Prediagnostic circulating 25-hydroxyvitamin D and prostate cancer-specific survival: a collaborative pooled analysis of 13 prospective studies
Abstract
Abstract Background Previous research suggests higher risk of prostate cancer diagnosis in men with high vitamin D serology, but there are limited data related to prostate cancer survival. In this study, we examine the associations between prediagnostic circulating levels of 25-hydroxyvitamin D [25(OH)D] with risk of prostate cancer-specific mortality, as well as mortality from other causes, in participants diagnosed with prostate cancer. Methods We conducted a prospective multi-national collaborative analysis of pre-diagnostic circulating 25(OH)D, the major biochemical indicator of vitamin D status, with data for 12,635 incident prostate cancer cases from 13 cohorts. Multivariable-adjusted Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between study-specific/season-standardized categories as well as clinically defined 25(OH)D categories (<30, 30-<50, 50-<75, and ≥75 nmol/L) and mortality from prostate cancer and other causes. Results Analyses of circulating 25(OH)D and mortality were based on 3,445 deaths, of which 1,316 (38.2%) were due to prostate cancer. In fully adjusted models, men with high pre-diagnostic 25(OH)D concentrations experienced lower prostate cancer-specific mortality (HR for 80-percentile increase = 0.75, 95% CI: 0.64, 0.88; P trend < 0.001) and slightly lower risk of mortality from other causes (HR = 0.85, 95% CI: 0.75, 0.96, P trend = 0.009). In the subset of cases with complete stage and grade data (5,078 cases [40.2%] and 761 deaths from prostate cancer [57.8%]), the association between 25(OH)D and prostate cancer mortality was 0.81 (0.65, 0.99, P trend =0.04). Conclusions In this pooled analysis of 13 prospective cohorts, higher pre-diagnostic circulating vitamin D (25(OH)D) was associated with increased prostate cancer survival.
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Authors: Jiaqi Huang, Aurora Perez‐Cornago, Ruth C. Travis, Paul N. Appleby, Danrui Chen, Mahboubeh Parsaeian, Urwah Noor, Stephanie J. Weinstein, Neal D. Freedman, Andreas Josefsson, Ingegerd Johansson, Elizabeth A. Platz, Corinne E. Joshu, Bu B. Yeap, Leon Flicker, Lorelei A. Mucci, Konstantinos K. Tsilidis, Paul Knekt, Pamela L. Lutsey, Alison Mondul, Kala Visvanathan, Kathy J. Helzlsouer, Graham G. Giles, Matthias B. Schulze, Mélanie Deschasaux, Mathilde Touvier, Jose M.ª Huerta, Loic Le Marchand, Meir Stampfer, Timothy J. Key, Demetrius Albanes, Naomi E. Allen
Institutions: Johns Hopkins University, Imperial College London, Sun Yat-sen University, The University of Melbourne, Harvard University, University of Oxford, University of Michigan, Inserm, Monash University, University of Minnesota, University of Ioannina, University of Hawaiʻi at Mānoa, Université Paris Cité, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Sorbonne Paris Nord, Centre de Recherche Épidémiologie et Statistique, The University of Western Australia, Third Affiliated Hospital of Sun Yat-sen University, Monash Health, National Cancer Institute, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto Murciano de Investigación Biosanitaria, University of Potsdam, National Institutes of Health, Umeå University, Finnish Institute for Health and Welfare, German Institute of Human Nutrition, University of Hawaii System, Cancer Center of Hawaii, University of Hawaii Cancer Center, Cancer Council Victoria