Vitamin D prostate cancer cloudy outlook?

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Vitamin D may be a negative consideration regarding prostate cancer, may be suggested by the below story. The EDITORIAL is free full-text and the Ahn et al paper is pdf-availed. http://www.sciencedaily.com/releases/2008/05/080527193204.htm No Association Found Between Vitamin D Concentration In Blood And Risk Of Prostate CancerScienceDaily (May 27, 2008) Prostate Cancer Risk Not Associated With Vitamin D Journal pre-amble: High levels of vitamin D in the blood were not associated with risk of prostate cancer overall, although there was some evidence for an association between higher levels of vitamin D and an increased risk of aggressive prostate cancer. FREE: Vitamin D and Prostate Cancer Risk — A Less Sunny

Outlook?Journal of the National Cancer Institute Advance Access published online on May 27, 2008 EDITORIALSLorelei A. Mucci, Donna Spiegelmanhttp://jnci.oxfordjournals.org/cgi/content/full/djn164 Journal of the National Cancer Institute Advance Access published online on May 27, 2008 ARTICLES Serum Vitamin D Concentration and Prostate Cancer Risk: A Nested Case–Control StudyJiyoung Ahn, Ulrike s, Demetrius Albanes, Mark P. Purdue, Christian C. Abnet, Nilanjan Chatterjee, L. Horst, Bruce W. Hollis, Wen-Yi Huang, M. Shikany, B. , For the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Project Team Background: Epidemiological studies have yielded inconsistent associations between vitamin D status and prostate cancer risk, and few studies have evaluated whether the

associations vary by disease aggressiveness. We investigated the association between vitamin D status, as determined by serum 25-hydroxyvitamin D [25(OH)D] level, and risk of prostate cancer in a case–control study nested within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Methods: The study included 749 case patients with incident prostate cancer who were diagnosed 1–8 years after blood draw and 781 control subjects who were frequency matched by age at cohort entry, time since initial screening, and calendar year of cohort entry. All study participants were selected from the trial screening arm (which includes annual standardized prostate cancer screening). Conditional logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) by quintile of season-standardized serum 25(OH)D concentration. Statistical tests were two-sided. Results: No

statistically significant trend in overall prostate cancer risk was observed with increasing season-standardized serum 25(OH)D level. However, serum 25(OH)D concentrations greater than the lowest quintile (Q1) were associated with increased risk of aggressive (Gleason sum 7 or clinical stage III or IV) disease (in a model adjusting for matching factors, study center, and history of diabetes, ORs for Q2 vs Q1 = 1.20, 95% CI = 0.80 to 1.81, for Q3 vs Q1 =1.96, 95% CI = 1.34 to 2.87, for Q4 vs Q1 = 1.61, 95% CI = 1.09 to 2.38, and for Q5 vs Q1 = 1.37, 95% CI = 0.92 to 2.05; Ptrend = .05). The rates of aggressive prostate cancer for increasing quintiles of serum 25(OH)D were 406, 479, 780, 633, and 544 per 100 000 person-years. In exploratory analyses, these associations with aggressive disease were consistent across subgroups defined by age, family history of prostate cancer, diabetes, body mass index, vigorous physical activity, calcium intake, study center, season of blood

collection, and assay batch. Conclusion: The findings of this large prospective study do not support the hypothesis that vitamin D is associated with decreased risk of prostate cancer; indeed, higher circulating 25(OH)D concentrations may be associated with increased risk of aggressive disease. CONTEXT AND CAVEATS Prior knowledge Although data from laboratory studies have suggested that vitamin D inhibits prostate cell proliferation and differentiation, epidemiological studies have yielded mixed results on the association between vitamin D status and prostate cancer risk. Study design Nested case–control study in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. All of the men in this analysis were receiving regular prostate cancer screening. Contributions An increase in season-standardized serum 25-hydroxyvitamin D level was not associated with a decreased risk of prostate cancer. There was some evidence that men with vitamin D levels above the lowest quintile had an increased risk of prostate cancer with aggressive characteristics, but no clear monotonic trend was evident. Implications Higher levels of serum 25-hydroxyvitamin D may not reduce the risk of prostate cancer; indeed, it is possible that higher levels are associated with increased risk of aggressive disease. Limitations Only a single baseline vitamin D measurement was available. Whether vitamin D levels could affect prostate-specific antigen levels in some cancers, causing a diagnosis bias, is not known. As with all epidemiology studies, unmeasured confounders could account for the

results. -- Al Pater, alpater@...

