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Cancer Epidemiol Biomarkers Prev. 2014 Aug;23(8):1494-504. doi: 10.1158/1055-9965.EPI-14-0115. Epub 2014 Apr 14.

Plasma vitamin D and prostate cancer risk: results from the Selenium and Vitamin E Cancer Prevention Trial.

Author information

1
Cancer Prevention Program; Departments of Epidemiology and Akristal@fhcrc.org.
2
SWOG Statistical Center, Fred Hutchinson Cancer Research Center;
3
Cancer Prevention Program;
4
Cancer Prevention Program; SWOG Statistical Center, Fred Hutchinson Cancer Research Center;
5
Department of Urology, University of Texas-San Antonio Health Science Center, San Antonio, Texas;
6
Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California;
7
Departments of Epidemiology and Environmental Health, University of Washington, Seattle, Washington;
8
Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; and.
9
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.

Abstract

BACKGROUND:

In vitro, animal, and ecological studies suggest that inadequate vitamin D intake could increase prostate cancer risk, but results of biomarker-based longitudinal studies are inconsistent.

METHODS:

Data for this case (n = 1,731) and cohort (n = 3,203) analysis are from the Selenium and Vitamin E Cancer Prevention Trial. Cox proportional hazard models were used to test whether baseline plasma vitamin D (25-hydroxy) concentration, adjusted for season of blood collection, was associated with the risk of total and Gleason score 2-6, 7-10, and 8-10 prostate cancer.

RESULTS:

There were U-shaped associations of vitamin D with total cancer risk: compared with the first quintile, HRs were 0.83 [95% confidence interval (CI), 0.66-1.03; P = 0.092], 0.74 (95% CI, 0.59-0.92; P = 0.008), 0.86 (95% CI, 0.69-1.07; P = 0.181), and 0.98 (95% CI, 0.78-1.21; P = 0.823), for the second through fifth quintiles, respectively. For Gleason 7-10 cancer, corresponding HRs were 0.63 (95% CI, 0.45-0.90; P = 0.010), 0.66 (95% CI, 0.47-0.92; P = 0.016), 0.79 (95% CI, 0.56-1.10; P = 0.165), and 0.88 (95% CI, 0.63-1.22; P = 0.436). Among African American men (n = 250 cases), higher vitamin D was associated with reduced risk of Gleason 7-10 cancer only: in the a posteriori contrast of quintiles 1-2 versus 3-5, the HR was 0.55 (95% CI, 0.31-0.97; P = 0.037), with no evidence of dose-response or a U-shaped association.

CONCLUSIONS:

Both low and high vitamin D concentrations were associated with increased risk of prostate cancer, and more strongly for high-grade disease.

IMPACT:

The optimal range of circulating vitamin D for prostate cancer prevention may be narrow. Supplementation of men with adequate levels may be harmful. Cancer Epidemiol Biomarkers Prev; 23(8); 1494-504. ©2014 AACR.

PMID:
24732629
PMCID:
PMC4119495
DOI:
10.1158/1055-9965.EPI-14-0115
[Indexed for MEDLINE]
Free PMC Article

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