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New meta-analysis: No link between vitamin D and pancreatic cancer

Posted on: September 3, 2013   by  Brant Cebulla

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According to a new meta-analysis, there is no link between vitamin D and pancreatic cancer.

The cause of pancreatic cancer is unknown, though there are some known risk factors. These include older age, smoking, type II diabetes, obesity, sedentary lifestyle and chronic pancreatitis.

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12 Responses to New meta-analysis: No link between vitamin D and pancreatic cancer

  1. Rita and Misty

    I wonder why an optimal D blood level doesn’t protect us from pancreatic cancer?

    We know that optimal vitamin D levels play a protective role in prevention of diabetes II.

    And diabetes II is the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Epidemiological investigations have found that long-term diabetes II is associated with a 1.5- to 2.0-fold increase in the risk of pancreatic cancer.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238796/

    So, it begs the question, doesn’t it?

  2. IAW

    To: Rita
    I think you took this study the wrong way. I think the studies intent was to prove if higher Vitamin D levels caused an increase in pancreatic cancer. The answer was no it does not.
    I am sure none of these studies used enough to say whether or not Vitamin D helps or not. We at the VDC all no better without the studies.

  3. Rita and Misty

    IAW~Greetings!

    🙂

    I understood the intent of the study. And, this isn’t the first study to show a slight but statistically non-significant increased risk of getting pancreatic cancer if you are in the highest category of vitamin D blood serum levels compared to lowest.

    And it is this slight, but non significant risk which perplexes me.

    Because, as I am seeing it:

    As optimal vitamin D levels are essential for healthy glucose/insulin levels; and long term diabetes II is a significant risk factor for developing pancreatic cancer, I would have thought that anything that treated or prevented diabetes II would also keep pancreatic cancer at bay…And, therefore, I am wondering WHY even the statistically non-significant increased risk of getting pancreatic cancer with higher 25(OH)D levels rather than lower….

    I might be missing something…I hope someone will enlighten me…this vitamin D/pancreatic cancer thing has piqued my interest for some time now.

    I have a high history of diabetes I and II on both sides of my family line.

    BTW, Ivy, we at the VDC do KNOW better without the studies; however, mainstream medicine demands such studies; and without them we are all no better off (in terms of mainstream vitamin D acceptance, and this is MY life mission). 😉

    Be well,
    Rita

  4. Dr William Grant

    Ecological studies find strong inverse correlations between solar UVB doses and pancreatic cancer:
    Grant WB. Ecological studies of the UVB–vitamin D–cancer hypothesis; review. Anticancer Res. 2012;32(1):223-36.

    This study found significant inverse correlations between serum 25-hydroxyvitamin D and pancreatic cancer incidence:
    Wolpin BM, Ng K, Bao Y, Kraft P, Stampfer MJ, Michaud DS, Ma J, Buring JE, Sesso H, Lee IM, Rifai N, Cochrane BB, Wactawaski-Wende J, Chlebowski RT, Willett WC, Manson JE, Giovannucci EL, Fuchs CS. Plasma 25-hydroxyvitamin D and risk of pancreatic cancer. Cancer Epidemiol Biomarkers Prev. 2012;21(1):82-91.

    One of the problems with many of the studies included in the meta-analysis is that they were nested case-control studies from cohort studies in which serum 25-hydroxyvitamin D levels were determined from blood drawn at the time of enrollment. Follow-up periods were as long as 17 years. Serum 25-hydroxyvitamin D levels change with time and adversely affect the findings:
    Grant WB. Effect of interval between serum draw and follow-up period on relative risk of cancer incidence with respect to 25-hydroxyvitamin D level; implications for meta-analyses and setting vitamin D guidelines. Dermatoendocrinol. 2011;3(3):199-204.
    Grant WB. Effect of follow-up time on the relation between prediagnostic serum 25-hydroxyitamin D and all-cause mortality rate. Dermatoendocrinol. 2012;4(2):198-202.

    In my opinion, the authors dumped the data into a vat, turned the crank, and looked at the results. They provided no insight into the topic. Their finding should be taken with a grain of salt.

  5. Rita and Misty

    Dr. Grant, this is certainly reassuring to read. And, it does make sense to me. Every time I read a negative study on D and pancreatic cancer, I would shake my head in disbelief. The connection between diabetes II and pancreatic cancer is so strong that I found it difficult to believe that anything as helpful as vitamin D has been shown to be with respect to diabetes wouldn’t also be as helpful in preventing pancreatic cancer.

  6. cmsjr719@comcast.net

    There was a slight but statistically non-significant increased risk of getting pancreatic cancer if you were in the highest category of vitamin D compared to lowest (OR=1.14, 0.896–1.451).

    No one ever says what constitutes the “highest category” of Vitamin D level and what is the “lowest.” Can anyone answer this question?

    • Brant Cebulla

      cmsjr719,

      Good question. For these style of meta-analyses, researchers are not able to define highest category because each study they include in their meta-analysis uses different cutoffs.

      For example, let’s say you pooled together 10 studies that all looked at the risk of pancreatic cancer and vitamin D levels. Each study split their population into quartiles of vitamin D levels. Even though they all use quartiles, they’re all going to have different cutoffs for these quartiles. For example, the highest quartile in Iceland might be something like 30-50 ng/ml, while the highest quartile in Brazil might be 35-70 ng/ml.

      When all 10 studies are pooled together, the researchers do not put all the people in a big pot and redefine quartiles (or could be tertiles, etc). They simply look at the odds ratio of highest vs lowest categories of each study, take into account population of each study so they know how much weight to place on each, and then see what the combined odds ratio of all 10 studies is.

