Journal article
Incidence of hematologic malignancy and cause‐specific mortality in the Women's Health Initiative randomized controlled trial of calcium and vitamin D supplementation
Cancer, Vol.123(21), pp.4168-4177
11/01/2017
DOI: 10.1002/cncr.30858
PMCID: PMC5650536
PMID: 28654155
Abstract
BACKGROUND
Prior evidence of a possible link between vitamin D status and hematologic malignancy (HM) in humans comes from observational studies, leaving unresolved the question of whether a true causal relationship exists.
METHODS
The authors performed a secondary analysis of data from the Women's Health Initiative Calcium/Vitamin D (CaD) trial, a large randomized controlled trial of CaD supplementation compared with placebo in older women. Kaplan‐Meier and Cox proportional hazards survival analysis methods were used to evaluate the relationship between treatment assignment and 1) incident HM and 2) HM‐specific mortality over 10 years following randomization. HMs were classified by cell type (lymphoid, myeloid, or plasma cell) and analyzed as distinct endpoints in secondary analyses.
RESULTS
A total of 34,763 Women's Health Initiative CaD trial participants (median age, 63 years) had complete baseline covariate data and were eligible for analysis. Women assigned to CaD supplementation had a significantly lower risk of incident HM (hazard ratio [HR], 0.80; 95% confidence interval [95% CI], 0.65‐0.99) but not HM‐specific mortality (HR, 0.77 [95% CI, 0.53‐1.11] for the entire cohort; and HR, 1.03 [95% CI, 0.70‐1.51] among incident HM cases after diagnosis). In secondary analyses, protective associations were found to be most robust for lymphoid malignancies, with HRs of 0.77 (95% CI, 0.59‐1.01) and 0.46 (95% CI, 0.24‐0.89), respectively, for cancer incidence and mortality in those assigned to CaD supplementation.
CONCLUSIONS
The current post hoc analysis of data from a large and well‐executed randomized controlled trial demonstrates a protective association between modest CaD supplementation and HM risk in older women. Additional research concerning the relationship between vitamin D and HM is warranted. Cancer 2017;123:4168–4177. © 2017 American Cancer Society.
In the Women's Health Initiative Calcium/Vitamin D trial, women assigned to calcium and vitamin D appear to have a significantly lower risk of incident hematologic malignancies over 10 years of follow‐up. Although no significant association with hematologic cancer‐specific mortality is noted, further research is needed to elucidate the possible role of vitamin D (and/or calcium) in the development and progression of hematologic malignancies.
Details
- Title: Subtitle
- Incidence of hematologic malignancy and cause‐specific mortality in the Women's Health Initiative randomized controlled trial of calcium and vitamin D supplementation
- Creators
- Eric M. Ammann - University of IowaMatthew T. Drake - Department of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota.Bjarni Haraldsson - University of IowaRobert B. Wallace - University of IowaKaren C. Johnson - University of Tennessee Health Science CenterPinkal Desai - Cornell UniversityEmily M. Lin - Ronald Reagan UCLA Medical CenterBrian K. Link - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Cancer, Vol.123(21), pp.4168-4177
- DOI
- 10.1002/cncr.30858
- PMID
- 28654155
- PMCID
- PMC5650536
- NLM abbreviation
- Cancer
- ISSN
- 0008-543X
- eISSN
- 1097-0142
- Number of pages
- 11
- Grant note
- University of Iowa Holden Comprehensive Cancer Center Population Research Core National Cancer Institute (P30 CA086862) National Heart, Lung, and Blood Institute National Center for Research Resources of the Department of Health and Human Services
- Language
- English
- Date published
- 11/01/2017
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359858102771
Metrics
20 Record Views