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Cancer Epidemiology, Biomarkers & Prevention
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A Prospective Study of Calcium Intake and Incident and Fatal Prostate Cancer

Edward Giovannucci, Yan Liu, Meir J. Stampfer and Walter C. Willett
Edward Giovannucci
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Yan Liu
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Meir J. Stampfer
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Walter C. Willett
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DOI: 10.1158/1055-9965.EPI-05-0586 Published February 2006
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Tables

  • Table 1.

    Mean or prevalence of age-standardized characteristics in 1986 by calcium intake (mg/d) of Health Professionals Follow-up Study

    Dietary calcium
    Supplemental calcium
    Total calcium intake
    <585 (Q1)≥933 (Q4)0>400<750≥1,500
    Total calcium6091,2898521,6235771,878
    Dietary calcium5041146780796592992
    Supplemental calcium354008591278
    Age (not standardized)53.754.253.757.253.455.8
    Body mass index (kg/m2)24.924.925.024.625.024.9
    Leisure time activity*18.721.520.726.119.423.1
    Vigorous activity*10.813.312.517.411.315.4
    Multivitamin use (%)38.244.039.182.932.166.6
    Current smoker (%)12.38.59.78.311.17.6
    Total fat (g/d)73.169.471.468.673.067.9
    Saturated fat (g/d)23.925.424.522.924.324.5
    α-linolenic acid (g/d)1.091.031.081.051.091.02
    Zinc (mg/d)19.922.019.058.816.345.9
    Vitamin E (IU/d)941008440067258
    Vitamin D (IU/d)263495342734245713
    Red meat (servings/d)0.740.520.610.520.690.43
    Fish (servings/d)0.390.360.380.460.390.38
    Tomato sauce (servings/wk)1.00.880.960.990.990.84
    Dairy foods (servings/d)1.23.11.931.950.943.3
    Lactose (g/d)7.930.915.114.05.430.3
    PSA test ≥1 (%)†93.293.693.694.493.293.5
    PSA test ≥3 (%)†72.073.873.476.072.376.4
    • ↵* MET-hours of vigorous leisure time physical activity.

    • ↵† Men who had at least one PSA test between 1994 and 2000 and men who had at least three PSA tests between 1994 and 2000.

  • Table 2.

    RR and 95% CI of prostate cancer in relation to total calcium intake in the Health Professionals Follow-up Study (1986-2002)

