Prevalence of serum vitamin D deficiency and insufficiency in cancer: Review of the epidemiological literature

Gupta,Digant; Vashi,Pankaj  G.; Trukova,Kristen; Lis,Christopher   G.; Lammersfeld,Carolyn   A.

doi:10.3892/etm.2011.205

Prevalence of serum vitamin D deficiency and insufficiency in cancer: Review of the epidemiological literature

Authors:
- Digant Gupta
- Pankaj G. Vashi
- Kristen Trukova
- Christopher G. Lis
- Carolyn A. Lammersfeld
View Affiliations

Affiliations: Cancer Treatment Centers of America® at Midwestern Regional Medical Center, Zion, IL 60099, USA
Published online on: January 20, 2011 https://doi.org/10.3892/etm.2011.205
Pages: 181-193

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Vitamin D deficiency has been found to be associated with a variety of cancers, including prostate, multiple myeloma, colorectal and breast cancer. Several studies have shown vitamin D levels to have an inverse relation with cancer mortality, while others have considered it a potential risk factor. Vitamin D is believed to influence cancer prevalence, risk and survival; hence the need to assess vitamin D levels in cancer. Although numerous studies have been conducted to demonstrate vitamin D deficiency as a risk factor for cancer, relatively few have studied its prevalence. Moreover, studies estimating prevalence differ from each other, with respect to study population, sample size, study design, definition of vitamin D deficiency used and method of vitamin D assessment (with most studies limited to one particular type of cancer with relatively small sample sizes). Therefore, we qualitatively reviewed the epidemiological evidence in the oncology literature on the prevalence of vitamin D deficiency and insufficiency as measured by serum vitamin D concentrations.

