Vitamin D and Cancer Risk and Mortality: State of the Science, Gaps, and Challenges
Vitamin D and Cancer Risk and Mortality: State of the Science, Gaps, and Challenges
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DOI：
10.1093/epirev/mxx005
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发表时间：
2017-01-01
影响因子：
5.5
通讯作者：
Albanes, Demetrius
中科院分区：
文献类型：
--
作者：
Mondul, Alison M.;Weinstein, Stephanie J.;Albanes, Demetrius
最近，人们对维生素D在一级和二级预防癌症中的潜在作用非常感兴趣。实验室研究证明维生素D化合物具有一系列的抗癌作用，但人体研究几乎没有得出一致的证据来支持维生素D与抗癌之间的联系。较高的循环维生素D水平（即25-羟基维生素D或25(OH)D）似乎与降低结肠直肠癌和膀胱恶性肿瘤的风险有关，但前列腺癌和可能的胰腺癌的风险较高，与大多数其他器官部位的研究没有明确的联系。尽管没有关于使用维生素D补充剂预防癌症的官方机构建议，但在过去十年中，维生素D缺乏症的筛查和维生素D补充剂的使用大幅增加。这些广泛的做法表明，人口社会行为的改变往往在科学上有充分信息的政策和建议出台之前就被采纳了。这篇综述严格审查了目前可用的流行病学文献关于循环25(OH)D、维生素D补充和维生素D相关遗传变异与癌症风险和死亡率之间的关系，特别强调了前瞻性研究。我们确定了我们科学知识中的几个重要空白，这些空白应该得到解决，以便提供足够的可重复数据，为基于证据的建议提供有关最佳25(OH)D浓度（以及维生素D补充的任何作用），以一级和二级预防癌症。除少数例外情况外，目前无法提出此类建议。
There has been substantial enthusiasm recently regarding the potential role of vitamin D in the primary and secondary prevention of cancer. Laboratory studies demonstrate a range of anticarcinogenic effects for vitamin D compounds, but human studies have yielded little consistent evidence supporting a protective association. Higher circulating levels of vitamin D (i.e., 25-hydroxyvitamin D or 25(OH)D) appear to be associated with reduced risk of colorectal and bladder malignancies, but higher risk of prostate and possibly pancreatic cancers, with no clear association for most other organ sites examined. Despite there being no official institutional recommendations regarding the use of vitamin D supplements for cancer prevention, screenings for vitamin D deficiency and vitamin D supplement use have increased substantially over the past decade. These widespread practices demonstrate that population sociobehavioral changes are often adopted before scientifically well-informed policies and recommendations are available. This review critically examines the currently available epidemiologic literature regarding the associations between circulating 25(OH)D, vitamin D supplementation, and vitamin D-related genetic variation and cancer risk and mortality, with a particular emphasis on prospective studies. We identify several important gaps in our scientific knowledge that should be addressed in order to provide sufficient reproducible data to inform evidence-based recommendations related to optimal 25(OH)D concentrations (and any role for vitamin D supplementation) for the primary and secondary prevention of cancer. With few exceptions, such recommendations cannot be made at this time.