stefan pilz - vitamin d und krebs

Wirkung von Vitamin D bei Krebserkrankungen

Stefan PilzDepartment of Internal Medicine, Division of Endocrinology and

Metabolism, Medical University of Graz, AustriaDepartment of Epidemiology and Biostatistics, EMGO Institute for Health

and Care Research, VU University Amsterdam, The Netherlands

OUTLINE

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D deficiency and cancer risk

Outlook and conclusions

Anti-cancer effects of vitamin D

Vitamin D treatment and cancer

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D and sun

Reichrath J. British Journal of Dermatology, 2009; 161: 54-60

Cancer and sunlight

Cancer Res 1:191-195, 1941 Apperly FL

Cancer and sunlight

Apperly FL. Cancer Res 1:191-195, 1941

Solar radiation and colon cancer

Int J Epidemiol 1980; 9:227-231

UV-B and cancer mortality

Cancer 2002;94:1867-1875

OUTLINE

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D deficiency and cancer

Outlook and conclusions

Anti-cancer effects of vitamin D

Vitamin D treatment and cancer

Vitamin D and melanoma

Vitamin D and melanoma

„…there was no evidence for a

nything other than a

beneficial effe

ct for h

igher (vita

min D) levels“

Vitamin D and cancer

47,800 men4,286 incident cancers2,025 cancer deaths

Largest study in this field

Follow-up (years)

1086420

Cu

mu

lati

ve S

urv

ival

1.00

0.99

0.98

0.97

0.96

0.95

0.94

Q4 (High)Q3Q2Q1 (Low)

25-hydroxyvitamin D (ng/ml)

(N=95)

HR 0.49 (0.28-0.88)(fully adjusted model)

Pilz S et al, Cancer Epidemiol Biomarkers Prev 2008; 17: 1228-1233

Vitamin D and cancer mortality

Data from 3299 patients referred for coronary angiography and followed up for 7.7 years

Vitamin D and colorectal cancer

Non-linear dose-response meta-analyses on circulating 25-

hydroxyvitamin D and risk of colorectal cancer

Vitamin D and colorectal cancer

Dose-response meta-analyses of total (dietary + supplemental) vitamin D intake and risk of colorectal and colon cancer

OUTLINE

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D deficiency and cancer

Outlook and conclusions

Anti-cancer effects of vitamin D

Vitamin D treatment and cancer

Anticancer effects of vitamin D

684-700

Anticancer effects of vitamin D

JNCI J Natl Cancer Inst (1992) 84(17): 1355-1357

OUTLINE

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D deficiency and cancer risk

Outlook and conclusions

Anti-cancer effects of vitamin D

Vitamin D treatment and cancer

Vitamin D and cancer incidence

Lappe J, et al. Am J Clin Nutr 2007;85:1586-91

A 4-year, population based, double-blind, randomized, placebo controlled trial among healthy postmenopausal women (n=1179) receiving 1400-1500 mg calcium/d (Ca-only), calcium plus 1100 IU vitamin D/d (Ca + D), or placebo

** P=0.01 *** P=0.005

RR 0.40**RR 0.23***

Entire study cohort Free of cancer at 1 years of intervention

WHI-Study

WHI-Study

OUTLINE

Sunlight (ultraviolet-B) exposure and cancer

Vitamin D deficiency and cancer risk

Outlook and Conclusions

Anti-cancer effects of vitamin D

Vitamin D treatment and cancer

Conclusion

Sunlight (ultraviolet-B exposure), which increases vitamin D synthesis in the skin, is associated with reduced cancer risk

Vitamin D exerts various anti-carcinogenic effects

Observational and interventional studies have partially but not consistently shown an association of a poor vitamin D status with increased cancer risk

Whether vitamin D supplementation is effective in the prevention and treatment of cancer remains to be further evaluated in large-scale randomized controlled trials but the promising data on vitamin D regarding cancer and various other health outcomes strongly argue that it is reasonable to prevent and treat vitamin D deficiency

Thank you for your attention !