View Figures

View References

1.	Holick MF: Vitamin D deficiency. N Engl J Med. 357:266–281. 2007. View Article : Google Scholar
2.	Adams JS and Hewison M: Update in vitamin D. J Clin Endocrinol Metab. 95:471–478. 2010. View Article : Google Scholar : PubMed/NCBI
3.	Hollis BW: Assessment of circulating 25(OH)D and 1,25(OH)2D: emergence as clinically important diagnostic tools. Nutr Rev. 65:S87–S90. 2007. View Article : Google Scholar : PubMed/NCBI
4.	Hollis BW: Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 135:317–322. 2005.PubMed/NCBI
5.	Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ and Vieth R: Estimates of optimal vitamin D status. Osteoporos Int. 16:713–716. 2005. View Article : Google Scholar : PubMed/NCBI
6.	Bischoff-Ferrari HA: Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Adv Exp Med Biol. 624:55–71. 2008. View Article : Google Scholar : PubMed/NCBI
7.	Dusso AS, Brown AJ and Slatopolsky E: Vitamin D. Am J Physiol Renal Physiol. 289:F8–F28. 2005. View Article : Google Scholar : PubMed/NCBI
8.	Holick MF: Resurrection of vitamin D deficiency and rickets. J Clin Invest. 116:2062–2072. 2006. View Article : Google Scholar : PubMed/NCBI
9.	Dalhoff K, Dancey J, Astrup L, et al: A phase II study of the vitamin D analogue Seocalcitol in patients with inoperable hepatocellular carcinoma. Br J Cancer. 89:252–257. 2003. View Article : Google Scholar : PubMed/NCBI
10.	Diaz GD, Paraskeva C, Thomas MG, Binderup L and Hague A: Apoptosis is induced by the active metabolite of vitamin D3 and its analogue EB1089 in colorectal adenoma and carcinoma cells: possible implications for prevention and therapy. Cancer Res. 60:2304–2312. 2000.PubMed/NCBI
11.	Vandewalle B, Wattez N and Lefebvre J: Effects of vitamin D3 derivatives on growth, differentiation and apoptosis in tumoral colonic HT 29 cells: possible implication of intracellular calcium. Cancer Lett. 20:99–106. 1995. View Article : Google Scholar : PubMed/NCBI
12.	Scaglione-Sewell BA, Bissonnette M, Skarosi S, Abraham C and Brasitus TA: A vitamin D3 analog induces a G1-phase arrest in CaCo-2 cells by inhibiting cdk2 and cdk6: roles of cyclin E, p21Waf1, and p27Kip1. Endocrinology. 141:3931–3939. 2000.PubMed/NCBI
13.	Fernandez-Garcia NI, Palmer HG, Garcia M, et al: 1alpha,25-Dihydroxyvitamin D3 regulates the expression of Id1 and Id2 genes and the angiogenic phenotype of human colon carcinoma cells. Oncogene. 24:6533–6544. 2005.PubMed/NCBI
14.	Evans SR, Shchepotin EI, Young H, Rochon J, Uskokovic M and Shchepotin IB: 1,25-dihydroxyvitamin D3 synthetic analogs inhibit spontaneous metastases in a 1,2-dimethylhydrazine-induced colon carcinogenesis model. Int J Oncol. 16:1249–1254. 2000.
15.	Lamprecht SA and Lipkin M: Cellular mechanisms of calcium and vitamin D in the inhibition of colorectal carcinogenesis. Ann NY Acad Sci. 952:73–87. 2001. View Article : Google Scholar : PubMed/NCBI
16.	Ahn J, Peters U, Albanes D, et al: Serum vitamin D concentration and prostate cancer risk: a nested case-control study. J Natl Cancer Inst. 100:796–804. 2008. View Article : Google Scholar : PubMed/NCBI
17.	Mucci LA and Spiegelman D: Vitamin D and prostate cancer risk – a less sunny outlook? J Natl Cancer Inst. 100:796–804. 2008.
18.	Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D and Chang-Claude J: Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer – results of a large case-control study. Carcinogenesis. 29:93–99. 2008.PubMed/NCBI
19.	Freedman DM, Looker AC, Chang SC and Graubard BI: Prospective study of serum vitamin D and cancer mortality in the United States. J Natl Cancer Inst. 99:1594–1602. 2007. View Article : Google Scholar : PubMed/NCBI
20.	Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ and Willett WC: Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 98:451–459. 2006. View Article : Google Scholar : PubMed/NCBI
21.	Heist RS, Zhou W, Wang Z, et al: Circulating 25-hydroxyvitamin D, VDR polymorphisms, and survival in advanced non-small-cell lung cancer. J Clin Oncol. 26:5596–5602. 2008. View Article : Google Scholar : PubMed/NCBI
22.	Ng K, Meyerhardt JA, Wu K, Feskanich D, Hollis BW, Giovannucci EL and Fuchs CS: Circulating 25-hydroxyvitamin D levels and survival in patients with colorectal cancer. J Clin Oncol. 26:2984–2991. 2008. View Article : Google Scholar : PubMed/NCBI
23.	Pilz S, Dobnig H, Winklhofer-Roob B, et al: Low serum levels of 25-hydroxyvitamin D predict fatal cancer in patients referred to coronary angiography. Cancer Epidemiol Biomarkers Prev. 17:1228–1233. 2008. View Article : Google Scholar : PubMed/NCBI
24.	Tretli S, Hernes E, Berg JP, Hestvik UE and Robsahm TE: Association between serum 25(OH)D and death from prostate cancer. Br J Cancer. 100:450–454. 2009. View Article : Google Scholar : PubMed/NCBI
25.	Zhou W, Heist RS, Liu G, et al: Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small-cell lung cancer patients. J Clin Oncol. 25:479–485. 2007. View Article : Google Scholar : PubMed/NCBI