[Guest guest]

Unless the highest quintile had much higher 25(OH)D levels than is

typically found in the " top " quintile of our D-deprived

population, this study is useless. Maybe a specification of what the

quintile levels mean would be revelatory.

It is almost impossible to avoid the siren song of gleaning some kind of

information from a study that you do and want to publish, but there

bottom line, after all, was

Results: No statistically significant trend in overall prostate cancer

risk was observed with increasing season-standardized serum 25(OH)D

level.

" The rates of aggressive prostate cancer for increasing quintiles of

serum 25(OH)D were 406, 479, 780, 633, and 544 per 100 000

person-years. " Gee, now there's a trend. Not.

Also, they start with cancer patients, it's not a prospective study,

bless their hearts.

Sigh . . . .

Maco

At 06:36 PM 5/27/2008, you wrote:

Vitamin D may be a negative

consideration regarding prostate cancer, may be suggested by the below

story. The EDITORIAL is free full-text and the Ahn et al paper is

pdf-availed.

http://www.sciencedaily.com/releases/2008/05/080527193204.htm

No Association Found Between Vitamin D Concentration In Blood And Risk Of

Prostate Cancer

ScienceDaily (May 27, 2008)

Prostate Cancer Risk Not Associated With Vitamin D

Journal pre-amble: High levels of vitamin D in the blood were not

associated with risk of prostate cancer overall, although there was some

evidence for an association between higher levels of vitamin D and an

increased risk of aggressive prostate cancer.

FREE: Vitamin D and Prostate Cancer! Risk — A Less Sunny Outlook?

Journal of the National Cancer Institute Advance Access published online

on May 27, 2008

EDITORIALS

Lorelei A. Mucci, Donna Spiegelman

http://jnci.oxfordjournals.org/cgi/content/full/djn164

Journal of the National Cancer Institute Advance Access published online

on May 27, 2008

ARTICLES

Serum Vitamin D Concentration and Prostate Cancer Risk: A Nested

Case–Control Study

Jiyoung Ahn, Ulrike s, Demetrius Albanes, Mark P. Purdue, Christian

C. Abnet, Nilanjan Chatterjee, L. Horst, Bruce W. Hollis, Wen-Yi

Huang, M. Shikany, B. , For the Prostate, Lung,

Colorectal, and Ovarian Cancer Screening Trial Project Team

Background: Epidemiological studies have yielded inconsistent

associations between vitamin D status and prostate cancer risk, and few

studies have evaluated whe! ther the associations vary by disease

aggressiveness. We investigated the association between vitamin D status,

as determined by serum 25-hydroxyvitamin D [25(OH)D] level, and risk of

prostate cancer in a case–control study nested within the Prostate, Lung,

Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

Methods: The study included 749 case patients with incident prostate

cancer who were diagnosed 1–8 years after blood draw and 781 control

subjects who were frequency matched by age at cohort entry, time since

initial screening, and calendar year of cohort entry. All study

participants were selected from the trial screening arm (which includes

annual standardized prostate cancer screening). Conditional logistic

regression was used to estimate adjusted odds ratios (ORs) with 95%

confidence intervals (CIs) by quintile of season-standardized serum

25(OH)D concentration. Statistical tests were two-sided.

Results: No statistically significant trend in overall prostate cancer

risk was observed with increasing season-standardized serum 25(OH)D

level. However, serum 25(OH)D concentrations greater than the lowest

quintile (Q1) were associated with increased risk of aggressive (Gleason

sum 7 or clinical stage III or IV) disease (in a model adjusting for

matching factors, study center, and history of diabetes, ORs for Q2 vs Q1

= 1.20, 95% CI = 0.80 to 1.81, for Q3 vs Q1 =1.96, 95% CI = 1.34 to 2.87,

for Q4 vs Q1 = 1.61, 95% CI = 1.09 to 2.38, and for Q5 vs Q1 = 1.37, 95%

CI = 0.92 to 2.05; Ptrend = .05). The rates of aggressive prostate cancer

for increasing quintiles of serum 25(OH)D were 406, 479, 780, 633, and

544 per 100 000 person-years. In exploratory analyses, these associations

with aggressive disease were consistent across subgroups defined by age,

family history of prostate cancer, diabetes, body mass index, vigorous

physical activity, calcium intake, study center, season of blood

collection, and assay batch.

