鼻咽癌与变应性鼻炎诸参数关系的观察

探讨鼻咽癌发病与变态反应性疾病的关系。方法对４９例治疗前鼻咽癌和５６例变应性鼻炎的诸临床参数进行探讨，测定总ＩｇＥ、特异性ＩｇＥ和ＥＢ－ＶＣＡ／ＩｇＡ皮肤过敏原及了解他们的过敏性鼻炎史，以１００名健康人为对照组。结论应变性鼻炎组患ＮＰＣ的概率很低，其机体的免疫状态与肿瘤的发生，发展有密切关系。     

Circulating 25-Hydroxy Vitamin D Relative to Vitamin D Receptor Polymorphism after Vitamin D3 Supplementation in Breast Cancer Women: A Randomized,Double-Blind Controlled Clinical Trial

Objective: The influence of vitamin D receptor (VDR) genetic variation on serum 25-hydroxyvitamin D levels [25(OH)D] after vitamin D3 supplementation remains unclear. We aimed to investigate changes of 25(OH)D in a randomized, double-blind, placebo-controlled clinical trial, according to VDR genotype, after provision of vitamin D3 to breast cancer cases for a 2-month period. Methods: Participants were assigned to two treatment arms: placebo (n = 28) and vitamin D3 supplementation (n =28). The supplementation group received 50,000 IU of vitamin D every week for 2 months. Blood samples were collected at baseline and after intervention to measure serum 25(OH) D3. Genotypes were assessed for FokI, BsmI, ApaI, and TaqI polymorphisms. Results: After eight weeks supplementation, the rvention group showed a significant increase in the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004). Subjects were then classified into twelve subgroups according to different VDR genotypes. Subjects with ff/Ff, TT/Tt, and Bb genotypes had significantly higher increases in serum 25(OH)D compared to those with FF, tt, and BB/bb genotypes post-intervention. Serum vitamin D3 levels with the AA genotype were lower than with aa/ Aa. No differences were found among other subgroups. Conclusion: Vitamin D3 supplementation increases serum 25(OH)D in women with breast cancer. Serum vitamin D3 in TT/Tt, ff/Ff, and Bb carriers was more responsive to vitamin D supplementation than in those with FF/ff and tt genotypes. Other subgroups might gain less from vitamin D3 supplementation.     

Nasal Breathing Exercise and its Effect on Symptoms of Allergic Rhinitis

Allergic rhinitis (AR) is a common and chronic health problem with a high prevalence and a significant effect on the health care expenditure. Intranasal steroid spray is recommended as the first line therapy for patients with moderate to severe AR. Our study clinically analysed the use of nasal breathing exercise (NBE) as an adjunct to intranasal steroid spray as a cheap and effective mode of management of AR. A 3 month, parallel, randomized study was carried out in a zonal and tertiary care referral center. In this study, participants (N = 60) with symptomatic AR were administered either a intranasal steroid spray fluticasone propionate (group A) or fluticasone propionate nasal spray and NBE (group B). Participants assessed their symptom severity daily over the 3 month treatment period. The mean total nasal symptom scores were lower in both the groups (5.1 vs. 3.8333 for group A and 5.2 vs. 2.6777 for group B) and the difference was statistically significant (P < 0.05). The patients showed a definite improvement in overall and individual symptoms for both groups with significantly greater reduction in individual symptoms in the group B (P < 0.05). In our study we have found that both treatments provided clinically meaningful responses, but the overall results favored fluticasone propionate and the NBE group. Hence NBE is a simple and cost effective measure to reduce symptoms of AR and improve patient satisfaction.     

Allergic Rhinitis in Children: A Randomized Clinical Trial Targeted at Symptoms

Allergic rhinitis (AR) underlies many symptoms and complications which severely affect children’s quality of life. This two-arm study aimed at evaluate the efficacy and safety of the medical device Narivent^® versus topical corticosteroids in the symptomatic management of allergic rhinitis in paediatric patients. A randomized study was conducted. Forty subjects with a diagnosis of allergic rhinitis were randomized to receive one puff of Narivent^® into each nostril twice daily for 30 days (n = 20) or to receive one puff of topical intranasal corticosteroid into each nostril twice daily for 30 days (n = 20). In both treatment arms, severity of major symptoms related to AR, including nasal congestion, rhinorrhoea, sneezing and nasal itching, was assessed subjectively on a 0–100 mm visual analogue scale. Nasal congestion, rhinorrhoea and sneezing improved significantly after 30 days of treatment with Narivent^®. Similarly, in topical steroids group severity of all subjective symptoms decreased significantly. Narivent^® appears to be efficacious in treating nasal congestion and other major symptoms in children with AR over a 30-day period, showing comparable results to intranasal corticosteroids therapy but with a better safety profile.     