26.	Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J and Albanes D: A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Cancer Res. 66:10213–10219. 2006. View Article : Google Scholar : PubMed/NCBI
27.	Grant WB: An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer. 94:1867–1875. 2002. View Article : Google Scholar : PubMed/NCBI
28.	Feskanich D, Ma J, Fuchs CS, Kirkner GJ, Hankinson SE, Hollis BW and Giovannucci EL: Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev. 13:1502–1508. 2004.PubMed/NCBI
29.	Pritchard RS, Baron JA and Gerhardsson DV: Dietary calcium, vitamin D, and the risk of colorectal cancer in Stockholm, Sweden. Cancer Epidemiol Biomarkers Prev. 5:897–900. 1996.PubMed/NCBI
30.	Giovannucci E: The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control. 16:83–95. 2005. View Article : Google Scholar : PubMed/NCBI
31.	Nogues X, Servitja S, Pena MJ, et al: Vitamin D deficiency and bone mineral density in postmenopausal women receiving aromatase inhibitors for early breast cancer. Maturitas. 66:291–297. 2010. View Article : Google Scholar : PubMed/NCBI
32.	Neuhouser Ml, Bernstein L, Hollis BW, et al: Serum vitamin D and breast density in breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 19:412–417. 2010. View Article : Google Scholar : PubMed/NCBI
33.	Khan QJ, Reddy PS, Kimler BF, et al: Effect of vitamin D supplementation on serum 25-hydroxy vitamin D levels, joint pain, and fatigue in women starting adjuvant letrozole treatment for breast cancer. Breast Cancer Res Treat. 119:111–118. 2010. View Article : Google Scholar : PubMed/NCBI
34.	Crew KD, Shane E, Cremers S, McMahon DJ, Irani D and Hershman DL: High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy. J Clin Oncol. 27:2151–2156. 2009. View Article : Google Scholar : PubMed/NCBI
35.	Rainville C, Khan Y and Tisman G: Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series. Cases J. 2:83902009. View Article : Google Scholar : PubMed/NCBI
36.	Waltman NL, Ott CD, Twiss JJ, Gross GJ and Lindsey AM: Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. Cancer Nurs. 32:143–150. 2009. View Article : Google Scholar : PubMed/NCBI
37.	Neuhouser Ml, Sorensen B, Hollis BW, et al: Vitamin D insufficiency in a multiethnic cohort of breast cancer survivors. Am J Clin Nutr. 88:133–139. 2008.PubMed/NCBI
38.	Wang-Gillam A, Miles DA and Hutchins LF: Evaluation of vitamin D deficiency in breast cancer patients on bisphosphonates. Oncologist. 13:821–827. 2008. View Article : Google Scholar : PubMed/NCBI
39.	De Lyra EC, da Silva IA, Katayama Ml, Brentani MM, Nonogaki S, Goes JC and Folgueira MA: 25(OH)D3 and 1,25(OH)2D3 serum concentration and breast tissue expression of 1alpha-hydroxylase, 24-hydroxylase and vitamin D receptor in women with and without breast cancer. J Steroid Biochem Mol Biol. 100:184–192. 2006.PubMed/NCBI
40.	Palmieri C, MacGregor T, Girgis S and Vigushin D: Serum 25-hydroxyvitamin D levels in early and advanced breast cancer. J Clin Pathol. 59:1334–1336. 2006. View Article : Google Scholar : PubMed/NCBI
41.	Charalampopoulos A, Charalabopoulos A, Batistatou A, et al: Parathormone and 1,25(OH)2D3 but not 25(OH)D3 serum levels, in an inverse correlation, reveal an association with advanced stages of colorectal cancer. Clin Exp Med. 10:69–72. 2010. View Article : Google Scholar : PubMed/NCBI
42.	Fakih MG, Trump DL, Johnson CS, Tian L, Muindi J and Sunga AY: Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer. Int J Colorectal Dis. 24:219–224. 2009. View Article : Google Scholar : PubMed/NCBI
43.	Niv Y, Sperber AD, Figer A, Igael D, Shany S, Fraser G and Schwartz B: In colorectal carcinoma patients, serum vitamin D levels vary according to stage of the carcinoma. Cancer. 86:391–397. 1999. View Article : Google Scholar : PubMed/NCBI
44.	Hofmann JN, Yu K, Horst RL, Hayes RB and Purdue MP: Long-term variation in serum 25-hydroxyvitamin D concentration among participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cancer Epidemiol Biomarkers Prev. 19:927–931. 2010. View Article : Google Scholar : PubMed/NCBI
45.	Laney N, Meza J, Lyden E, Erickson J, Treude K and Goldner W: The prevalence of vitamin D deficiency is similar between thyroid nodule and thyroid cancer patients. Int J Endocrinol. 8057162010.(E-pub ahead of print).
46.	Thill M, Fischer D, Kelling K, et al: Expression of vitamin D receptor (VDR), cyclooxygenase-2 (COX-2) and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) in benign and malignant ovarian tissue and 25-hydroxycholecalciferol (25(OH(2))D(3)) and prostaglandin E(2) (PGE(2)) serum level in ovarian cancer patients. J Steroid Biochem Mol Biol. 121:387–390. 2010.
47.	McCombie AM, Mason RS and Damian DL: Vitamin D deficiency in Sydney skin cancer patients. Med J Aust. 190:1022009.PubMed/NCBI
48.	Nurnberg B, Graber S, Gartner B, et al: Reduced serum 25-hydroxyvitamin D levels in stage IV melanoma patients. Anticancer Res. 29:3669–3674. 2009.PubMed/NCBI
