Low vitamin D levels as a risk factor for cancer
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4952 (Published 31 October 2017) Cite this as: BMJ 2017;359:j4952
- Despoina Manousaki, paediatric endocrinologist1,
- J Brent Richards, endocrinologist and associate professor1 2 3
- 1Centre for Clinical Epidemiology, Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- 2Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, Jewish General Hospital, McGill University Montreal, Quebec, Canada
- 3Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
- Correspondence to: J B Richards brent.richards{at}mcgill.ca
Arguably, to date the most clinically effective way to reduce the burden of cancer has been through primary prevention.1 One promising such strategy has been to target vitamin D insufficiency as epidemiological and animal studies have found that low levels of vitamin D are associated with an increased risk of cancer.23 Furthermore, vitamin D insufficiency affects 40% of the general population,4 is easily diagnosed by a simple blood test, and can be treated safely and inexpensively. This may partially explain the 60-fold increase in the use of vitamin D supplements in the US general population between 2000 and 2014, where 18% currently take ≥1000 IU of vitamin D daily.5
Limiting bias
Yet the most prudent way to test the efficacy of vitamin D would be through large scale randomised controlled trials because observational studies may be biased by residual confounding (vitamin D levels are confounded by known drivers of cancer risk, such as smoking, obesity, and the healthy user effect6). Yet such trials are …
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