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The effect of vitamin D on the occurrence and development of colorectal cancer: a systematic review and meta-analysis

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Abstract

Purpose

There has been a lot of controversies about the correlation between vitamin D and colorectal cancer (CRC). In this meta-analysis, we purposed to explore the relationship between vitamin D and the incidence of CRC/the prognosis of CRC.

Methods

A systematic search for articles in databases (Pubmed, Web of Science, EBSCO and Cochrane Library) was terminated in April 2020. The primary outcomes were the incidence rate of CRC and the long-term survival of patients with CRC.

Results

According to the estimated pooled OR from 21 eligible studies, covering 904,152 people, the use of vitamin D was inversely associated with the incidence of CRC [OR = 0.87, (0.82–0.92)]. Among the four studies included in this meta-analysis, covering 7486 patients, compared the overall survival (OS) of CRC between the vitamin D users and the non-users. Based on the estimated pooled HR, vitamin D potentially improved the long-term survival of CRC patients [HR = 0.91, (0.83–0.98)].

Conclusion

This meta-analysis demonstrates that vitamin D not only has a positive impact on the incidence of CRC from either the dietary or supplemental sources but also benefits clinical outcomes and improves the long-term survival of CRC patients. However, further studies are recommended to clarify the above phenomena.

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Data availability

The datasets supporting the conclusions of this article are included within the article.

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Funding

This study was funded by the Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (Grant No. 2019E10020), Ningbo Clinical Research Center for Digestive System Tumors (Grant No. 2019A21003).

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Author notes

  1. Yunbao Xu and Mingxia Qian contributed equally to this work.

Authors and Affiliations

  1. Department of Radiotherapy and Chemotherapy, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China

    Yunbao Xu

  2. Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China

    Yunbao Xu

  3. Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, Zhejiang, China

    Yunbao Xu

  4. School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

    Mingxia Qian & Liuhong Xu

  5. The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

    Jiaze Hong

  6. Medical College of Ningbo University, Ningbo, Zhejiang, China

    Derry Minyao Ng

  7. Department of Tumor HIFU Therapy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China

    Tong Yang

  8. Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, 998 North Qianhe Road, Yinzhou District, Ningbo, Zhejiang, 315100, China

    Xia Ye

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  1. Yunbao Xu
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Contributions

XY designed the research process. YBX searched the database for corresponding articles. MXQ and JZH extracted useful information from the articles above. DMG and TY used statistical software for analysis. LHX and YBX drafted the meta-analysis. XY polished this article. All authors had read and approved the manuscript and ensured that this was the case.

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Correspondence to Xia Ye.

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Supplementary information

Supplementary Fig. 1.

Publication bias of the correlation of total vitamin D and colorectal cancer incidence (Egger’s, p=0.278; Begg’s, p=0.597). (PNG 208 kb)

High resolution image (TIF 37 kb)

Supplementary Fig. 2.

Sensitivity analysis of the correlation of total vitamin D and colorectal cancer incidence. (PNG 488 kb)

High resolution image (TIF 55 kb)

Supplementary Fig. 3.

Publication bias of the correlation of dietary vitamin D and colorectal cancer incidence (Egger’s, p=0.617; Begg’s, p=0.923). (PNG 211 kb)

High resolution image (TIF 37 kb)

Supplementary Fig. 4.

Sensitivity analysis of the correlation of dietary vitamin D and colorectal cancer incidence. (PNG 476 kb)

High resolution image (TIF 55 kb)

Supplementary Fig. 5.

Publication bias of the correlation of supplementary vitamin D and colorectal cancer incidence (Egger’s, p=0.337; Begg’s, p=0.374). (PNG 185 kb)

High resolution image (TIF 36 kb)

Supplementary Fig. 6.

Sensitivity analysis of the correlation of supplementary vitamin D and colorectal cancer incidence. (PNG 332 kb)

High resolution image (TIF 43 kb)

Supplementary Table 1.

Quality assessment of the enrolled studies. (DOCX 21 kb)

ESM 1

(DOC 64 kb)

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Xu, Y., Qian, M., Hong, J. et al. The effect of vitamin D on the occurrence and development of colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 36, 1329–1344 (2021). https://doi.org/10.1007/s00384-021-03879-w

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