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Association between Vitamin B12 Levels and Colon Cancer Survival: A Global Network Study
Bruce Chang-Gu1,2, George Golovko2, Anthony P D'Andrea3
1MD-PhD Combined Degree Program, University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas.
Cancer Research Communications
|January 7, 2026
Summary
Elevated vitamin B12 levels are linked to worse outcomes in colon cancer patients, including increased metastases and reduced survival. This highlights vitamin B12 as a potential biomarker for colon cancer progression.
Area of Science:
- Oncology
- Biochemistry
- Genetics
Background:
- Emerging research suggests a correlation between elevated vitamin B12 levels and a higher incidence of malignancies.
- Understanding the role of vitamin B12 in colon cancer progression is crucial for identifying new biomarkers and therapeutic targets.
Purpose of the Study:
- To investigate the association between vitamin B12 levels and adverse outcomes in colon cancer patients, specifically focusing on metastases and mortality.
- To explore the relationship between vitamin B12 levels, tumor characteristics, and patient survival.
- To analyze gene expression patterns related to vitamin B12 metabolism in colon cancer.
Main Methods:
- A retrospective analysis of a multi-institutional database (TriNetX) involving 37,106 colon cancer patients with vitamin B12 measurements.
- Patients were stratified into low (<300 pg/mL), normal (300-1000 pg/mL), and elevated (>1000 pg/mL) vitamin B12 groups.
- Statistical analyses included log-rank tests, Cox-proportional hazards models, and risk ratios to compare survival, metastasis incidence, and gene expression from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) projects.
Main Results:
- Elevated vitamin B12 levels were associated with significantly decreased median overall survival (59.4 months) compared to normal (129.8 months) and low (137.3 months) levels.
- Patients with elevated vitamin B12 exhibited higher rates of metastatic involvement, advanced tumor stage at diagnosis, and increased 1-year incidence of liver, lung, and peritoneal metastases.
- Gene expression analysis revealed elevated levels of the vitamin B12-dependent methionine synthase (MTR) in colon cancer tissues, which correlated with poorer survival.
Conclusions:
- Elevated vitamin B12 levels are a significant indicator of adverse outcomes in colon cancer, including increased metastasis and reduced survival.
- The findings suggest that vitamin B12 may serve as a valuable clinical biomarker for predicting colon cancer progression and patient prognosis.
- Further research into the role of MTR in colon cancer pathogenesis could reveal novel therapeutic strategies.
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