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Cancer Res. 2018 Nov 13. pii: canres.2318.2018. doi: 10.1158/0008-5472.CAN-18-2318. [Epub ahead of print]

A collaborative analysis of individual participant data from 19 prospective studies assesses circulating vitamin D and prostate cancer risk.

Author information

1
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford.
2
Nuffield Department of Population Health, University of Oxford aurora.perez-cornago@ndph.ox.ac.uk.
3
Nuffield Department of Population Health, University of Oxford.
4
Division of Cancer Epidemiology, National Cancer Institute.
5
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health.
6
Division of Epidemiology and Community Health, University of Minnesota School of Public Health.
7
Department of Epidemiology, University of Michigan School of Public Health.
8
Division of Cancer Epidemiology & Genetics, National Cancer Institute.
9
Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO.
10
School of Public Health, Imperial College.
11
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment.
12
Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, WHO Collaborating Center for Nutrition and Health.
13
Nutrition and Metabolism, International Agency For Research On Cancer.
14
Epidemiology and Biostatistics, Imperial College.
15
CIBER de Epidemiologia y Salud Pública (CIBERESP).
16
Diet, Genes and Environment, Danish Cancer Society Research Center.
17
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center.
18
German Cancer Research Center.
19
Saarland Cancer Registry.
20
National Institute for Health and Welfare.
21
Medical School, University of Western Australia.
22
Western Australian Centre for Health and Ageing, University of Western Australia.
23
Fiona Stanley Hospital.
24
Geriatric Medicine, Western Australian Centre for Health & Ageing (WACHA), Centre for Medical Research, Western Australian Institute for Medical Research (WAIMR).
25
Dept of Epidemiology & Biostatistics and Urology, University of California, San Francisco.
26
Department of Nutrition, Harvard T.H. Chan School of Public Health.
27
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School.
28
Cancer Registry of Norway.
29
Institute of Population-based Cancer Research, Cancer Registry of Norway.
30
University of Bergen.
31
University of Oslo.
32
Department of Nutrition, Institute for Basic Medical Research Departments of Nutrition, University of OSLO.
33
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre.
34
Centre for Epidemiology and Biostatistics, Melbourne School of Population Health.
35
University of Queensland.
36
School of Public Health, Imperial College London.
37
Department of Medical Statistics, London School of Hygiene & Tropical Medicine.
38
Department of Surgery, Lund University.
39
Department of Translational Medicine, Clinical Chemistry, Lund University.
40
Dept. of Surgery, Malmö Diet and Cancer Study.
41
Department of Epidemiology, University of Hawaii Cancer Center.
42
Department of Preventive Medicine, University of Southern California.
43
Cancer Prevention Program, Fred Hutchinson Cancer Research Center.
44
Hutchinson Cancer Research Centre.
45
Division of Cancer Epidemiology and Genetics, National Cancer Institute.
46
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH.
47
Bristol Medical School: Population Health Sciences, University of Bristol.
48
Nuffield Department of Surgical Sciences, University of Oxford.
49
School of Social and Community Medicine, University of Bristol.
50
Nuffield Department of Surgery, University of Oxford.
51
Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Biostatistics Research Center: Inserm U1153; Inra U1125; Cnam; Paris 13, 7 and 5 Universities.
52
Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University.

Abstract

Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between pre-diagnostic concentrations of 25-hydroxyvitamin D (25(OH)D) and 1,25(OH)2D and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. Odds ratios (OR) for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest versus lowest study-specific fifth was 1.22, 95% CI 1.13-1.31; P trend<0.001). However, this association varied by disease aggressiveness (Pheterogeneity=0.014); higher circulating 25(OH)D was associated with a higher risk of non-aggressive disease (OR per 80 percentile increase=1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of non-aggressive prostate cancer may be influenced by detection bias.

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