Serum 25-OH vitamin D levels and risk of developing prostate cancer in older men

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Abstract

Objective

Multiple studies have shown clear evidence of vitamin D’s anti-tumor effects on prostate cancer cells in laboratory experiments, but the evidence has not been consistent in humans. We sought to examine the association between vitamin D and prostate cancer risk in a cohort of older men.

Methods

We conducted a prospective case-cohort study nested within the multicenter Osteoporotic Fractures in Men (MrOS) study. Baseline serum 25-OH vitamin D was measured in a randomly selected sub-cohort of 1,433 men ≥65 years old without a history of prostate cancer and from all participants with an incident diagnosis of prostate cancer ( n = 297). Cox proportional hazards models were used to evaluate the associations between quartiles of total 25-OH vitamin D and incident prostate cancer, as well as Gleason score.

Results

In comparison with the lowest quartile of 25-OH vitamin D, the hazard ratio for the highest quartile of 25-OH vitamin D was 1.22 (CI 0.50–1.72, p = 0.25), no trend across quartiles ( p = 0.94) or association with Gleason score was observed. Adjustment for covariates did not alter the results.

Conclusions

In this prospective cohort of older men, we found no association between serum 25-OH vitamin D levels and subsequent risk of prostate cancer.

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Most cited references 42

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The Physical Activity Scale for the Elderly (PASE): development and evaluation.

C G Janney, Cicely A. Jette, George W Smith … (1993)

A Physical Activity Scale for the Elderly (PASE) was evaluated in a sample of community-dwelling, older adults. Respondents were randomly assigned to complete the PASE by mail or telephone before or after a home visit assessment. Item weights for the PASE were derived by regressing a physical activity principal component score on responses to the PASE. The component score was based on 3-day motion sensor counts, a 3-day physical activity dairy and a global activity self-assessment. Test-retest reliability, assessed over a 3-7 week interval, was 0.75 (95% CI = 0.69-0.80). Reliability for mail administration (r = 0.84) was higher than for telephone administration (r = 0.68). Construct validity was established by correlating PASE scores with health status and physiologic measures. As hypothesized, PASE scores were positively associated with grip strength (r = 0.37), static balance (r = +0.33), leg strength (r = 0.25) and negatively correlated with resting heart rate (r = -0.13), age (r = -0.34) and perceived health status (r = -0.34); and overall Sickness Impact Profile score (r = -0.42). The PASE is a brief, easily scored, reliable and valid instrument for the assessment of physical activity in epidemiologic studies of older people.

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Prospective study of predictors of vitamin D status and cancer incidence and mortality in men.

Edward L. Giovannucci, Yan Liu, Eric Rimm … (2006)

Vitamin D has potent anticancer properties, especially against digestive-system cancers. Many human studies have used geographic residence as a marker of solar ultraviolet B and hence vitamin D exposure. Here, we considered multiple determinants of vitamin D exposure (dietary and supplementary vitamin D, skin pigmentation, adiposity, geographic residence, and leisure-time physical activity-to estimate sunlight exposure) in relation to cancer risk in the Health Professionals Follow-Up Study. Among 1095 men of this cohort, we quantified the relation of these six determinants to plasma 25-hydroxy-vitamin D [25(OH)D] level by use of a multiple linear regression model. We used results from the model to compute a predicted 25(OH)D level for each of 47,800 men in the cohort based on these characteristics. We then prospectively examined this variable in relation to cancer risk with multivariable Cox proportional hazards models. From 1986 through January 31, 2000, we documented 4286 incident cancers (excluding organ-confined prostate cancer and nonmelanoma skin cancer) and 2025 deaths from cancer. From multivariable models, an increment of 25 nmol/L in predicted 25(OH)D level was associated with a 17% reduction in total cancer incidence (multivariable relative risk [RR] = 0.83, 95% confidence interval [CI] = 0.74 to 0.92), a 29% reduction in total cancer mortality (RR = 0.71, 95% CI = 0.60 to 0.83), and a 45% reduction in digestive-system cancer mortality (RR = 0.55, 95% CI = 0.41 to 0.74). The absolute annual rate of total cancer was 758 per 100,000 men in the bottom decile of predicted 25(OH)D and 674 per 100,000 men for the top decile; these respective rates were 326 per 100,000 and 277 per 100,000 for total cancer mortality and 128 per 100,000 and 78 per 100,000 for digestive-system cancer mortality. Results were similar when we controlled further for body mass index or physical activity level. Low levels of vitamin D may be associated with increased cancer incidence and mortality in men, particularly for digestive-system cancers. The vitamin D supplementation necessary to achieve a 25(OH)D increment of 25 nmol/L may be at least 1500 IU/day.

