Sufficient 25-Hydroxyvitamin D Levels 2 Years after Colorectal Cancer Diagnosis are Associated with a Lower Risk of All-cause Mortality

• Published in: Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2021-04, Vol.30 (4), p.765-773
• Main Authors: Wesselink, Evertine, Kok, Dieuwertje E, de Wilt, Johannes H W, Bours, Martijn J L, van Zutphen, Moniek, Keulen, Eric T P, Kruyt, Flip M, Breukink, Stephanie O, Kouwenhoven, Ewout A, van den Ouweland, Jody, Weijenberg, Matty P, Kampman, Ellen, van Duijnhoven, Fränzel J B
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers, Tumor - blood; Cause of Death; Colorectal Neoplasms - mortality; Female; Follow-Up Studies; Humans; Male; Middle Aged; Netherlands; Prospective Studies; Risk; Vitamin D - analogs & derivatives; Vitamin D - blood
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1055-9965.EPI-20-1388

Whether changes in 25 hydroxy vitamin D (25(OH)D ) levels after colorectal cancer diagnosis influence clinical outcomes is unclear. We investigated the association of trajectories of 25(OH)D levels with recurrence and all-cause mortality. In total, 679 patients were included in our data analyses. Trajectories of 25(OH)D levels were defined on the basis of vitamin D status at diagnosis, at 6 months, and 2 years after diagnosis. Observed trajectories of 25(OH)D levels were consistent deficient levels (20%), consistent sufficient levels (39%), increasing levels (20%), and a temporary drop in levels (13%). Associations of trajectories of 25(OH)D with recurrence and all-cause mortality were assessed using multivariable Cox proportional hazards regression models. During a follow-up time of 2.2 years for recurrence and 3.5 years for all-cause mortality, 31 and 65 events occurred, respectively. No statistically significant associations were observed for vitamin D trajectories and the risk of recurrence. Patients who were consistently sufficient compared with patients who were consistently deficient had a lower risk of all-cause mortality [HR 0.39; 95% confidence interval (CI), 0.21-0.73]. The risk of all-cause mortality seems lower in patients with increasing levels or a temporary drop in levels (HR 0.54; 95% CI, 0.27-1.10 and HR 0.40 95% CI, 0.17-0.93) relative to patients with consistent deficient levels. Patients with colorectal cancer following a trajectory characterized by sufficient levels of 25(OH)D 2 years after diagnosis all appeared to have a lower risk of all-cause mortality compared with patients having consistent deficient levels. Further studies should investigate how trajectories of 25(OH)D levels are associated with colorectal cancer recurrence.