49.	Trump DL, Chadha MK, Sunga AY, et al: Vitamin D deficiency and insufficiency among patients with prostate cancer. BJU Int. 104:909–914. 2009. View Article : Google Scholar : PubMed/NCBI
50.	Badros A, Goloubeva O, Terpos E, Milliron T, Baer MR and Streeten E: Prevalence and significance of vitamin D deficiency in multiple myeloma patients. Br J Haematol. 142:492–494. 2008. View Article : Google Scholar : PubMed/NCBI
51.	Everett PC: The prevalence of vitamin D deficiency and insufficiency in a hematology-oncology clinic. Clin J Oncol Nurs. 12:33–35. 2008. View Article : Google Scholar : PubMed/NCBI
52.	Reinhold U, Schmitz B, Kurbacher C, Nagel W, Schmidt M and Malaisse WJ: Circulating 25-hydroxyvitamin D concentration in German cancer patients. Oncol Rep. 20:1539–1543. 2008.PubMed/NCBI
53.	Hollender A, Bjoro T, Otto KK, Kvaloy SO, Nome O and Holte H: Vitamin D deficiency in patients operated on for gastric lymphoma. Scand J Gastroenterol. 41:673–681. 2006. View Article : Google Scholar : PubMed/NCBI
54.	Lammert M, Friedman JM, Roth HJ, et al: Vitamin D deficiency associated with number of neurofibromas in neurofibromatosis 1. J Med Genet. 43:810–813. 2006. View Article : Google Scholar : PubMed/NCBI
55.	Plant AS and Tisman G: Frequency of combined deficiencies of vitamin D and holotranscobalamin in cancer patients. Nutr Cancer. 56:143–148. 2006. View Article : Google Scholar : PubMed/NCBI
56.	Reichrath J and Querings K: No evidence for reduced 25-hydroxyvitamin D serum level in melanoma patients. Cancer Causes Control. 15:97–98. 2004. View Article : Google Scholar : PubMed/NCBI
57.	Tangpricha V, Colon NA, Kaul H, et al: Prevalence of vitamin D deficiency in patients attending an outpatient cancer care clinic in Boston. Endocr Pract. 10:292–293. 2004.PubMed/NCBI
58.	Gaugris S, Heaney RP, Boonen S, Kurth H, Bentkover JD and Sen SS: Vitamin D inadequacy among post-menopausal women: a systematic review. QJM. 98:667–676. 2005. View Article : Google Scholar : PubMed/NCBI
59.	Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D and Adami S: Prevalence of hypovitaminosis D in elderly women in Italy: clinical consequences and risk factors. Osteoporos Int. 14:577–582. 2003. View Article : Google Scholar : PubMed/NCBI
60.	Plotnikoff GA and Quigley JM: Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 78:1463–1470. 2003. View Article : Google Scholar : PubMed/NCBI
61.	Rovner AJ and O'Brien KO: Hypovitaminosis D among healthy children in the United States: a review of the current evidence. Arch Pediatr Adolesc Med. 162:513–519. 2008. View Article : Google Scholar : PubMed/NCBI
62.	Gordon CM, DePeter KC, Feldman HA, Grace E and Emans SJ: Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 158:531–537. 2004. View Article : Google Scholar : PubMed/NCBI
63.	Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW and Sahyoun NR: Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 30:771–777. 2002. View Article : Google Scholar : PubMed/NCBI
64.	Tangpricha V, Pearce EN, Chen TC and Holick MF: Vitamin D insufficiency among free-living healthy young adults. Am J Med. 112:659–662. 2002. View Article : Google Scholar : PubMed/NCBI
65.	Lips P: Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 22:477–501. 2001. View Article : Google Scholar : PubMed/NCBI
66.	McKenna MJ: Differences in vitamin D status between countries in young adults and the elderly. Am J Med. 93:69–77. 1992. View Article : Google Scholar : PubMed/NCBI
67.	Das G, Crocombe S, McGrath M, Berry JL and Mughal MZ: Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child. 91:569–572. 2006. View Article : Google Scholar : PubMed/NCBI
68.	Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D and Nickelsen T: A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 86:1212–1221. 2001. View Article : Google Scholar
69.	Sullivan SS, Rosen CJ, Halteman WA, Chen TC and Holick MF: Adolescent girls in Maine are at risk for vitamin D insufficiency. J Am Diet Assoc. 105:971–974. 2005. View Article : Google Scholar : PubMed/NCBI
70.	Yanoff LB, Parikh SJ, Spitalnik A, et al: The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans. Clin Endocrinol. 64:523–529. 2006. View Article : Google Scholar : PubMed/NCBI
71.	Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ and Shaw S: Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest. 76:370–373. 1985. View Article : Google Scholar : PubMed/NCBI
72.	De Boer IH, Ioannou GN, Kestenbaum B, Brunzell JD and Weiss NS: 25-Hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis. 50:69–77. 2007.
73.	Chatfield SM, Brand C, Ebeling PR and Russell DM: Vitamin D deficiency in general medical inpatients in summer and winter. Intern Med J. 37:377–382. 2007. View Article : Google Scholar : PubMed/NCBI
74.	Olmez D, Bober E, Buyukgebiz A and Cimrin D: The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatr. 95:1266–1269. 2006. View Article : Google Scholar : PubMed/NCBI