Abstract
Objective: Epidemiologic studies on calcium, vitamin D and colon cancer are inconsistent, whereas experimental studies more regularly show a protective effect. To evaluate potential sources of inconsistencies, data from a large case–control study were analyzed, stratifying on potential effect modifiers.
Methods: Data were collected by certified interviewers in Northern California, Utah and Minnesota. Analyses included 1993 incident colon cancer cases and 2410 population-based controls. Multivariate logistic regression models included age, sex, BMI, family history, physical activity, intake of energy, dietary fiber, aspirin and NSAIDs.
Results: Dietary calcium was inversely associated with colon cancer risk in men (OR highest vs lowest quintile = 0.6, 95% CI = 0.5–0.9) and women (OR = 0.6, 95% CI = 0.4–0.9). No statistically significant associations were observed for dietary vitamin D or sunshine exposure. Consumption of total low-fat dairy products was associated with a statistically significantly decreased risk in men and women (ORs highest vs lowest category of intake = 0.8 and 0.7 respectively). Calcium supplement use was inversely associated with risk in both sexes (ORs use vs non-use = 0.8). Vitamin D supplements were inversely associated with risk in men (OR = 0.5) and women (OR = 0.6) but confidence limits included 1.0.
Conclusions: These data provide additional support of an inverse association between high levels of calcium intake and colon cancer risk.
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References
World Cancer Research Fund Panel (JD Potter, Chair) (1997) Food, Nutrition and the Prevention of Cancer: A Global Perspective, 1st edn. Washington, DC: American Institute for Cancer Research.
Martinez ME, Willett WC (1998) Calcium, vitamin D, and colorectal cancer: a review of the epidemiologic evidence. Cancer Epidemiol Biomarkers Prev 7: 163–168.
Bergsma-Kadijk JA, van’t Veer P, Kampman E, Burema J (1996) Calcium does not protect against colorectal neoplasia. Epidemiology 7: 590–597.
Sellers TA, Bazyk AE, Bostick RM, et al. (1998) Diet and risk of colon cancer in a large prospective study of older women: an analysis stratified on family history (Iowa, United States). Cancer Causes Control 9: 357–367.
Newmark HL, Wargovich MJ, Bruce WR (1984) Colon cancer and dietary fat, phosphate, and calcium: a hypothesis. J Natl Cancer Inst 72: 1323–1325.
Buset M, Lipkin M, Winawer S, Friedman E (1987) Direct and indirect protection of human epithelial cells by calcium. Gastroenterology 92: 1334.
Bostick RM (1997) Human studies of calcium supplementation and colorectal epithelial cell proliferation. Cancer Epidemiol Biomarkers Prev 6: 971–980.
Bostick RM, Fosdick L, Wood-JR,et al. (1995) Calcium and colorectal epithelial cell proliferation in sporadic adenoma patients: a randomized, double-blinded, placebo-controlled clinical trial. J Natl Cancer Inst 87: 1307–1315.
Baron JA, Beach M, Mandel JS, et al. (1999) Calcium supplements for the prevention of colorectal adenomas. N Engl J Med 340: 101–107.
Shabahang M, Buras RR, Davoodi F, et al. (1994) Growth inhibition of HT-29 human colon cancer cells by analogues of 1,25-dihydroxyvitamin D3. Cancer Res 54: 407–464.
Cross HS, Pavelka M, Slavik J, Peterlik M (1992) Growth control of human colon cancer cells by vitamin D and calcium in vitro. J Natl Cancer Inst 84: 1355–1357.
Slattery ML, Edwards SL, Caan BJ, Kerber RA, Potter JD (1995) Response rates among control subjects in case-control studies. Ann Epidemiol 5: 245–249.
Edwards S, Slattery ML, Mori M, et al. (1994) Objective system for interviewer performance evaluation for use in epidemiologic studies. Am J Epidemiol 140: 1020–1028.
McDonald A, Van Horn L, Slattery ML, et al. (1991) The CARDIA dietary history, development and implementation. J Am Diet Assoc 91: 1104–1200.
Liu K, Slattery ML, Jacobs DR, et al. (1994) The reliability and relative validity of the CARDIA diet history. J Ethnic Dis 4: 15–27.
Dennis B, Ernst N, Hjortland M, Tillotson J, Grambsch V (1980) The NHLBI nutrition system. J Am Diet Assoc 77: 641–647.
Martínez ME, Giovannucci El, Colditz GA, et al. (1996). Calcium, vitamin D, and the occurrence of colon cancer among women. J Natl Cancer Inst 88: 1375–1382.
Bostick RM, Potter JD, Sellers TA, McKenszie DR, Kushi H, Folsom AR (1993) Relation of calcium, vitamin D, and dairy food intake to incidence of colon cancer in older women. Am J Epidemiol 137: 1302–1317.
Kampman E, Goldbohm RA, van den Brandt PA, van’t Veer P (1994) Fermented dairy products, calcium, and colorectal cancer in the Netherlands Cohort Study. Cancer Res 54: 3186–3190.
Slattery ML, Sorenson AW, Ford MH (1988) Dietary calcium intake as a mitigating factor in colon cancer. Am J Epidemiol 128: 504–514.
Slattery ML, Potter JD, Caan BJ, et al. (1997) Energy balance and colon cancer-beyond physical activity. Cancer Res 57: 75–80.
Giovannucci E, Stampfer MJ, Colditz GA, et al. (1993) A comparison of prospective and retrospective assessments of diet in the study of breast cancer. Am J Epidemiol 137: 502–511.
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Kampman, E., Slattery, M.L., Caan, B. et al. Calcium, vitamin D, sunshine exposure, dairy products and colon cancer risk (United States). Cancer Causes Control 11, 459–466 (2000). https://doi.org/10.1023/A:1008914108739
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DOI: https://doi.org/10.1023/A:1008914108739