      The pro to an meta-analysis is that you get to answer the question, “What does all the research say?” All the research shows there’s no correlation between vitamin D and pancreatic cancer (while some specific studies says there is), and there’s no difference between being in lowest category and highest.

      The con is that it doesn’t provide insight into some nuances on the topic, as Dr Grant notes above, and as you ask about (“What is the highest category?”).

      In the context of pancreatic cancer-vitamin D, I find the paper useful because there are a few studies that show increased risk of pancreatic cancer with higher vitamin D levels. But there are also studies that show the opposite. To put to rest any doubts, we need a study that answers, “What do all of these studies combined say?”

      Cheers,
      Brant

  7. cmsjr719@comcast.net

    Brant thanks for the answer….however, excuse my ignorance but Dr. C and I believe Grass Roots call for a level of 40-60 ng, so therefore, that is the highest quintile (using your example above.). And, as the other cancers that D3 would be protective (breast, colon etc) these are types of cancer that can be detected, with common screening. However pancreatic cancer is not detectable until it is usually too late. I realize that there is a cost vs. benefit ratio involved but it certainly gives me pause for keeping levels at the recommended levels.

    Thanks again,

    Clay S.

  8. Brant Cebulla

    Clay,

    One thing I didn’t explain very well is that the categories in these studies, whether it’s a tertile, quartile, quintile, are not for researchers to decide.

    For example, maybe they study a population in Brazil and draw vitamin D levels in every single person. Let’s say the 0th percentile vitamin D level is 7 ng/ml, the 25th percentile level is 15 ng/ml, the 50th percentile is 25 ng/ml, 75th is 35 ng/ml and 100th is 70 ng/ml. Then those are your categories:

    Q1: 7-15 ng/ml
    Q2: 15-25 ng/ml
    Q3: 25-35 ng/ml
    Q4: 35-70 ng/ml

    In some studies, they do use predefined cutoffs, ie lower than 20 ng/ml, 20-30 ng/ml, above 30 ng/ml, but in this meta-analysis (and in most), since each study has different categories and cutoffs, they simply pool the odds ratio of high vs low from each study, as they have no power to put each individual in a big pot and redefine cutoffs.

    Hope that makes sense.

    Cheers,
    Brant

  9. turbomac@bigpond.net.au

    Paul McGinnes
    Have a look at March,April,June July 2013 Newsletters from Hair testing(www.traceelements.com)
    about the levels of minerals affect the outcome of drug treatment of most Diabetes.
    the same conditions could affect outcome with Pancreatic Cancer vs Vitamin D
    Cheers Paul

  10. Michael

    Hello all,

    When it comes to pancreatic cancer, I have only my experience/observation of the identical twin of a person with pancreatic cancer. I met the healthy twin, who worked with me, in September in Arizona. By Christmas he quit his job upon the diagnosis that his identical twin brother had just been diagnosed with advanced pancreatic cancer back in Maryland. My co-worker returned to Maryland to help stabilize and then take over his dying twin’s Computer Consulting business to ensure an income for the upcoming widow and children.

    One: My co-worker was chubby, 35-ish, blond and white as a sheet. We were in ARIZONA at 7,000 feet elevation and working with grade school kids. Evidently at recess he stood in the shade. There was no evidence that he had ever been in sunshine, no pinkness, no tan, no tan line, nothing.

    Two: Both brothers were computer geeks. Sadly we would all have to admit that most computer geeks we know typically are not interested in sports or outside activities, often stay up all night and sleep all day.

    I myself at this time (totally oblivious to the Vitamin D Council’s existence, and completely unaware of Vitamin D and health issues, AND scared cr*pless of ever talking vitamin D pills of any strength–lest I melt my brain or some other horrible fate) was walking shirtless around the football field track every day all fall, all winter (even in the snow), and all Spring to “maintain my tan so that I would not sunburn should I be caught accidently outside the next summer” — as well as for the exercise.

    My point is: as merely anecdotal as this episode about my unfortunate friend whose brother has most likely passed away is, the telling of it is more humanly relevant, reliable and authentic than the quacks that performed lobotomies in the 1930′ and 40’s and maybe even into the 50’s and collected handsome payments for slicing people frontal lobes away from the rest of the brain with a knife hammered through the eye socket — lobotomies that were based on “science”.

    Real science is compatible with common sense. Fear of sunshine does not pass the basic test of common sense.

  11. Michael

    Hello all,

    There are always flies in the ointment of research which makes much of it merely “so-called research”.

    The FLY: When people start feeling sickly or feeling that something is not “right” they tend to start looking for cheap, handy, no-doctor-involved, self-medicating solutions. Some of those are, but not limited to, better bowel movements by taking bran / metamusil / prunes / etc. and starting or increasing vitamin intake, or starting new specialty vitamin (like C, D, K, B*, etc) and health-nut supplements of various kinds (St John’s Wort, etc) or food changes like more mushrooms or more carrots or more of whatever miracle food has recently been yakked about in the media.

    When that person finally goes up the chain of doctors (months or years after starting his self-help cures) and gets a conclusive diagnosis of, say, pancreatic cancer or whatever, that person self-divulges into the medical record the large amounts of vitamins / minerals / herbs they are currently taking. Lab blood tests at the point of diagnosis reflect the fairly recent upping of supplemental intake — at which time the fly squats down and takes a dump.

    Michael

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