Predicted Vitamin D Status and Colorectal Cancer Incidence in the Black Women's Health Study

Authors

Lauren E Barber
Kimberly A Bertrand
Jessica L Petrick
Hanna Gerlovin
Laura F White
Lucile L Adams-Campbell
Lynn Rosenberg
Hemant K Roy
Julie R Palmer

Publication Date

12-1-2021

Journal

Cancer Epidemiology, Biomarkers & Prevention

DOI

10.1158/1055-9965.EPI-21-0675

PMID

34620630

PMCID

PMC8643345

PubMedCentral® Posted Date

6-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adult, Black People, Colorectal Neoplasms, Female, Humans, Incidence, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Assessment, Surveys and Questionnaires, Vitamin D, Women's Health, Black or African American, Vitamin D status, Colorectal cancer, African American, Women

Abstract

BACKGROUND: Observational studies, mostly among White populations, suggest that low vitamin D levels increase colorectal cancer risk. African Americans, who are disproportionately burdened by colorectal cancer, often have lower vitamin D levels compared with other populations.

METHODS: We assessed predicted vitamin D score in relation to colorectal cancer among 49,534 participants in the Black Women's Health Study, a cohort of African American women followed from 1995 to 2017 through biennial questionnaires. We derived predicted vitamin D scores at each questionnaire cycle for all participants using a previously validated prediction model based on actual 25-hydroxyvitamin D values from a subset of participants. We calculated cumulative average predicted vitamin D score at every cycle by averaging scores from cycles up to and including that cycle. Using Cox proportional hazards regression, we estimated hazard ratios (HR) and 95% confidence intervals (CI) for colorectal cancer incidence according to predicted score quartiles.

RESULTS: Over follow-up, 488 incident colorectal cancers occurred. Compared with women in the highest quartile of predicted vitamin D score, those in the lowest had an estimated 41% (HR = 1.41; 95% CI, 1.05-1.90) higher colorectal cancer risk. Comparable HRs were 1.44 (95% CI, 1.02-2.01) for colon and 1.34 (95% CI, 0.70-2.56) for rectal cancer.

CONCLUSIONS: Low vitamin D status may lead to elevated colorectal cancer risk in African American women.

IMPACT: Our findings, taken together with established evidence that vitamin D levels are generally lower in African Americans than other U.S. groups, suggest that low vitamin D status may contribute to the disproportionately high colorectal cancer incidence among African Americans.

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