Genetic Variations in VDR could Modulate the Efficacy of Vitamin D3 Supplementation on Inflammatory Markers and Total Antioxidant Capacity among Breast Cancer Women: A Randomized Double Blind Controlled Trial

Background: Low levels of vitamin D are found in a great part of breast cancer women. Study subjects using vitaminD3 supplement had lower rates of cancers and fewer markers of inflammation. Additionally, recent studies demonstratethe power of vitamin D supplementation to lower inflammation and oxidative stress biomarkers associate with VDRpolymorphism to reduce inflammation. This study was aimed to assess the impact of vitamin D3 supplementation onthe serum concentration of inflammatory markers and antioxidant capacity with regard to VDR polymorphism in theVDR gene in breast cancer women. Methods: A randomized, double-blind, placebo-controlled trial was conducted on 56breast cancer women. Participants were assigned to 2 treatment arms: placebo and vitamin D3 for 2 months intervention.Supplementation group received 50,000 IU of vitamin weekly. Blood samples were collected at baseline and afterthe intervention to measure the 25(OH) D3, TNF-α, TGF- β and TAC. Genotyping was performed for FokI, BsmI, ApaI,and TaqI polymorphism. Results: After eight weeks supplementation, the intervention group showed a significant increasein the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004 and TAC (48.9±13.3 to 63.5±13.3; p= 0.017).Changes in TNF-α, TGF- β1 were not significant. Serum TAC levels of participants with the TT/Tt, Ff genotypes weremore responsive to supplementation. Conclusions: Supplementation with a vitamin D3 increased the TAC in breastcancer women, although it had no effect on inflammatory markers. Serum TAC in the TT/Tt, Ff were more responsive tovitamin D supplement compared with those with the FF/ff and tt genotypes.     

Vitamin D and breast cancer

In addition to its role in calcium homeostasis and bone health, vitamin D has also been reported to have anticancer activities against many cancer types, including breast cancer. The discovery that breast epithelial cells possess the same enzymatic system as the kidney, allowing local manufacture of active vitamin D from circulating precursors, makes the effect of vitamin D in breast cancer biologically plausible. Preclinical and ecologic studies have suggested a role for vitamin D in breast cancer prevention. Inverse associations have also been shown between serum 25-hydroxyvitamin D level (25(OH)D) and breast cancer development, risk for breast cancer recurrence, and mortality in women with early-stage breast cancer. Clinical trials of vitamin D supplementation, however, have yielded inconsistent results. Regardless of whether or not vitamin D helps prevent breast cancer or its recurrence, vitamin D deficiency in the U.S. population is very common, and the adverse impact on bone health, a particular concern for breast cancer survivors, makes it important to understand vitamin D physiology and to recognize and treat vitamin D deficiency. In this review, we discuss vitamin D metabolism and its mechanism of action. We summarize the current evidence of the relationship between vitamin D and breast cancer, highlight ongoing research in this area, and discuss optimal dosing of vitamin D for breast cancer prevention.     

Vitamin D Levels,Vitamin D Receptor Polymorphisms,and Inflammatory Cytokines in Aromatase Inhibitor-Induced Arthralgias: An Analysis of CCTG MA.27

Background

Approximately half of women taking aromatase inhibitor (AI) therapy develop AI-induced arthralgia (AIA), and many might discontinue AI therapy because of the pain. Using plasma samples from the MA.27 study, we assessed several factors potentially associated with AIA.

Association of Vitamin D Level with Clinicopathological Features in Breast Cancer

A population-based relationship between low vitamin D status and increased cancer risk is now generallyaccepted. However there were only few studies reported on prognostic impact. To determine the effect of lowvitamin D on progression of breast cancer, we conducted a cross-sectional analysis of vitamin D levels and clinicopathologicalcharacteristics in 200 cases of breast cancer diagnosed during 2011-2012 at the National CancerInstitute of Thailand. Vitamin D levels were measured by high-performance liquid chromatography (HPLC). Clinical and pathological data were accessed to examine prognostic effects of vitamin D. We found that themean vitamin D level was 23.0±6.61 ng/ml. High vitamin D levels (≥32 ng/ml) were detected in 7% of patients,. low levels (<32 ng/ml) in 93% Mean vitamin D levels for stages 1-4 were 26.1±6.35, 22.3±6.34, 22.2±6.46 and21.3±5.42 ng/ml respectively (P=0.016) and 24.1 and 21.3 ng/ml for lymph node negative and positive cases(P=0.006). Low vitamin D level (<32 ng/ml) was significantly found in majority of cases with advanced stage ofthe disease (P=0.036), positive node involvement (P=0.030) and large tumors (P=0.038). Our findings suggestthat low and decreased level of vitamin D might correlate with progression and metastasis of breast cancer.     

