caa a22 4500 39756595X CHVBK 20180308164828.0 cr unu---uuuuu 161202e19961002xx s 000 0 eng 10.1093/jnci/88.19.1375 doi (NATIONALLICENCE)oxford-10.1093/jnci/88.19.1375 Calcium, Vitamin D, and the Occurrence of Colorectal Cancer Among Women [Elektronische Daten] [María Elena Martínez, Edward L. Giovannucci, Graham A. Colditz, Meir J. Stampfer, David J. Hunter, Frank E. Speizer, Alvin Wing, Walter C. Willett] Background: Despite evidence from animal studies for a protective effect of higher calcium and possibly vitamin D intake against colorectal cancer, epidemiologic studies have been inconclusive. Purpose: We investigated the associations between the intake of calcium and vitamin D and the occurence of colorectal cancer. Methods: In a prospective study, 89 448 female registered nurses who were free of cancer responded to a mailed, semiquantitative food-frequency questionnaire in 1980; dietary information was updated in 1984 and 1986. Through 1992, 501 incident cases of colorectal cancer (396 colon and 105 rectal cancers) were documented. As measures of exposure, we used nutrient intake in 1980 and also two measures of long-term intake on the basis of the three questionnaires: the average of intakes from the three questionnaires and consistent intakes, which were defined as high if women were in the upper tertile on all questionnaires and low if they were in the lower tertile on all questionnaires. To further characterize long-term intake, we conducted analyses excluding women who reported a change in their consumption of milk (primary source of calcium and vitamin D) in the 10 years prior to 1980. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using the lowest quintile of intake as a reference. The Mantel extension test was used to evaluate linear trends across the categories of nutrient intake. In multivariate analyses, the trends were tested with use of the medians of the intake as a continuous variable in the logistic model. The P values for the trends were two-sided. Results: On the basis of the data from the 1980 questionnaire alone, the multivariate RR for colorectal cancer for women in the upper versus the lower quintile were 0.80 (95% CI= 0.60-1.07) for dietary calcium, 0.84 (95% CI = 0.63-1.13) for dietary vitamin D (from foods only), and 0.88 (95% CI = 0.66-1.16) for total vitamin D (from foods and supplements). After the exclusion of women who reported a change in their milk intake, the RRs for colorectal cancer for the highest versus the lowest categories of average intake were 0.74 (95% CI = 0.36-1.50) for dietary calcium, 0.72 (95% CI = 0.34-1.54) for dietary vitamin D, and 0.42 (95% CI = 0.19-0.91) for total vitamin D. The corresponding RRs for the consistency analyses were 0.70 (95% CI = 0.35-1.39) for dietary calcium, 0.59 (95% CI = 0.30-1.16) for dietary vitamin D, and 0.33 (95% CI = 0.16-0.70) for total vitamin D. Conclusions: These findings do not support a substantial inverse association between calcium intake and risk of colorectal cancer, but an inverse association between intake of total vitamin D and risk of colorectal cancer was suggested. Implications: Available evidence does not warrant an increase in calcium intake to prevent colon cancer, but longer-term studies of both calcium and especially vitamin D in relation to colorectal cancer risk are needed. © Oxford University Press ARTICLES nationallicence Martínez María Elena Department of Nutrition, Harvard School of Public Health Boston, MA aut Giovannucci Edward L. Department of Nutrition, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut Colditz Graham A. Channing Laboratory. Department of Medicine, Harvard Medical School and Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health Boston aut Stampfer Meir J. Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut Hunter David J. Channing Laboratory. Department of Medicine, Harvard Medical School and Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health Boston aut Speizer Frank E. Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut Wing Alvin Department of Epidemiology, Harvard School of Public Health Boston aut Willett Walter C. Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut JNCI: Journal of the National Cancer Institute Oxford University Press 88/19(1996-10-02), 1375-1382 0027-8874 88:19<1375 1996 88 jnci https://doi.org/10.1093/jnci/88.19.1375 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jnci/88.19.1375 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Martínez María Elena Department of Nutrition, Harvard School of Public Health Boston, MA aut NATIONALLICENCE 700 1- Giovannucci Edward L. Department of Nutrition, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut NATIONALLICENCE 700 1- Colditz Graham A. Channing Laboratory. Department of Medicine, Harvard Medical School and Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health Boston aut NATIONALLICENCE 700 1- Stampfer Meir J. Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut NATIONALLICENCE 700 1- Hunter David J. Channing Laboratory. Department of Medicine, Harvard Medical School and Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health Boston aut NATIONALLICENCE 700 1- Speizer Frank E. Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut NATIONALLICENCE 700 1- Wing Alvin Department of Epidemiology, Harvard School of Public Health Boston aut NATIONALLICENCE 700 1- Willett Walter C. Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston aut NATIONALLICENCE 773 0- JNCI: Journal of the National Cancer Institute Oxford University Press 88/19(1996-10-02), 1375-1382 0027-8874 88:19<1375 1996 88 jnci Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford