Vitamin D for Cancer Prevention: Global Perspective

Garland, Cedric F.; Gorham, Edward D.; Mohr, Sharif B.; Garland, Frank C.

doi:10.1016/j.annepidem.2009.03.021

« Previous Next »Annals of Epidemiology
Volume 19, Issue 7 , Pages 468-483, July 2009

Vitamin D for Cancer Prevention: Global Perspective

Cedric F. Garland, Dr PH, FACE
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla
- Moores University of California San Diego Cancer Center, La Jolla
Edward D. Gorham, MPH, PhD
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla
- Moores University of California San Diego Cancer Center, La Jolla
- Naval Health Research Center, San Diego
- Address correspondence to: Edward D. Gorham, Naval Health Research Center, PO Box 85122, San Diego, CA 92186-5122. Tel.: 619-524-9876.
Sharif B. Mohr, MPH
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla
- Moores University of California San Diego Cancer Center, La Jolla
Frank C. Garland, PhD
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla
- Moores University of California San Diego Cancer Center, La Jolla
- Naval Health Research Center, San Diego

Received 14 August 2008; accepted 15 March 2009.

Purpose

Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are associated with substantially lower incidence rates of colon, breast, ovarian, renal, pancreatic, aggressive prostate and other cancers.

Methods

Epidemiological findings combined with newly discovered mechanisms suggest a new model of cancer etiology that accounts for these actions of 25(OH)D and calcium. Its seven phases are disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition (abbreviated DINOMIT). Vitamin D metabolites prevent disjunction of cells and are beneficial in other phases.

Results/Conclusions

It is projected that raising the minimum year-around serum 25(OH)D level to 40 to 60 ng/mL (100–150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D₃, or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D and calcium.

Key Words: Vitamin D, Breast Neoplasms, Colorectal Neoplasms, Ovarian Neoplasms, Dose-Response, Calcium, Etiology, Prevention, Treatment, Survival