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The largest trial of vitamin D and fish-oil pills found they did not prevent cancer. A possible reduction in cancer deaths, and hints of benefit after a digestive cancer diagnosis, keep the question alive.
VITAL (NEJM 2019) randomised 25,871 US adults to vitamin D3 2000 IU/day and/or omega-3 fatty acids 1 g/day for a median 5.3 years: invasive cancer incidence was unchanged (HR 0.96 for vitamin D, 1.03 for omega-3). Total cancer mortality was numerically lower with vitamin D, reaching significance only in analyses excluding the first two years (HR 0.75), an exploratory finding, and a pooled meta-analysis of vitamin D trials suggests a 10-15% reduction in cancer death but not incidence. In patients already diagnosed, the Japanese AMATERASU (digestive tract cancers) and SUNSHINE (metastatic colorectal, high-dose vitamin D with chemotherapy) trials were null on their primary endpoints with subgroup hints; the phase 3 SOLARIS trial of high-dose vitamin D with FOLFOX-bevacizumab in metastatic colorectal cancer was negative (2025). Omega-3 supplements have no consistent cancer prevention effect; in cachexia they preserve weight in some trials but not function. The defensible summary: correct deficiency, do not expect prevention from supplements.
Vitamin D acts through the vitamin D receptor on cell differentiation, proliferation and immune modulation; omega-3 fatty acids reduce pro-inflammatory eicosanoids. Neither has translated into reduced cancer incidence in randomised trials.
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Query for this technology: (TITLE:"Vitamin D and omega-3 supplementation" OR ABSTRACT:"Vitamin D and omega-3 supplementation") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Vitamin D and omega-3 supplementation, not a curated reading list.
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