Cheema Huzaifa Ahmad, Fatima Maurish, Shahid Abia, Bouaddi Oumnia, Elgenidy Anas, Rehman Aqeeb Ur, Oussama Kacimi Salah Eddine, Hasan Mohammad Mehedi, Lee Ka Yiu
Department of Oncology, King Edward Medical University, Lahore, Pakistan.
Department of Medicine, King Edward Medical University, Lahore, Pakistan.
Heliyon. 2022 Oct 28;8(11):e11290. doi: 10.1016/j.heliyon.2022.e11290. eCollection 2022 Nov.
Previous randomized controlled trials (RCTs) and meta-analyses of RCTs evaluating vitamin D supplementation for the prevention of cancer incidence and mortality have found inconsistent results and no meta-analysis has assessed the quality of the evidence available. We, therefore, aimed to perform an updated meta-analysis by including recent large-scale RCTs and assessing the quality of the pooled evidence.
We searched several databases and trial registers from inception to April 2022. We used a random-effects model to estimate pooled risk ratios (RRs) and 95% confidence intervals (CIs). We used the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considerations to evaluate the certainty of evidence.
We included 13 RCTs in our study. Vitamin D supplementation had no effect on the risk of total cancer incidence (RR 0.99, 95% CI: 0.94-1.04; 0%), total cancer mortality (RR 0.93, 95% CI: 0.84-1.03; 24%) and total mortality (RR 0.92, 95% CI: 0.82-1.04; 36%). The overall quality of evidence was high for all outcomes.
Vitamin D supplementation is ineffective in reducing total cancer incidence and mortality in largely vitamin D-replete older adult populations. Future research should be based on populations with a higher prevalence of vitamin D deficiency and should involve more extended follow-up periods.
PROSPERO database, CRD42021285401.
既往评估补充维生素D预防癌症发病率和死亡率的随机对照试验（RCT）及RCT的荟萃分析结果并不一致，且尚无荟萃分析评估现有证据的质量。因此，我们旨在纳入近期大规模RCT并评估汇总证据的质量，进行一项更新的荟萃分析。
我们检索了从数据库建立至2022年4月的多个数据库和试验注册库。我们使用随机效应模型来估计汇总风险比（RR）和95%置信区间（CI）。我们使用推荐分级、评估、制定与评价（GRADE）考量来评估证据的确定性。
我们的研究纳入了13项RCT。补充维生素D对总癌症发病率风险（RR 0.99，95% CI：0.94 - 1.04； 0%）、总癌症死亡率（RR 0.93，95% CI：0.84 - 1.03； 24%）和总死亡率（RR 0.92，95% CI：0.82 - 1.04； 36%）均无影响。所有结局的总体证据质量都很高。
在维生素D水平基本充足的老年人群中，补充维生素D对降低总癌症发病率和死亡率无效。未来的研究应以维生素D缺乏患病率较高的人群为基础，并应包括更长的随访期。
PROSPERO数据库，CRD42021285401。