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Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study--a large observational study of the determinants of fracture in older men.

Eric S Orwoll, Janet Blank, Elizabeth Barrett-Connor … (2005)

Very little information is available to direct the prevention or management of osteoporosis in men. The Osteoporotic Fractures in Men (MrOS) Study is a prospective cohort study designed to examine the extent to which fracture risk is related to bone mass, bone geometry, lifestyle, anthropometric and neuromuscular measures, and fall propensity, as well as to determine how fractures affect quality of life in men. The study is also designed to understand how osteoporosis is related to prostate disease. At baseline, participants completed questionnaires regarding medical history, medications, physical activity, diet, alcohol intake, and cigarette smoking. Objective measures of anthropometric, neuromuscular, vision, strength, and cognitive variables were obtained. Skeletal assessments included DEXA, calcaneal ultrasound, and vertebral radiographs. Vertebral and proximal femoral QCT was performed on a subset (65%). Serum, urine, and DNA specimens were collected. After the baseline assessments, a questionnaire is mailed to participants every 4 months to ascertain incident falls, fractures, prostate cancer, and deaths. After an average of 4.5 years, participants are scheduled to return for a second comprehensive visit. Men were eligible if > or =65 years. 5995 men enrolled with a mean (+/-SD) age of 73.7 (+/-5.9) years, 11% of which were minorities. Most rated their health as good/excellent. Few were current smokers, although 59% had smoked previously, and 35% reported no alcohol intake, while 47% consumed at least 2 drinks per week. The mean (range) body mass index was 26.9 kg/m2 (17-56). A non-traumatic fracture after age 50 was reported by 17% of the cohort. The MrOS cohort should provide valuable information concerning the determinants of fracture in men and should help set the stage for the development of effective methods to identify those at risk.

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Author and article information

Contributors

: +1-503-4940365 , +1-503-4946197 , beert@ohsu.edu

Journal

Journal ID (nlm-ta): Cancer Causes Control

Title: Cancer Causes & Control

Publisher: Springer Netherlands (Dordrecht )

ISSN (Print): 0957-5243

ISSN (Electronic): 1573-7225

Publication date (Electronic): 10 April 2010

Publication date PMC-release: 10 April 2010

Publication date (Print): August 2010

Volume: 21

Issue: 8

Pages: 1297-1303

Affiliations

[1 ]Division of Hematology and Medical Oncology and the Knight Cancer Institute, Oregon Health & Science University, CH-14R, 3303 SW Bond Ave, Portland, OR 97239 USA

[2 ]Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR USA

[3 ]Portland VA Medical Center and CROET, Oregon Health & Science University, Portland, OR USA

[4 ]Departments of Epidemiology & Biostatistics and Urology, University of California San Francisco, San Francisco, CA USA

[5 ]Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL USA

[6 ]University of California, Oakland, San Francisco, CA USA

[7 ]Department of Medicine, Stanford University, Stanford, CA USA

[8 ]Division of Epidemiology, Department of Family and Preventative Medicine, University of California, San Diego, CA USA

[9 ]Bone and Mineral Unit, Division of Endocrinology, Oregon Health & Science University, Portland, OR USA

Article

Publisher ID: 9557

DOI: 10.1007/s10552-010-9557-y

PMC ID: 2903686

PubMed ID: 20383574

SO-VID: 0ed241b9-f66b-4936-b0d2-906b3971a399

History

Date received : 16 December 2009

Date accepted : 24 March 2010

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ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: prostate cancer,vitamin d

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ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: prostate cancer, vitamin d

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Serum 25-OH vitamin D levels and risk of developing prostate cancer in older men

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Abstract

Objective

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Conclusions

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Karger: Oncology

Most cited references 42

The Physical Activity Scale for the Elderly (PASE): development and evaluation.

Prospective study of predictors of vitamin D status and cancer incidence and mortality in men.

Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study--a large observational study of the determinants of fracture in older men.

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Cited by 13

Most referenced authors 698