New studies add to link between Vitamin D deficiency and breast and colon cancer

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November 2010

*

*More data on link between Vitamin D deficiency and breast and colon

cancer.*

*Two new vitamin D studies from the University of Rochester Medical

Center suggest intriguing ties between a deficiency of D and breast and

colon cancer, particularly among African Americans.*

The research adds to mounting evidence of a connection between vitamin D

deficiency and cancer.

In a retrospective study of 224 women being treated for breast cancer at

the URMC P. Wilmot Cancer Center, researchers found that 66

percent were either severely deficient or moderately deficient of vitamin D.

The deficiency was particularly high among non-Caucasians and women with

later-stage disease, said Alissa Huston, M.D., assistant professor of

Medicine at URMC. She presented the data Oct. 16, 2010, at the American

Society of Bone and Mineral Research meeting in Toronto.

African American women had the lowest mean levels of vitamin D, as

compared to white or Hispanic patients, although the study population

was small. Black women can be prone to more aggressive breast cancer,

but what is not known is whether vitamin D plays a role in this, Huston

said, adding that further study is needed.

" Our data certainly suggests that it is important to test patients for

serum vitamin D levels, and if necessary, treat the deficiency along

with the disease, " said Huston, a specialist in Wilmot's Comprehensive

Breast Cancer Program. " In some cases, weekly high doses of vitamin D

are needed to bring the patient up to sufficient levels. "

Huston's study also described the effect of various vitamin D

supplementation regimens on deficiency. Weekly doses of 50,000 IU

resulted in significant increases in vitamin D levels for those women

whose baseline status was severely deficient. Lower levels of vitamin D

were associated with reduced spinal bone mineral density and patients

undergoing radiation therapy.

In a separate study led by Fiscella, M.D., M.P.H., reported online

Oct. 13, 2010, by the journal, Cancer, investigators found that vitamin

D deficiency among African Americans may explain a persistent mystery in

colorectal cancer: why black people die of this disease far more often

than whites.

He constructed an epidemiology study of American adults, using a

publicly available health data. Among 91 deaths from colorectal cancer

during the study period, researchers assessed a range of factors that

could contribute to death, from age and race, to smoking status and

weight, to history of colorectal cancer and access to medical care

through health insurance.

Researchers found that simply being African American doubled the risk of

dying from colorectal cancer. Furthermore, vitamin D deficiency based on

a blood test explained about 40 percent of the risk associated with

being African American.

Earlier this year, using similar data from the National Health and

Nutrition Examination Survey, Fiscella also showed that vitamin D

deficiency may contribute to a higher number of heart and stroke-related

deaths among blacks compared to whites.

" Together these findings are very provocative and suggest that vitamin D

may partly explain two of the leading causes of death in African

Americans where there are major disparities - cardiovascular and

cancer, " said Fiscella, a professor of Family Medicine, Community and

Preventive Medicine, and Oncology at URMC.

Fiscella has been investigating the reasons behind racial disparities in

health care for years, and noted that vitamin D is not the sole

explanation. For example in the cardiovascular study, poverty also

contributed to disparities in deaths. In the colorectal cancer study,

lack of health insurance was a contributor to disparities in deaths.

New Vitamin D Guidelines to Come

Vitamin D levels are being re-examined by the Institute of Medicine (

IOM ), an independent group of esteemed scientists who frequently advise

the government. The IOM panel is expected to release new guidelines on

vitamin D supplementation sometime this fall, Fiscella said.

Following the IOM recommendations, the Monroe County Medical Society in

Rochester, which also convened a task force recently to evaluate the

evidence around vitamin D, will make recommendations to local patients,

Fiscella said.

Many people around the world have low concentrations of vitamin D.

Genetic factors common to blacks, such as darker skin, reduce vitamin D

synthesis.

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