Vitamin D receptor variants and breast cancer risk in the Polish population

The aim of the study was to determine whether four VDR gene single nucleotide polymorphisms (SNPs: rs1544410, rs731236, rs10735810 and rs4516035) are associated with breast cancer risk in Polish population. Two independent series of female patients were employed: 960 consecutive breast cancer cases, and 800 unselected early onset cases diagnosed under the age of 51. The control group for the consecutive breast cancer cases consisted of 960 healthy, age-matched women with a negative cancer family history. 550 healthy women, aged 51 or less, with negative cancer family history were selected as the independent controls for the early onset breast cancer cases. The frequencies of the VDR polymorphisms in the unselected cases when compared to the respective control population failed to reveal any association between the individual SNPs and disease. Examination of the group of early-onset patients, revealed an association between rs10735810 and increased breast cancer risk. Heterozygous carriers for the change had an OR = 1.73 (95% CI 1.33–2.26, P < 0.0001) and homozygous carriers OR = 2.34 (95% CI 1.71–3.21, P < 0.0001). The remaining three examined SNPs failed to show any association with disease risk. In summary, this study has identified an association between the VDR gene and early onset breast cancer risk in the Polish population.     

Role of Postoperative Vitamin D and/or Calcium Routine Supplementation in Preventing Hypocalcemia After Thyroidectomy: A Systematic Review and Meta‐Analysis

Background.

Transient hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We performed a systematic review to assess the effectiveness of this intervention. The primary aim was to evaluate the efficacy of routine postoperative oral calcium and vitamin D supplementation in preventing symptomatic post-thyroidectomy hypocalcemia. The second aim was to draw clear guidelines regarding prophylactic calcium and/or vitamin D therapy for patients after thyroidectomy.

Methods.

We identified randomized controlled trials comparing the administration of vitamin D or its metabolites to calcium or no treatment in adult patients after thyroidectomy. The search was performed in PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and Web of Knowledge databases. Patients with a history of previous neck surgery, calcium supplementation, or renal impairment were excluded.

Results.

Nine studies with 2,285 patients were included: 22 in the vitamin D group, 580 in the calcium group, 792 in the vitamin D and calcium group, and 891 in the no intervention group, with symptomatic hypocalcemia incidences of 4.6%, 14%, 14%, and 20.5%, respectively. Subcomparisons demonstrated that the incidences of postoperative hypocalcemia were 10.1% versus 18.8% for calcium versus no intervention and 6.8% versus 25.9% for vitamin D and calcium versus no intervention. The studies showed a significant range of variability in patients'' characteristics.

Conclusions.

A significant decrease in postoperative hypocalcemia was identified in patients who received routine supplementation of oral calcium or vitamin D. The incidence decreased even more with the combined administration of both supplements. Based on this analysis, we recommend oral calcium for all patients following thyroidectomy, with the addition of vitamin D for high-risk individuals.     

Prognostic Significance of Serum Vitamin D Levels in Egyptian Females with Breast Cancer

