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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Plasma Vitamin D and Prostate Cancer Risk: Results from the Selenium and Vitamin E Cancer Prevention Trial

Alan R. Kristal, Cathee Till, Xiaoling Song, Catherine M. Tangen, Phyllis J. Goodman, Marian L. Neuhauser, Jeannette M. Schenk, Ian M. Thompson, Frank L. Meyskens Jr, Gary E. Goodman, Lori M. Minasian, Howard L. Parnes and Eric A. Klein
Alan R. Kristal
1Cancer Prevention Program;
3Departments of Epidemiology and
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  • For correspondence: Akristal@fhcrc.org
Cathee Till
2SWOG Statistical Center, Fred Hutchinson Cancer Research Center;
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Xiaoling Song
1Cancer Prevention Program;
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Catherine M. Tangen
1Cancer Prevention Program;
2SWOG Statistical Center, Fred Hutchinson Cancer Research Center;
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Phyllis J. Goodman
2SWOG Statistical Center, Fred Hutchinson Cancer Research Center;
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Marian L. Neuhauser
1Cancer Prevention Program;
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Jeannette M. Schenk
1Cancer Prevention Program;
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Ian M. Thompson
5Department of Urology, University of Texas–San Antonio Health Science Center, San Antonio, Texas;
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Frank L. Meyskens Jr
6Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California;
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Gary E. Goodman
3Departments of Epidemiology and
4Environmental Health, University of Washington, Seattle, Washington;
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Lori M. Minasian
7Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; and
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Howard L. Parnes
7Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; and
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Eric A. Klein
8Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
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DOI: 10.1158/1055-9965.EPI-14-0115 Published August 2014
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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.

This article is featured in Highlights of This Issue, p. 1443

See related commentary by Schwartz, p. 1447, and article by Schenk et al., p. 1484

  • Received January 31, 2014.
  • Revision received March 28, 2014.
  • Accepted April 8, 2014.
  • ©2014 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 23 (8)
August 2014
Volume 23, Issue 8
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Plasma Vitamin D and Prostate Cancer Risk: Results from the Selenium and Vitamin E Cancer Prevention Trial
Alan R. Kristal, Cathee Till, Xiaoling Song, Catherine M. Tangen, Phyllis J. Goodman, Marian L. Neuhauser, Jeannette M. Schenk, Ian M. Thompson, Frank L. Meyskens Jr, Gary E. Goodman, Lori M. Minasian, Howard L. Parnes and Eric A. Klein
Cancer Epidemiol Biomarkers Prev August 1 2014 (23) (8) 1494-1504; DOI: 10.1158/1055-9965.EPI-14-0115

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Plasma Vitamin D and Prostate Cancer Risk: Results from the Selenium and Vitamin E Cancer Prevention Trial
Alan R. Kristal, Cathee Till, Xiaoling Song, Catherine M. Tangen, Phyllis J. Goodman, Marian L. Neuhauser, Jeannette M. Schenk, Ian M. Thompson, Frank L. Meyskens Jr, Gary E. Goodman, Lori M. Minasian, Howard L. Parnes and Eric A. Klein
Cancer Epidemiol Biomarkers Prev August 1 2014 (23) (8) 1494-1504; DOI: 10.1158/1055-9965.EPI-14-0115
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