    Total calcium (mg/d)
    Ptrend
    <500500-749750-9991,000-1,4991,500-1,999≥2,000
    Total prostate cancer
        All cases
            Cases1831072109989820785
            RR (95% CI)0.98 (0.84-1.15)11.07 (0.98-1.16)1.03 (0.94-1.12)1.06 (0.91-1.23)1.28 (1.02-1.60)0.10
        Excluding men using calcium supplements <5 y
            Cases1821040101674315557
            RR (95% CI)0.98 (0.84-1.15)11.09 (1.00-1.18)1.03 (0.94-1.14)1.10 (0.93-1.31)1.28 (0.97-1.67)0.09
        Limited to men with a PSA test (1992-2002)
            Cases11474582067314441
            RR (95% CI)1.05 (0.86-1.28)11.08 (0.98-1.20)1.05 (0.95-1.17)1.06 (0.88-1.27)1.01 (0.73-1.38)0.65
    Nonadvanced prostate cancer
        All cases
            Cases15291595276917063
            RR (95% CI)0.98 (0.83-1.17)11.07 (0.98-1.17)1.02 (0.92-1.12)1.01 (0.86-1.20)1.13 (0.88-1.47)0.55
        Excluding men using calcium supplements < 5 y
            Cases15188887963212538
            RR (95% CI)0.98 (0.82-1.17)11.09 (0.99-1.20)1.02 (0.92-1.13)1.03 (0.85-1.24)1.02 (0.73-1.4)0.80
        Limited to men with a PSA test (1992-2002)
            Cases10967474161113132
            RR (95% CI)1.11 (0.91-1.37)11.08 (0.97-1.20)1.06 (0.95-1.18)1.07 (0.88-1.29)0.87 (0.61-1.25)0.95
    Advanced prostate cancer
        All cases
            Cases311571471293722
            RR (95% CI)0.99 (0.67-1.46)11.02 (0.81-1.28)1.05 (0.83-1.33)1.36 (0.94-1.95)2.02 (1.28-3.19)0.005
        Excluding men using calcium supplements <5 y
            Cases311521371113019
            RR (95% CI)1.01 (0.68-1.49)11.06 (0.84-1.33)1.12 (0.87-1.43)1.60 (1.07-2.38)2.60 (1.60-4.23)0.0003
        Limited to men with a PSA test (1992-2002)
            Cases5717962139
            RR (95% CI)0.48 (0.19-1.19)11.09 (0.79-1.51)1.03 (0.72-1.45)1.03 (0.57-1.88)2.21 (1.09-4.50)0.09
    Fatal prostate cancer
        All cases
            Cases219481762614
            RR (95% CI)1.05 (0.65-1.69)10.95 (0.70-1.28)1.04 (0.77-1.42)1.56 (1.00-2.43)2.02 (1.14-3.58)0.01
        Excluding men using calcium supplements <5 y
            Cases219476632212
            RR (95% CI)1.03 (0.64-1.66)10.97 (0.71-1.31)1.04 (0.75-1.44)1.87 (1.17-3.01)2.43 (1.32-4.48)0.003
        Limited to men with a PSA test (1992-2002)
            Cases231342555
            RR (95% CI)0.45 (0.11-1.90)11.05 (0.79-1.51)0.89 (0.64-1.72)0.82 (0.52-1.53)2.55 (0.96-6.76)0.34
    • NOTE: Multivariable RR controlled for age, time period, body mass index at age 21, vigorous physical activity, height, cigarette pack-years in the previous 10 years, family history of prostate cancer, history of diabetes mellitus, race, and intake of total calories, red meat, fish, α-linolenic acid, zinc supplements, and tomato sauce.

  • Table 3.

    Calcium intake from dietary and supplemental sources in relation to risk of advanced and fatal prostate cancer in the Health Professionals Follow-up Study (1986-2002)

    Dietary calcium intake, quartiles (mg/d)
    Ptrend
    <585585-731732-932≥933
    Advanced prostate cancer
        Cases98109124149
        RR* (95% CI)11.11 (0.84-1.46)1.22 (0.93-1.60)1.46 (1.12-1.90)0.003
    Fatal prostate cancer
        Cases59687784
        RR* (95% CI)11.16 (0.82-1.66)1.26 (0.89-1.78)1.36 (0.97-1.92)0.08
    Supplemental calcium intake (mg/d)
    Ptrend

    0
    1-400
    ≥401


    Advanced prostate cancer
        Cases4081557
        RR* (95% CI)11.08 (0.64-1.81)1.22 (0.93-1.62)0.17
    Fatal prostate cancer
        Cases237942
        RR* (95% CI)11.05 (0.54-2.04)1.51 (1.09-2.10)0.05
    • ↵* Multivariable RR controlled for age, time period, body mass index at age 21, vigorous physical activity, height, cigarette pack-years in the previous 10 years, family history of prostate cancer, history of diabetes mellitus, race, and intake of total calories, red meat, fish, α-linolenic acid, zinc supplements, and tomato sauce; excluding men using calcium supplements <5 years at baseline.

  • Table 4.

