JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Calcium plus vitamin D supplementation and the risk of nonmelanoma and melanoma skin cancer: post hoc analyses of the women's health initiative randomized controlled trial

Jean Y Tang, Teresa Fu, Erin Leblanc, Joann E Manson, David Feldman, Eleni Linos, Mara Z Vitolins, Nathalie C Zeitouni, Joseph Larson, Marcia L Stefanick
Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 2011 August 1, 29 (22): 3078-84
21709199

PURPOSE: In light of inverse relationships reported in observational studies of vitamin D intake and serum 25-hydroxyvitamin D levels with risk of nonmelanoma skin cancer (NMSC) and melanoma, we evaluated the effects of vitamin D combined with calcium supplementation on skin cancer in a randomized placebo-controlled trial.

METHODS: Postmenopausal women age 50 to 79 years (N = 36,282) enrolled onto the Women's Health Initiative (WHI) calcium/vitamin D clinical trial were randomly assigned to receive 1,000 mg of elemental calcium plus 400 IU of vitamin D3 (CaD) daily or placebo for a mean follow-up period of 7.0 years. NMSC and melanoma skin cancers were ascertained by annual self-report; melanoma skin cancers underwent physician adjudication.

RESULTS: Neither incident NMSC nor melanoma rates differed between treatment (hazard ratio [HR], 1.02; 95% CI, 0.95 to 1.07) and placebo groups (HR, 0.86; 95% CI, 0.64 to 1.16). In subgroup analyses, women with history of NMSC assigned to CaD had a reduced risk of melanoma versus those receiving placebo (HR, 0.43; 95% CI, 0.21 to 0.90; P(interaction) = .038), which was not observed in women without history of NMSC.

CONCLUSION: Vitamin D supplementation at a relatively low dose plus calcium did not reduce the overall incidence of NMSC or melanoma. However, in women with history of NMSC, CaD supplementation reduced melanoma risk, suggesting a potential role for calcium and vitamin D supplements in this high-risk group. Results from this post hoc subgroup analysis should be interpreted with caution but warrant additional investigation.

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Dr Ahmed Fadel

In our countries sun exposure is avaiable for human being and so Vitamin D synthesis but the problem is in females who are in door and not well expose to sun due her Islamic cloth if they went outdoor and so most of females at any age have low calicium in serum and need supplement of calicium as well as diet supplement plus their knowledges about sun exposure importance.

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