I read with great interest the paper published  by Ismail et al. in your journal entitled “Prognostic significance of serum vitamin d levels in Egyptian females with breast cancer” (Ismail et al., 2018).  While I really thank the authors for addressing a very controversial and challenging topic, I have few points to address. The association, or the link, between vitamin-D deficiency and cancer in general, breast in particular, is old and controversial, at best! Several studies had linked Vitamin-D deficiency with increasing risk of having breast cancer (Crew KD et al., 2009),  worse pathological features (Peppone L J et al., 2012) advanced stage at presentation and even poor treatment outcome (Chiba A, et al., 2017). Additionally, several studies had supported the vitamin D-cancer prevention hypothesis. (Grant WB, 2018).   However, many of such studies suffered methodology problems! Vitamin-D deficiency and breast cancer are both very common and such association may happen. Though many studies described a correlation between Vitamin-D concentration  and disease stage; researchers questioned such association. Authors of one study (Jacobs ET, et al., 2016) cited by the authors, concluded that "though their study confirmed previous work regarding the correlates of vitamin-D concentrations, it does not provide support for an association between vitamin D status and breast cancer stage”. In this study, 50 women with primary invasive, non-metastatic breast cancer were tested  for vitamin-D level at diagnosis, before any cancer treatment. Fifteen (30.0%) patients were found to be vitamin-D deficient. All  patients were followed up for a median of 30 months. It is hard to believe that a study that involved only 50 patients with only 15 of them  had  vitamin-D deficiency,  recruited over a period of 4 years  in one of the busiest national cancer centers with a median follow up of only  30 months can jump to such major conclusions. Reviewing the  data presented in Table-2 of the current study, in a different way than presented,  clearly shows major differences between both study groups (attached table). Compared to those with normal vitamin-D level, deficient patients had larger tumor size (46.7% vs. 2.9%), more advanced-stage disease at presentation ( 53.3% vs. 2.9%), had tumors with higher grade (33.3% vs. 2.9%), hormone-receptor negative (73.3% vs. 51.4%) and HER-2 positive ( 86.7% vs. 40.0%). All these pathological features are well-established poor prognostic features and associated with poor disease-free and overall survival. It is also difficult to assume that low vitamin-D levels in a very small number of patients (n= 15) was the reason behind all such poor prognostic  features. The multivariate analysis presented in the study showed that progesterone receptor status was the only factor independently affecting overall survival. Additionally, authors found out that stage II had worse survival compared to stage I with HR 4.8 (p = 0.042) while stage III compared to stage I had HR of 1.7 (p = 0.577). Such findings raised many questions about the validity of the final conclusions. As such, I believe that the conclusions made by the authors that vitamin D deficiency had a negative effect on overall and disease-free survival in their 15 vitamin-D deficient breast cancer patients is not supported and should not be stated based on this study. Given the huge amount of literature on this topic, I really doubt that a large prospective study can be carried out to further address this issue.     

维生素 D 与肿瘤发生风险的系统评价

肿瘤是世界范围内的主要公共卫生问题,对人类生命和健康具有严重威胁。 维生素 D 缺乏会增加肿瘤的发生风 险。 流行病学证据支持维生素 D 对肿瘤发生风险的保护作用,维生素 D 的抗肿瘤作用主要来自其活性代谢物与受体的结合 而发挥相关生物学功能,但两者之间的关系因肿瘤的部位而有所差异。 meta 分析普遍报道了高维生素 D 状态是乳腺癌、结直 肠癌、肝癌、膀胱癌及肺癌的保护因素(OR= 0. 46~ 0. 92)。 此外,维生素 D 相关基因多态性与肿瘤的关系及其对维生素 D 水 平与肿瘤发生、风险之间关系的影响也引起人们的广泛关注。 维生素 D 受体和维生素 D 合成和降解途径中的单核苷酸多态 性与肿瘤发生、发展风险有关。 本文就维生素 D 代谢、潜在抗癌机制及其与不同肿瘤发生风险关系的研究进展进行综述,并 探索维生素 D 相关基因多态性与肿瘤之间关系,对于未来肿瘤的一级预防提供理论参考依据。     

A Prospective Study of Shortened Vitamin Supplementation Prior to Cisplatin–Pemetrexed Therapy for Non‐Small Cell Lung Cancer

Background.

Prior supplementation with folic acid and vitamin B₁₂ is required to reduce pemetrexed therapy toxicity; the recommended lead-in time is at least 7 days. On the basis of previous pharmacokinetic and clinical studies, we hypothesized that the lead-in time could be shortened to 24 hours, enabling earlier commencement of standard chemotherapy; thus, we planned the first prospective trial of this regimen.

Methods.

Patients with advanced nonsquamous non-small cell lung cancer who had not previously received cytotoxic chemotherapy were enrolled. After measurement of homocysteine concentrations, the patients received 1,000 μg of vitamin B₁₂ by intramuscular injection and began taking 350–500 μg of oral folic acid daily. Starting 24–48 hours after the vitamin B₁₂ injection, the patients received intravenous 500 mg/m² pemetrexed and 75 mg/m² cisplatin for 4 cycles at 3 weekly intervals. The primary endpoint was the proportion of patients who developed neutropenia grade ≥3.

Results.

