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@ARTICLE{Kuznia:275218,
author = {S. Kuznia$^*$ and A. Zhu$^*$ and T. Akutsu and J. E. Buring
and C. A. Camargo and N. R. Cook and L.-J. Chen$^*$ and T.
D. Cheng and S. Hantunen and I.-M. Lee and J. E. Manson and
R. E. Neale and R. Scragg and A. H. Shadyab and S. Sha$^*$
and J. Sluyter and T.-P. Tuomainen and M. Urashima and J. K.
Virtanen and A. Voutilainen and J. Wactawski-Wende and M.
Waterhouse and H. Brenner$^*$ and B. Schöttker$^*$},
title = {{E}fficacy of vitamin {D}3 supplementation on cancer
mortality: systematic review and individual patient data
meta-analysis of randomised controlled trials.},
journal = {Ageing research reviews},
volume = {87},
issn = {1568-1637},
address = {Oxford [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2023-00676},
pages = {101923},
year = {2023},
note = {#EA:C070#LA:C070# / 2023 Jun;87:101923},
abstract = {To evaluate the effect of vitamin D3 supplementation on
cancer mortality in the general population and on prognosis
in cancer patients, a systematic review and meta-analysis of
randomised, placebo-controlled trials (RCTs) and individual
patient data (IPD) was conducted. Overall, 14 RCTs with a
total of 104,727 participants (2,015 cancer deaths) were
identified and 7 RCTs, including $90\%$ of all study
participants (n=94,068), could be included in the IPD
meta-analyses. The main meta-analysis of the 14 RCTs yielded
a statistically non-significant reduction in cancer
mortality by $6\%$ (risk ratio (RR) $[95\%-confidence$
interval $(95\%CI)]:$ 0.94 [0.86-1.02]). Subgroup analyses
revealed a $12\%$ lower cancer mortality in the vitamin D3
group compared with the placebo group in 10 trials with a
daily dosing regimen (RR $[95\%CI]:$ 0.88 [0.78-0.98]),
whereas no mortality reduction was seen in 4 trials using a
bolus regimen (RR $[95\%CI]:$ 1.07 [0.91-1.24]; p-value for
interaction: 0.042). The IPD meta-analysis (RR $[95\%CI]:$
0.93 [0.84; 1.02]) confirmed the finding of all trials. The
IPD were used to test effect modification by age, sex, body
mass index, ethnicity, baseline serum 25-hydroxyvitamin D
concentration, adherence and cancer-related factors but no
statistically significant findings were obtained in
meta-analyses of all trials. When restricted to trials with
daily dosing in a post-hoc analysis, adults aged ≥70 years
(RR $[95\%CI]:$ 0.83 [0.77; 0.98]) and subjects with vitamin
D3 therapy initiation before cancer diagnosis (RR
$[95\%CI]:$ 0.87 [0.69; 0.99]) appeared to benefit most from
daily vitamin D3 supplementation. Measurements of baseline
25-hydroxyvitamin D levels and inclusion of other than
non-Hispanic White adults were too sparse in the trials to
draw conclusions. Results for all-cause and cancer-specific
survival of participants with cancer were comparable to
those obtained in the general population for cancer
mortality. In conclusion, vitamin D3 did not reduce cancer
mortality in the main meta-analysis of all RCTs because the
observed risk reduction by $6\%$ was not statistically
significant. However, a subgroup analysis revealed that
vitamin D3 administered daily, in contrast to bolus
supplementation, reduced cancer mortality by $12\%.$},
subtyp = {Review Article},
keywords = {Vitamin D (Other) / cancer (Other) / individual
patient-data (Other) / mortality (Other) / survival (Other)
/ systematic review (Other)},
cin = {C070 / C120 / HD01},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37004841},
doi = {10.1016/j.arr.2023.101923},
url = {https://inrepo02.dkfz.de/record/275218},
}