BACKGROUND - Recent epidemiologic evidence suggests that higher circulating vitamin D does not protect against prostate cancer and, in fact, may increase the risk of developing this malignancy. However, few studies have examined the most clinically relevant outcome, prostate cancer mortality.
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METHODS - We examined pre-diagnostic serum 25-hydroxy-vitamin D (25(OH)D) and prostate cancer survival in a cohort of 1,000 cases in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. During 23 years of follow-up, 363 men died from their disease. Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% CI of death from prostate cancer by season-specific quintile of 25(OH)D. Multivariable models were adjusted for age, physical activity, cigarettes per day, and family history of prostate cancer.
RESULTS - Men with higher serum 25(OH)D were less likely to die from their prostate cancer (Q5 vs. Q1 HR=0. 72, 95% CI=0. 52 - 0. 99, p-trend=0. 006). This finding was independent of stage or grade at diagnosis, and appeared restricted to men who survived longer (survived <3. 3 years: Q5 vs. Q1 HR=0. 95, 95% CI=0. 61 - 1. 50, p-trend=0. 53; survived ≥3. 3 years: Q5 vs. Q1 HR=0. 53, 95% CI=0. 34 - 0. 85, p-trend=0. 0002).
CONCLUSIONS - In this population of men diagnosed with prostate cancer, higher serum 25(OH)D years prior to diagnosis was associated with longer prostate cancer survival.
IMPACT - In light of inconsistent evidence regarding the role of vitamin D in the development of prostate cancer, the present findings regarding the most clinically relevant prostate cancer outcome, disease-specific mortality, could have important public health implications.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2016 Jan 25 [Epub ahead of print]
Alison M Mondul, Stephanie J Weinstein, Kristin A Moy, Satu Mannisto, Demetrius Albanes
Department of Epidemiology, University of Michigan School of Public health Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health. , National Cancer Institute. , Department of Chronic Disease Prevention, National Institute for Health and Welfare. , Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health.