysis was performed. The five RCTs meeting eligibility criteria were determined to be of high methodologic quality and enrolled 416,159 total subjects. Four European studies compared FS to no screening and one study from the United States compared FS to usual care. By intention to treat analysis, FS-based screening was associated with an 18% relative risk reduction in the incidence of CRC (0.82, 95% CI 0.73-0.91, p<0.001, number needed to screen [NNS] to prevent one case of CRC = 361), a 33% reduction in the incidence of left-sided CRC (RR 0.67, 95% CI 0.59-0.76, p<0.001, NNS = 332), and a 28% reduction in the mortality of CRC (relative risk [RR] 0.72, 95% CI 0.65-0.80, p<0.001, NNS = 850). The efficacy estimate, the amount of benefit for those who actually adhered to the recommended treatment, suggested that FS screening reduced CRC incidence by 32% (p<0.001), and CRC-related mortality by 50% (p<0.001). Limitations of this meta-analysis include heterogeneity in the design of the included trials, absence of studies from Africa, Asia, or South America, and lack of studies comparing FS with colonoscopy or stool-based testing.ConclusionsThis meta-analysis of randomized controlled trials demonstrates that FS-based screening significantly reduces the incidence and mortality of colorectal cancer in average-risk patients.

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Meta-analysis of randomized controlled trials on vitamin D supplement and cancer incidence and mortality.

Publications

Meta-analysis of randomized controlled trials on vitamin D supplement and cancer incidence and mortality.

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