This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Ng, K. Articles by Fuchs, C. S. PubMed PubMed Citation Articles by Ng, K. Articles by Fuchs, C. S. Related Articles Related Editorial

Circulating 25-Hydroxyvitamin D Levels and Survival in Patients With Colorectal Cancer

Kimmie Ng, Jeffrey A. Meyerhardt, Kana Wu, Diane Feskanich, Bruce W. Hollis, Edward L. Giovannucci, Charles S. Fuchs

From the Division of Medical Oncology, Dana-Farber Cancer Institute; Departments of Nutrition and Epidemiology, Harvard School of Public Health; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; and Division of Pediatrics, Medical University of South Carolina, Charleston, SC

Corresponding author: Kimmie Ng, MD, MPH, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: kng4{at}partners.org

Purpose: Higher plasma 25-hydroxyvitamin D₃ (25(OH)D) levels are associated with a decreased incidence of colorectal cancer, but the influence of plasma 25(OH)D on the outcome of patients with established colorectal cancer is unknown.

Patients and Methods: We prospectively examined the association between prediagnosis 25(OH)D levels and mortality among 304 participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) who were diagnosed with colorectal cancer from 1991 to 2002. Participants diagnosed within 2 years of blood collection were excluded. Patients were observed until death, June 2005 (NHS), or January 2005 (HPFS), whichever came first. The primary end point was overall mortality. Cox proportional hazards models were used to calculate hazard ratios (HR) adjusted for other risk factors for cancer survival.

Results: Higher plasma 25(OH)D levels were associated with a significant reduction in overall mortality (P for trend = .02). Compared with the lowest quartile, participants in the highest quartile had an adjusted HR of 0.52 (95% CI, 0.29 to 0.94) for overall mortality. A trend toward improved colorectal cancer–specific mortality was also seen (HR = 0.61; 95% CI, 0.31 to 1.19). The results remained unchanged after excluding patients diagnosed within 5 years of blood collection (P for trend = .04); the multivariate HR for overall mortality comparing extreme quartiles was 0.45 (95% CI, 0.19 to 1.09).

Conclusion: Among patients with colorectal cancer, higher prediagnosis plasma 25(OH)D levels were associated with a significant improvement in overall survival. Further study of the vitamin D pathway and its influence on colorectal carcinogenesis and cancer progression is warranted.

Supported in part by Grants No. CA118553, CA87969, and CA108341 from the National Cancer Institute, National Institutes of Health.

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Terms in blue are defined in the glossary, found at the end of this article and online at www.jco.org.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Related Editorial

• Shedding Light on Colorectal Cancer Prognosis: Vitamin D and Beyond
  Cornelia M. Ulrich and Rebecca S. Holmes
  JCO 2008 26: 2937-2939 [Full Text]

This article has been cited by other articles:

				C. M. Ulrich and R. S. Holmes Shedding Light on Colorectal Cancer Prognosis: Vitamin D and Beyond J. Clin. Oncol., June 20, 2008; 26(18): 2937 - 2939. [Full Text] [PDF]