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Calcium, Dairy Foods, Vitamin D, and Colorectal Cancer Risk: The Fukuoka Colorectal Cancer Study

¹ Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan; Departments of ² Preventive Medicine, ³ Surgery and Oncology, and ⁴ Surgery and Science, Graduate School of Medical Sciences, Kyushu University; ⁵ Department of Gastroenterological Surgery, National Kyushu Cancer Center; ⁶ Division of Surgery, National Kyushu Medical Center, Fukuoka, Japan; ⁷ Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan; ⁸ The First and ⁹ Second Departments of Surgery, Fukuoka University School of Medicine; ¹⁰ Division of Surgery, Fukuoka City Hospital; ¹¹ Division of Surgery, Hamanomachi General Hospital; and ¹² Division of Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan

Requests for reprints: Tetsuya Mizoue, Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. Phone: 81-33202-7181; Fax: 81-33202-7364. E-mail: mizoue{at}ri.imcj.go.jp

Epidemiologic evidence supporting a protective role of calcium and vitamin D in colorectal carcinogenesis has been accumulating in Western populations, but it is limited in Asian populations, whose intake of calcium is relatively low. We investigated the association of intakes of these nutrients with colorectal cancer risk in Japanese. Study subjects were participants of a large-scale case-control study in Fukuoka, Japan. Diet was assessed through interview regarding 148 dietary items by showing typical foods or dishes on the display of a personal computer. In a multivariate analysis adjusting for potential confounding variables, calcium intake was significantly, inversely associated with colorectal cancer risk (P for trend = 0.01); the odds ratio for the highest versus lowest quintile of calcium intake was 0.64 (95% confidence interval, 0.45-0.93). Higher levels of dietary vitamin D were significantly associated with decreased risk of colorectal cancer among those who had fewer chances of sunlight exposure at work or in leisure (P for trend = 0.02). A decreased risk of colorectal cancer associated with high calcium intake was observed among those who had higher levels of vitamin D intake or among those who had a greater chance of daily sunlight exposure, but not among those with medium or lower intake of vitamin D or among those with potentially decreased sunlight exposure. These results add to support for a joint action of calcium and vitamin D in the prevention of colorectal carcinogenesis. (Cancer Epidemiol Biomarkers Prev 2008;17(10):2800–7)