Projects per year
Abstract
Background
Low circulating vitamin D levels are associated with poor colorectal cancer (CRC) survival. We assess whether vitamin D supplementation improves CRC survival outcomes.
Methods
PubMed and Web of Science were searched. RCTs of vitamin D supplementation reporting CRC mortality were included. RCTs with high risk of bias were excluded from analysis. Random-effects meta-analysis models calculated estimates of survival benefit with supplementation. PROSPERO:CRD42020173397
Results
7 RCTs (n=957 CRC cases) were identified: three trials included patients with CRC at outset, four population trials reported survival in incident cases. Two RCTs were excluded from meta-analysis (high risk of bias; no hazard ratio). Whilst trials varied in inclusion criteria, intervention dose and outcomes, meta-analysis found a 30% reduction in adverse CRC outcomes with supplementation (n=815, HR=0.70; 95%CI:0.48-0.93). A beneficial effect was seen in trials of CRC patients (progression-free survival, HR=0.65; 95%CI:0.36-0.94), with suggestive effect in incident CRC cases from population trials (CRC-specific survival, HR=0.76; 95%CI:0.39-1.13). No heterogeneity or publication bias was noted.
Conclusions
Meta-analysis demonstrates a clinically meaningful benefit of vitamin D supplementation on CRC survival outcomes. Further well-designed, adequately powered RCTs are needed to fully evaluate benefit of supplementation in augmenting ‘real life’ follow-up and adjuvant chemotherapy regimens, as well as determining optimal dosing.
Low circulating vitamin D levels are associated with poor colorectal cancer (CRC) survival. We assess whether vitamin D supplementation improves CRC survival outcomes.
Methods
PubMed and Web of Science were searched. RCTs of vitamin D supplementation reporting CRC mortality were included. RCTs with high risk of bias were excluded from analysis. Random-effects meta-analysis models calculated estimates of survival benefit with supplementation. PROSPERO:CRD42020173397
Results
7 RCTs (n=957 CRC cases) were identified: three trials included patients with CRC at outset, four population trials reported survival in incident cases. Two RCTs were excluded from meta-analysis (high risk of bias; no hazard ratio). Whilst trials varied in inclusion criteria, intervention dose and outcomes, meta-analysis found a 30% reduction in adverse CRC outcomes with supplementation (n=815, HR=0.70; 95%CI:0.48-0.93). A beneficial effect was seen in trials of CRC patients (progression-free survival, HR=0.65; 95%CI:0.36-0.94), with suggestive effect in incident CRC cases from population trials (CRC-specific survival, HR=0.76; 95%CI:0.39-1.13). No heterogeneity or publication bias was noted.
Conclusions
Meta-analysis demonstrates a clinically meaningful benefit of vitamin D supplementation on CRC survival outcomes. Further well-designed, adequately powered RCTs are needed to fully evaluate benefit of supplementation in augmenting ‘real life’ follow-up and adjuvant chemotherapy regimens, as well as determining optimal dosing.
Original language | English |
---|---|
Journal | British Journal of Cancer |
DOIs | |
Publication status | Published - 15 Sept 2020 |
Fingerprint
Dive into the research topics of 'The effect of vitamin D supplementation on survival in patients with colorectal cancer: Systematic review and Meta-analysis of Randomised Controlled Trials'. Together they form a unique fingerprint.Projects
- 3 Finished
-
Colorectal cancer reduction through risk stratification of screening, follow-up and treatment
1/05/17 → 30/04/23
Project: Research
-
Profiles
-
Farhat Din
- Deanery of Molecular, Genetic and Population Health Sciences - Personal Chair Bowel Cancer UK Royal College of Surgeons of
- Edinburgh Cancer Research Centre
Person: Academic: Research Active