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Vitamin D and Cancer WORLD HEALTH ORGANIZATION INTERNATIONAL AGENCY FOR RESEARCH ON CANCER Vitamin D and Cancer IARC 2008 WORLD HEALTH ORGANIZATION INTERNATIONAL AGENCY FOR RESEARCH ON CANCER IARC Working Group Reports Volume 5 Vitamin D and Cancer - i - Vitamin D and Cancer Published by the International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France © International Agency for Research on Cancer, 2008-11-24 Distributed by WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264; fax: +41 22 791 4857; email: [email protected]) Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturer’s products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The authors alone are responsible for the views expressed in this publication. The International Agency for Research on Cancer welcomes requests for permission to reproduce or translate its publications, in part or in full. Requests for permission to reproduce or translate IARC publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; email: [email protected]). IARC Library Cataloguing in Publication Data IARC Working Group on Vitamin D Vitamin D and cancer / a report of the IARC Working Group on Vitamin D (IARC Working Group Reports ; 5) 1. Neoplasms – etiology 2. Neoplasms – prevention & control 3. Vitamin D – adverse effects 4. Vitamin D – therapeutic use 5. Risk Factors I. Title II. Series ISBN 978 92 832 2446 4 (NLM Classification: W1) ii Vitamin D and Cancer Working Group Membership International Scientists: Michaël John Barry, Massachusetts General Hospital, Harvard Medical School, USA (chair) Esther De Vries, Erasmus MC, The Netherlands Dallas English, University of Melbourne, Australia Edward Giovannucci, Harvard School of Public Health, USA Bodo Lehmann, Medical School "Carl Gustav Carus, Dresden University of Technology, Germany Henrik Møller, King's College London, School of Medicine, UK (co-chair) Paola Muti, Italian National Cancer Institute "Regina Elena," Italy Eva Negri, Istituto di Ricerche Farmacologiche "Mario Negri," Italy Julian Peto, London School of Hygiene and Tropical Medicine, UK Arthur Schatzkin, National Cancer Institute, Bethesda, USA Lars Vatten, Norwegian University of Science and Technology, Trondheim, Norway Stephen Walter, McMaster University, Hamilton, Canada Secretariat: Philippe Autier, IARC, Lyon, France (Working Group and Report coordinator) Mathieu Boniol, IARC, Lyon, France Graham Byrnes, IARC, Lyon, France Brian Cox, Otago Medical School, University of Otago, New Zealand Geneviève Deharveng, IARC, Lyon, France Jean François Doré, INSERM + IARC, Lyon Sara Gandini, European Institute of Oncology, Milano, Italy Mary Heanue, IARC, Lyon, France Mazda Jenab, IARC, Lyon, France Patrick Mullie, Jules Bordet Institute, Brussels, Belgium Mary Jane Sneyd, Otago Medical School, University of Otago, New Zealand Observer: Tahera Emilie van Deventer, World Health Organization, Geneva, Switerland Editorial assistance provided by: Asiedua Asante Anne-Sophie Hameau Elsa Labrosse Laurence Marnat Correspondence: Philippe Autier, MD, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon. Email: [email protected] Suggested citation:. IARC. Vitamin D and Cancer. IARC Working Group Reports Vol.5, International Agency for research on Cancer, Lyon, 25 November 2008. iii Vitamin D and Cancer iv Vitamin D and Cancer Contents List of chapters: Detailed contents..........................................................................................................................................................vi Terminology and abbreviations...................................................................................................................................x 1 – Summary overview of the report.......................................................................................................................... 1 2 – Objectives and format of the report...................................................................................................................... 3 3 – Sunlight and skin cancer: recall of essential issues........................................................................................... 5 4 – Sources of vitamin D............................................................................................................................................ 10 5 – Toxicity of vitamin D and long term health effects............................................................................................ 21 6 – Current recommendations for vitamin D intakes ............................................................................................. 29 7 – Determinants of vitamin D status ....................................................................................................................... 33 8 – Biological effects of vitamin D relevant to cancer............................................................................................. 52 9 – Ecological studies on sun exposure and cancer ............................................................................................. 59 10 – Observational studies on individual sun exposure and cancer.................................................................... 77 11 – Observational studies on dietary intakes of vitamin D and cancer.............................................................. 83 12 – Observational studies on serum 25-hydroxyvitamin D, cancer and all-cause mortality........................... 92 13 – Meta-analysis of observational studies on vitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma....................................................................................................100 14 – Randomised trials on vitamin D, cancer and mortality................................................................................113 15 – Vitamin D, cancer prognostic factors and cancer survival..........................................................................119 16 – Special topics: non-Hodgkin lymphoma and VDR genetic variants .........................................................122 16 – Special topics: non-Hodgkin lymphoma and VDR genetic variants .........................................................122 17 – Vitamin D and cancer in specific populations or conditions .......................................................................133 18 – Vitamin D: predictor or cause of cancer and of other chronic health conditions?....................................140 19 – Should recommendations for sun protection and vitamin D intakes be changed? ................................143 20 – Further research: a plea for new randomised trials on vitamin D..............................................................145 21 – Overall conclusions of the IARC Working Group on vitamin D and cancer.............................................148 References................................................................................................................................................................149 Annex Latitude of residence in Europe and serum 25-hydroxyvitamin D levels: a systematic review 201 v Vitamin D and Cancer Detailed contents 1 – Summary overview of the report............................................................................................................................... 1 2 – Objectives and format of the report .......................................................................................................................... 3 2.1 Background........................................................................................................................................ 3 2.2 Objectives of the report...................................................................................................................... 4 2.3 Format of the report........................................................................................................................... 4 2.4 Overview of the methodology used.................................................................................................... 4 3 – Sunlight and skin cancer: recall of essential issues ................................................................................................. 5 3.1 The skin cancer burden ..................................................................................................................... 5 3.2 Wavelengths of solar radiation relevant to skin cancer......................................................................5 3.3 Action spectra for sunburn, skin cancer and vitamin D synthesis.....................................................
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