TY - JOUR
T1 - Association of calcium and vitamin D supplementation with cancer incidence and cause-specific mortality in Black women
T2 - Extended follow-up of the Women's Health Initiative calcium-vitamin D trial
AU - Kato, Ikuko
AU - Sun, Jun
AU - Hastert, Theresa A.
AU - Abrams, Judy
AU - Larson, Joseph C.
AU - Bao, Wei
AU - Shadyab, Aladdin H.
AU - Mouton, Charles
AU - Qi, Lihong
AU - Warsinger Martin, Lisa
AU - Manson, Jo Ann E.
N1 - Funding Information:
The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN 268201600004C. Research reported in this publication also was supported by the National Cancer Institute of the National Institutes of Health under award number P30 CA023074.
Publisher Copyright:
© 2023 UICC.
PY - 2023
Y1 - 2023
N2 - Low circulating vitamin D levels are more prevalent in Black than White individuals. We analyzed the Women's Health Initiative (WHI) calcium plus vitamin D (CaD) randomized clinical trial extended follow-up data to evaluate associations between calcium plus vitamin D supplementation and incident cancer, cardiovascular disease (CVD), and cause-specific mortality endpoints among Black women. Intent-to-treat analysis was performed. Among 3325 Black women in the CaD trial who were randomized into either daily calcium (1000 mg of calcium carbonate) plus vitamin D (400 IU D3) or placebos for an average of 7 years, there were 813 deaths, 588 incident cancers, and 837 CVD events during an average of 15.7 years of follow up (52 230 total person-years). Using Cox's proportional hazards models, we calculated hazard ratios and their confidence intervals for outcomes ascertained during the trial period, posttrial follow-up period and overall periods combined. We found that total mortality, cause-specific mortality, and total cancer incidence were almost identical between CaD and placebo groups. These results suggest that calcium plus vitamin D supplementation does not reduce risks of cancer, CVD, or other major causes of death in Black women overall and, thus, other medical, behavioral or social interventions should be considered to narrow health disparities related to these outcomes. However, other finer endpoints, such as colorectal cancer, warrants further investigation.
AB - Low circulating vitamin D levels are more prevalent in Black than White individuals. We analyzed the Women's Health Initiative (WHI) calcium plus vitamin D (CaD) randomized clinical trial extended follow-up data to evaluate associations between calcium plus vitamin D supplementation and incident cancer, cardiovascular disease (CVD), and cause-specific mortality endpoints among Black women. Intent-to-treat analysis was performed. Among 3325 Black women in the CaD trial who were randomized into either daily calcium (1000 mg of calcium carbonate) plus vitamin D (400 IU D3) or placebos for an average of 7 years, there were 813 deaths, 588 incident cancers, and 837 CVD events during an average of 15.7 years of follow up (52 230 total person-years). Using Cox's proportional hazards models, we calculated hazard ratios and their confidence intervals for outcomes ascertained during the trial period, posttrial follow-up period and overall periods combined. We found that total mortality, cause-specific mortality, and total cancer incidence were almost identical between CaD and placebo groups. These results suggest that calcium plus vitamin D supplementation does not reduce risks of cancer, CVD, or other major causes of death in Black women overall and, thus, other medical, behavioral or social interventions should be considered to narrow health disparities related to these outcomes. However, other finer endpoints, such as colorectal cancer, warrants further investigation.
KW - Black
KW - postmenopausal women
KW - randomized clinical trial
KW - vitamin D
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U2 - 10.1002/ijc.34436
DO - 10.1002/ijc.34436
M3 - Article
C2 - 36650676
AN - SCOPUS:85147516379
SN - 0020-7136
JO - International Journal of Cancer
JF - International Journal of Cancer
ER -