title: Vitamin D intake and lung cancer risk in the Women's Health Initiative.
abstract: BACKGROUND
  Prior research suggests that vitamin D protects against lung cancer only among certain subgroups.
  
  
  OBJECTIVE
  We investigated whether vitamin D intake was associated with lung cancer and explored whether vitamin A intake modified the association.
  
  
  METHODS
  Prospective cohort data from 128,779 postmenopausal women, including 1771 incident lung cancers in the Women's Health Initiative (Clinical Trials and Observational Study) 1993-2010, were analyzed. Twelve percent of women received active intervention (1 g Ca + 400 IU vitamin D3/d) in the Calcium/Vitamin D Trial. Baseline total intake included both dietary intake (from food-frequency questionnaires) and supplement intake (from bottle labels). HRs were estimated by Cox proportional hazard models.
  
  
  RESULTS
  No significant association was observed overall. Among never smokers, a total vitamin D intake ≥400 IU/d was significantly associated with lower risks of lung cancer (HR: 0.37; 95% CI: 0.18, 0.77 for ≥800 compared with <100 IU/d; P-trend = 0.01). No significant effect modification of total vitamin A intake on the association between total vitamin D intake and lung cancer was found. However, the Calcium/Vitamin D Trial active intervention was significantly associated with a lower lung cancer risk only among women with a vitamin A intake <1000 μg/d retinol activity equivalents (HR: 0.69; 95% CI: 0.50, 0.96; P-interaction = 0.09).
  
  
  CONCLUSIONS
  Vitamin D intake was associated with a lower lung cancer risk in never-smoking, postmenopausal women. Lower vitamin A intake may be important for a beneficial association of 1 g Ca + 400 IU vitamin D3 supplementation with lung cancer. This trial was registered at clinicaltrials.gov as NCT00000611.
authors: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA and Biostatistics, University of Washington, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.
authors: Ting-Yuan David
authors: TY
authors: Cheng
authors: Andrea Z
authors: AZ
authors: Lacroix
authors: Shirley A A
authors: SA
authors: Beresford
authors: Gary E
authors: GE
authors: Goodman
authors: Mark D
authors: MD
authors: Thornquist
authors: Yingye
authors: Y
authors: Zheng
authors: Rowan T
authors: RT
authors: Chlebowski
authors: Gloria Y F
authors: GY
authors: Ho
authors: Marian L
authors: ML
authors: Neuhouser
mesh_terms: D000368:Aged; D002136:Calcium, Dietary / Q000008:administration & dosage; D015331:Cohort Studies; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage; D014807:Vitamin D / Q000008:administration & dosage*; D016387:Women's Health
chemical_list: D002136:Calcium, Dietary; D014801:Vitamin A; D014807:Vitamin D
references: J Natl Cancer Inst. 2006 Apr 5;98(7):451-9
references: 16595781
references: Endocr Rev. 2012 Jun;33(3):456-92
references: 22596255
references: Cancer Res. 1986 Mar;46(3):1465-70
references: 3510727
references: J Bone Miner Res. 2001 Dec;16(12):2306-12
references: 11760846
references: Am J Clin Nutr. 1989 Jan;49(1):112-20
references: 2911996
references: Am J Respir Cell Mol Biol. 2010 Jan;42(1):21-31
references: 19329555
references: Toxicol Sci. 2009 May;109(1):50-8
references: 19244278
references: Am J Clin Nutr. 1991 Nov;54(5):878-83
references: 1951160
references: Nat Rev Cancer. 2007 Oct;7(10):778-90
references: 17882278
references: Br J Nutr. 2001 Aug;86 Suppl 1:S97-103
references: 11520426
references: Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):1976-83
references: 20696660
references: Ann Epidemiol. 1999 Apr;9(3):178-87
references: 10192650
references: Ann Epidemiol. 2003 Oct;13(9 Suppl):S122-8
references: 14575944
references: PLoS One. 2011;6(6):e20796
references: 21695165
references: N Engl J Med. 2006 Feb 16;354(7):684-96
references: 16481636
references: Clin J Am Soc Nephrol. 2010 Jan;5 Suppl 1:S23-30
references: 20089499
references: Nutr Cancer. 2011;63(6):827-41
references: 21774589
references: Tob Control. 2009 Aug;18(4):317-23
references: 19491091
references: Cancer Epidemiol Biomarkers Prev. 2013 Jan;22(1):50-7
references: 23093548
references: Ann Epidemiol. 2003 Oct;13(9 Suppl):S18-77
references: 14575939
references: Ann Intern Med. 2011 Dec 20;155(12):827-38
references: 22184690
references: J Biol Chem. 1998 Apr 3;273(14):8483-91
references: 9525962
references: Ann Epidemiol. 2003 Oct;13(9 Suppl):S107-21
references: 14575943
references: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references: 22237781
references: Oncogene. 2011 Jun 23;30(25):2846-58
references: 21317921
references: Cancer Causes Control. 2012 Sep;23(9):1557-65
references: 22829430
references: Nature. 1993 Feb 18;361(6413):657-60
references: 8382345
references: J Natl Cancer Inst. 2010 Sep 22;102(18):1413-21
references: 20709992
references: Cancer Causes Control. 2005 Mar;16(2):83-95
references: 15868450
references: Public Health Nutr. 1999 Sep;2(3):273-6
references: 10512561
references: N Engl J Med. 2007 Jul 19;357(3):266-81
references: 17634462
references: Nat Rev Cancer. 2007 Sep;7(9):684-700
references: 17721433
references: Am J Clin Nutr. 2010 May;91(5):1324-35
references: 20219959
references: Cancer Res. 2010 Nov 1;70(21):8587-97
references: 20847342
references: N Engl J Med. 1996 May 2;334(18):1150-5
references: 8602180
references: J Natl Cancer Inst. 2011 Jul 20;103(14):1086-92
references: 21653922
references: Clin Endocrinol (Oxf). 1999 Apr;50(4):511-6
references: 10468912
references: Ann Epidemiol. 2011 Jun;21(6):440-9
references: 21414803
references: Cancer. 2006 Feb 1;106(3):654-63
references: 16365851
references: N Engl J Med. 1994 Apr 14;330(15):1029-35
references: 8127329
references: Am J Epidemiol. 2013 Apr 1;177(7):613-6
references: 23425628
references: J Gen Intern Med. 2011 May;26(5):546-50
references: 21203857
references: Am J Epidemiol. 2008 May 15;167(10):1247-59
references: 18344516
references: N Engl J Med. 2008 Sep 25;359(13):1367-80
references: 18815398
references: JAMA. 2011 Jul 27;306(4):428-9
references: 21730229
references: Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3274-8
references: 18990771
references: Cancer Res. 1999 Jun 1;59(11):2644-9
references: 10363987