Thirty patients received chemotherapy starting within 48 hours of the vitamin B₁₂ injection. No treatment-related deaths or grade 4 toxicity occurred. Neutropenia grade ≥3, other laboratory toxicities grade ≥3, and nonlaboratory toxicities grade ≥3 occurred in 6.7%, 13%, and 13% of patients, respectively. The baseline homocysteine concentrations were not higher in patients with grade ≥3 toxicities than in the remainder of the cohort (mean values, 8.6 and 10.7 μmol/L, respectively). The response rate to chemotherapy was 43%.

Conclusion.

The shortened vitamin supplementation was well tolerated and retained antitumor efficacy. Analysis of baseline homocysteine concentrations confirmed the efficacy of short-term vitamin supplementation.     

Single Nucleotide Polymorphisms in the Gc Gene for Vitamin D Binding Protein in Common Cancers in Thailand

Background: This case-control study aimed to determine if there were any associations between the two singlenucleotide polymorphisms (SNPs) in Gc, rs7041 (Asp416Glu) and rs4588 (Thr420Lys) and 3 common cancers(breast, lung and colorectal) in Thai patients. Materials and Methods: Two hundred and eighty two colorectal,101 breast and 113 lung cancer patients were recruited from one institute during 2011-2013. The controls wereage-matched volunteers who had a negative history of index cancers. In addition, vitamin D levels were comparedamong different genotypes in the 2 SNPs. Results: The minor allele frequencies of rs7041 (G) and rs4588 (A)were 0.32 and 0.24, respectively. Under the dominant model, the study found significant associations betweenminor-allele genotypes of the SNP rs7041 (TG/GG) and lung cancer (odds ratio [OR] 1.78, 95% CI 1.05-3.03).When subgroup analysis was performed according to sex and age at diagnosis, the study found that the minorallelegenotypes of rs7041 (TG/GG) were significantly associated with colorectal cancer in patients whose age atdiagnosis was more than 60 years (OR 1.67, 95%CI 1.06-2.61) and the minor-allele genotypes of rs4588 (CA/AA)were significantly associated with colorectal cancer in males aged 60 years or less (OR 2.34, 95%CI 1.25-4.37).When SNP combinations (rs7041-rs4588) were examined, the TT-CA combination had a significant protectiveassociation with lung cancer (OR 0.44, 95% CI 0.22-0.85). On evaluation of serum 25(OH)D levels in 205individuals without cancer (males 144, females 61), the proportion of subjects with low serum vitamin D (< 20ng/ml) in those harboring CA or AA genotypes of rs4588 (41.7%) was significantly higher than the CC genotype(15.5%, p-value < 0.01). Conclusions: Genetic polymorphisms in Gc were associated with lung and colorectalcancers in Thai patients. Lower serum 25(OH)D in minor variants of rs4588 may explain this association.     

Associations of Probiotics with Vitamin D and Leptin Receptors and their Effects on Colon Cancer

Colorectal cancer (CRC) is one of most common causes of cancer-related death worldwide. Recent studieshave suggested that microbial and environmental factors including diet and lifestyle can impact on colon cancerdevelopment. Vitamin D deficiency and dysfunction of vitamin D receptor (VDR) also correlate with coloncancer. Moreover, leptin, a 16-kDa polypeptide, participates in the regulation of food intake and is associatedwith other environmental factors affecting colon cancer through the leptin receptor. Altered levels of serum leptinand patterns of expression of its receptor (LPR) may be observed in human colon tumours. Furthermore, thecollected data from in vitro and in vivo studies have indicated that consuming probiotic non-pathogenic lacticacid bacteria have beneficial effects on colon cancer. Probiotics, inflammation and vitamin D/VDR have beencorrelated with leptin and its receptor and are also with colon cancer. Thus, in this paper, we review recentprogress on the roles of probiotic, vitamin D/VDR and leptin/LPR in inflammation and colon cancer.     

Prevention of Mammary Tumorigenesis in Acatalasemic Mice by Vitamin E Supplementation

Adult male and female acatalasemic (C3H/AnLCs^bCs^b), hypocatalasemic (C3H/AnLCs^cCs^c) and normal mice of C3H strain fed on regular laboratory chow for 15 months showed an increased incidence of spontaneous mammary tumor in the decreasing order of female acatalasemic, male acatalasemic, female hypocatalasemic and male hypocatalasemic mice. Normal mice did not develop mammary tumor. We conducted a prospective study with female acatalasemic mice, which showed the highest incidence of mammary tumor, to examine the preventive effect of vitamin E on mammary tumor. Female acatalasemic mice were fed on vitamin E-deficient (28 animals) and vitamin E-supplemented diet (25 animals) for 29 months. The incidence of mammary tumor in mice given the vitamin E-supplemented diet was 47%, while that in mice given vitamin E-deficient diet was 82% ( P <0.002). Mammary tumors were apparent after 9 months of vitamin E deprivation and after 14 months of vitamin E supplementation. Female normal mice did not develop mammary tumor during a comparable period of time. The mean catalase activity of mammary gland in acatalasemic mice was 18.8% of that in normal mice. The results indicate that vitamin E protects acatalasemic mice against the development of mammary tumor.     

