PRIMARY PREVENTION OF LUNG CANCER:HOW JUSTIFIED HIGH DOSES OF VITAMIN D3 ARE?
Morbidity and mortality from lung cancer varies in different countries and depends on insolation and historical smoking habits, with a latency period of up to 30 years from the start of active smoking to a sharp rise in the incidence of cancer. Over the past 2 decades, the mortality rate from lung cancer has a tendency to decrease (most pronounced among the male population), but remain stably high. The goal of the study: evaluation of the correlation of vitamin D level (VitD) in the blood serum with the rate of lung cancer development. The publications in medical literature for the period from 1994-2021 were studied. Using the PubMed, Scopus, CrossRef databases on the relations between the VitD level and the likelihood of developing lung cancer. The key words used were lung cancer, vitamin D deficiency, lung disease, and carcinogenesis. The issues of etiopathogenesis of lung cancer have been analyzed from the standpoint of primary prevention of this disease, including aspects of the molecular genetic status of patients with this disease. An increase in cases of cancer of the lungs, bladder, breast and pancreas, colorectal cancer, cancer of the esophagus, oral cavity, ovaries, skin cancer and mortality from cancer of the stomach in the countries with a low level of ultraviolet radiation of sunlight was observed. The authors explain this effect by the effect of vitD and ultraviolet radiation on a number of human genes. The authors suggested a possible role of vitD deficiency in the progression of some malignant neoplasms, the development of which is associated with the production of this vitamin in the skin and with concomitant inflammation. Residents of a number of regions of the Russian Federation live on a large territory, which is located in a zone of poor insolation. Vitamin D deficiency, combined with climatic conditions and inflammation of the lung tissue, can lead to the development of lung cancer, with high mortality rates in the working-age population. The association of VitD deficiency and lung tissue carcinogenesis is presented in a number of studies by foreign scientists, but the data are rather heterogeneous and require clarification in large RCTs. Correction of the diet with the addition of drugs based on VitD in patients with chronic lung diseases (asthma, COPD, cystic fibrosis) and in patients with metastatic lung carcinomas can improve the quality of life and prognosis.