Evidence map›Paper›PMID 29906273›Full record

ArticlePloS one2018

Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort.

Sharon L McDonnell, Carole A Baggerly, Christine B French, Leo L Baggerly, Cedric F Garland, Edward D Gorham, Bruce W Hollis, Donald L Trump, Joan M Lappe

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sharon L McDonnellGrassrootsHealth, Encinitas, California, United States of America.ORCID 0000-0002-3371-8081
Carole A BaggerlyGrassrootsHealth, Encinitas, California, United States of America.
Christine B FrenchGrassrootsHealth, Encinitas, California, United States of America.
Leo L BaggerlyGrassrootsHealth, Encinitas, California, United States of America.
Cedric F GarlandDepartment of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America.
Edward D GorhamDepartment of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America.
Bruce W HollisMedical University of South Carolina, Charleston, South Carolina, United States of America.
Donald L TrumpInova Schar Cancer Institute, Falls Church, Virginia, United States of America.
Joan M LappeDepartment of Medicine, Creighton University, Omaha, Nebraska, United States of America.ORCID 0000-0001-8274-2515

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml.

objectiveTo investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older.

methodsAnalyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements.

resultsWithin the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20-39, 40-59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin.

conclusionsHigher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.

Indexed as

AgedAged, 80 and overBreast NeoplasmsFemaleHumansMiddle AgedProportional Hazards ModelsProspective StudiesRandomized Controlled Trials as TopicRisk FactorsVitamin D25-hydroxyvitamin DVitamin D

Identifiers

PMID29906273
PMCPMC6003691

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.