The role of vitamin D in breast cancer

The biological role of vitamin D outside of calcium homeostasis is still under evaluation. The ability of vitamin D to inhibit cell proliferation and induce differentiation makes it a potential modifier of neoplastic transformation. Vitamin D affects the cell cycle, apoptosis, hormone receptors, angiogenesis, and hypoxia, all of which are related to the breast cancer growth, progression and metastasis. A large percentage of the industrial-world population is deficient in vitamin D. Epidemiological evidence suggests that vitamin D deficiency increases the risk of breast cancer. Vitamin D may have synergistic, additive, or antagonistic effects when combined with other therapeutic agents against breast cancer. Vitamin D appears to depress aromatase inhibitor by acting through cytochrome P 450. This evidence along with pre-clinical and clinical studies, justify the inclusion of vitamin D in future clinical trials related to breast cancer in order to determine its efficacy as a part of the breast cancer therapeutic armament.     

Impact of Nutritional and Environmental Factors on Vitamin D Deficiency

Background: Vitamin D can be obtained through a variety of food sources; however, ultraviolet rays in the sunlightcan convert a natural substance in the skin known as ergosterol to vitamin D. Aim: This study aims to investigate theprevalence and risk factors linked to vitamin D deficiency among a group of apparently healthy young male and femaleTabuk citizens in Saudi Arabia. Methods: A cross-sectional study that comprised a convenience sampling method of 350male and female Tabuk citizens. Results: The results indicated a generalized vitamin D deficiency and severe deficiencyamong the participants, where 74.57% of the population had vitamin D deficiency, and 25.43% reported vitamin Dsufficiency. There was a significant positive correlation among the BMI, exercise, exposure to sunlight, vitamin Dintake, and calcium intake with vitamin D status (r = 0.574,** 0.525,** 0.515,** 0.466 and 0.465** at p-value < 0.001,respectively). Conclusion: The present study indicates vitamin D deficiency to be relatively common even among thepopulation of Saudi Arabia, a country receiving adequate sunlight. Also, Vitamin D and calcium supplementation canprove to be beneficial in correcting the deficiency. Moreover, the individuals at a higher risk of vitamin insufficiency,such as women, need to be educated on the health benefits of vitamin D and calcium supplementation.     

Vitamin D levels and cancer incidence in 217,244 individuals from primary health care in Denmark

Vitamin D has been linked to cancer development in both pre-clinical and epidemiological studies. Our study examines the association between serum levels of vitamin D and cancer incidence in the Capital Region of Denmark. Individuals who had vitamin D analyzed at The Copenhagen General Practitioners Laboratory between April 2004 and January 2010 were linked to Danish registries with end of follow-up date at Dec 31st 2014, excluding individuals with pre-existing cancer. Cox regression models adjusted for age in one-year intervals, sex, month of sampling, and Charlson Comorbidity Index were applied. The study population of 217,244 individuals had a median vitamin D level of 46 nmol/L (IQR 27–67 nmol/L). Non-melanoma skin cancer was the most frequent form of cancer, followed by breast-, lung-, and prostate cancers. No associations were found between increments of 10 nmol/L vitamin D and incidence of breast, colorectal, urinary, ovary or corpus uteri cancer. However, higher levels of vitamin D were associated with higher incidence of non-melanoma (HR 1.09 [1.09–1.1]) and melanoma skin cancer (HR 1.1 [1.08–1.13]) as well as prostate (HR 1.05 [1.03–1.07]) and hematological cancers (HR 1.03 [1.01–1.06]), but with lower incidence of lung cancer (HR 0.95 [0.93–0.97]). In our study, vitamin D levels are not associated with the incidence of several major cancer types, but higher levels are significantly associated with a higher incidence of skin, prostate, and hematological cancers as well as a lower incidence of lung cancer. These results do not support an overall protective effect against cancer by vitamin D.