Association between Gastric Cancer and Vitamin D in Kashmiri Population: A 2 Year Case–Control Study at a Tertiary Care Hospital

Abstract

Introduction: The association between vitamin D level and gastric cancer has not been studied in our population despite the high prevalence of vitamin D deficiency and gastric cancer. Patients and Methods: This was a 26-month case series analysis study in which 59 patients with histologically confirmed gastric cancer and age and sex-matched 60 patients with suspicion of Helicobacter Pylori infection were taken as controls to find out any association between low 25 hydroxy vitamin D level and malignancy. Results: The mean age of the cases and controls was 57 SD (standard deviation)10 and 56 SD 9 years, respectively. The mean vitamin D levels in cases and controls were 20.15 ng/ml and 32.21 ng/ml, which was statistically significant (p < 0.0001). Only 3 (5%) controls showed vitamin D deficiency (< 20 ng/ml), compared to 30 (50.84%) cases, which was statistically significant (p < 0.001). The mean vitamin D levels in well differentiated, moderately differentiated and poorly differentiated adenocarcinoma were 26.10, 23.25 and 14.88 ng/ml, respectively, which was statistically significant (p < 0.001). Stage III gastric adenocarcinoma (50.8%) was the most common, followed by stage II (42.4%), stage I (5.08%) and stage IV (1.7%); however, vitamin D levels did not statistically differ among these stages. All these patients except stage IV underwent surgery, were followed for two years, and had a survival rate of 90 percent. Conclusion: There was a positive association between vitamin D deficiency and the occurrence of gastric cancer. Vitamin D levels were significantly associated with different tumour differentiation grades but not with clinical staging.