    RR and 95% CI of prostate cancer in relation to dairy food and lactose intake in the Health Professionals Follow-up Study (1986-2002)

    Dairy food intake, quintiles (median servings/d)
    Ptrend
    0.501.051.572.283.72
    Total prostate cancer
        Cases648713696771716
        Multivariable model
            RR (95% CI)1.001.04 (0.93-1.15)1.02 (0.91-1.14)1.11 (0.99-1.24)1.07 (0.95-1.20)0.20
        Multivariable model + calcium
            RR (95% CI)1.001.03 (0.92-1.15)1.00 (0.89-1.13)1.09 (0.96-1.23)1.05 (0.91-1.21)0.44
    Advanced prostate cancer
        Cases8111690111125
        Multivariable model
            RR (95% CI)1.001.25 (0.94-1.67)0.95 (0.70-1.29)1.08 (0.80-1.46)1.21 (0.89-1.64)0.39
        Multivariable model + calcium
            RR (95% CI)1.001.25 (0.93-1.69)0.93 (0.67-1.29)1.04 (0.74-1.45)1.08 (0.75-1.55)0.99
    Lactose intake, quintiles (median g/d)
    Ptrend

    3.8
    7.7
    12.0
    17.5
    31.1

    Total prostate cancer
        Cases608656720766794
        Multivariable model
            RR (95% CI)1.001.02 (0.91-1.14)1.07 (0.96-1.19)1.11 (0.99-1.23)1.13 (1.02-1.26)0.01
        Multivariable model + calcium
            RR (95% CI)1.001.02 (0.91-1.15)1.07 (0.95-1.21)1.12 (0.98-1.27)1.18 (1.02-1.35)0.02
    Advanced prostate cancer
        Cases8210394109135
        Multivariable model
            RR (95% CI)1.001.14 (0.85-1.52)0.99 (0.73-1.34)1.08 (0.80-1.44)1.35 (1.02-1.79)0.03
        Multivariable model + calcium
            RR (95% CI)1.001.15 (0.84-1.56)1.01 (0.72-1.40)1.10 (0.78-1.55)1.36 (0.95-1.97)0.09
    • NOTE: Multivariable RR controlled for age, time period, body mass index at age 21, vigorous physical activity, height, cigarette pack-years in the previous 10 years, family history of prostate cancer, history of diabetes mellitus, race, and intake of total calories, red meat, fish, α-linolenic acid, zinc supplements, and tomato sauce.

      Dairy foods based on servings/day of skim/low fat milk, whole milk, cream, sour cream, sherbet ice milk, ice cream, yogurt, cottage cheese, cream cheese, other cheese.

  • Table 5.

    Mean plasma 1,25(OH)2D, 25(OH)D, and 1,25(OH)2D/25(OH)D ratio according to calcium intake

    Total calcium (mg/d)
    Ptrend
    <500500-749750-9991,000-1,4991,500-1,999≥2,000
    n902432762305828
    Plasma 1,25(OH)2D35.534.533.932.932.631.20.002
    Plasma 25(OH)D23.022.523.324.525.123.90.002
    Plasma 1,25(OH)2D/25(OH)D1.831.681.621.461.421.46<0.0001
    • NOTE: Mean of plasma vitamin D is based on least square means from the regression model adjusting for age, season of blood drawn, and year of assay (1996 or 1998).

      Calcium intake is from 1994 food frequency questionnaire because blood samples were drawn in 1993-1994.

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Cancer Epidemiology Biomarkers & Prevention: 15 (2)
February 2006
Volume 15, Issue 2
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A Prospective Study of Calcium Intake and Incident and Fatal Prostate Cancer
Edward Giovannucci, Yan Liu, Meir J. Stampfer and Walter C. Willett
Cancer Epidemiol Biomarkers Prev February 1 2006 (15) (2) 203-210; DOI: 10.1158/1055-9965.EPI-05-0586

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A Prospective Study of Calcium Intake and Incident and Fatal Prostate Cancer
Edward Giovannucci, Yan Liu, Meir J. Stampfer and Walter C. Willett
Cancer Epidemiol Biomarkers Prev February 1 2006 (15) (2) 203-210; DOI: 10.1158/1055-9965.EPI-05-0586
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