Vitamin D and calcium intake in relation to risk of endometrial cancer: a systematic review of the literature.
OBJECTIVE
In response to a recent ecologic study of UV exposure and endometrial cancer incidence, we present the epidemiologic evidence on the relation between intake of vitamin D and its metabolically related nutrient, calcium, and the occurrence of endometrial cancer.


METHODS
We conducted a systematic literature review and meta-analysis of vitamin D and calcium in relation to endometrial cancer, including peer-reviewed manuscripts published up to May 2007. Random and fixed effects summary estimates were computed.


RESULTS
Pooled analyses of the three case-control studies of dietary vitamin D and endometrial cancer uncovered heterogeneous results that were not significant in random or fixed effects analyses. Cut-points for the highest vitamin D intakes ranged from >244 to >476 IU/day. Qualitatively similar findings were observed for dietary calcium. Only two studies provided estimates for calcium supplements (random effects OR=0.62, 95% CI 0.39-0.99; fixed effects OR=0.62, 95% CI 0.42-0.93, for top vs. bottom category, p for heterogeneity=0.25).


CONCLUSIONS
The limited epidemiological evidence suggests no relation between endometrial cancer in the ranges of dietary vitamin D examined, and suggests a possible inverse association for calcium from supplements. Prospective studies, ideally including plasma 25(OH) D to estimate vitamin D input from diet and sun exposure, are needed to further explore these hypotheses.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002136:Calcium, Dietary / Q000008:administration & dosage*; D019587:Dietary Supplements; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage*
D002136:Calcium, Dietary; D014807:Vitamin D