Conclusion: The findings of this large prospective study do not support

the hypothesis that vitamin D is associated with decreased risk of

prostate cancer; indeed, higher circulating 25(OH)D concentrations may be

associated with increased risk of aggressive disease.

CONTEXT AND CAVEATS

Prior knowledge

Although data from laboratory studies have suggested that vitamin D

inhibits prostate cell proliferation and differentiation, epidemiological

studies have yielded mixed results on the association between vitamin D

status and prostate cancer risk.

Study design

Nested case–control study in the Prostate, Lung, Colorectal, and Ovarian

Cancer Screening Trial. All of the men in this analysis were receiving

regular prostate cancer screening.

Contributions

An increase in season-standardized serum 25-hydroxyvitamin D level was

not associated with a decreased risk of prostate cancer. There was some

evidence that men with vitamin D levels above the lowest quintile had an

increased risk of prostate cancer with aggressive characteristics, but no

clear monotonic trend was evident.

Implications

Higher levels of serum 25-hydroxyvitamin D may not reduce the risk of

prostate cancer; indeed, it is possible that higher levels are associated

with increased risk of aggressive disease.

Limitations

Only a single baseline vitamin D measurement was available. Whether

vitamin D levels could affect prostate-specific antigen levels in some

cancers, causing a diagnosis bias, is not known. As with all epidemiology

studies, unmeasured confounders could account for the results.

-- Al Pater,

alpater@...

Maco

acting Chief of Staff, Office of the Chief Information Officer

Los Alamos National Laboratory

505-665-5175

505-664-8410 pager

[Guest guest]

Hi All, "Contrary to expectations, in multivariable models adjusted for smoking habits, education, occupational activity, and serum retinol, higher as opposed to lower vitamin D concentrations were associated with a nearly three times the risk of pancreatic cancer (Table 2, highest vs. lowest quintile, >65.5 vs. <32.0 nmol/L: odds ratio, 2.92, 95% CI, 1.56-5.48, p-trend = 0.001) (52)." The below (1) paper is pdf-availed. The (52) paper is free full-text and used to present Table 2 data. 52. Stolzenberg- RZ, Vieth R, Azad A, Pietinen P, PR, Virtamo J, Albanes D.A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers.Cancer Res. 2006 Oct 15;66(20):10213-9.PMID: 17047087 http://tinyurl.com/5fsaxuhttp://cancerres.aacrjournals.org/cgi/content/full/66/20/10213 1. Stolzenberg- RZ.Vitamin D and Pancreatic Cancer.Ann Epidemiol. 2008 May 24. [Epub ahead of print]PMID: 18504144 Sun exposure has been associated with lower death rates for pancreatic cancer in ecological studies. Skin exposure to solar ultraviolet B radiation induces cutaneous production of precursors to 25-hydroxy (OH) vitamin D (D) and is considered the primary contributor to vitamin D status in most populations. Pancreatic islet and duct cells express 25-(OH) D3-1alpha-hydroxylase that generates the biologically active 1,25-dihydroxy(OH)2 D form. Thus, 25(OH)D concentrations could affect pancreatic function and possibly pancreatic cancer etiology. Serum 25-(OH)D is the major circulating vitamin D metabolite and is considered the best indicator of vitamin D

status as determined by the sun and diet. Although recent prospective epidemiologic studies of higher predicted vitamin D status score and vitamin D intake and pancreatic cancer risk suggest protective associations, a nested case-control study showed a significant 3-fold increased risk for pancreatic cancer with higher vitamin D status. Limitations of these studies include the former do not measure vitamin D status on pancreatic cancer cases and the later was conducted in a male smoker population. More research is needed, particularly examination of pre-diagnostic vitamin D status and risk of pancreatic cancer, prior to conclusions for vitamin D's potential role in the etiology of this highly fatal cancer. Key Words: Vitamin D Intake; 25-Hydroxy-Vitamin D Status; Pancreatic Cancer ... Table 2. ORs and 95% CIs of baseline fasting 25 (OH) vitamin D (D2 and D3) status and

pancreatic cancer risk, among 200 cases and 400 matched control subjects from the ATBC Study^^a,b========================================================= Quintiles fasting vitamin D (D2 and D3), nmol/L^3--- 1, <32 2, >32 and <41.1 3, >41.1 and <51.1 4, >51.1 and <65.5 5, >65.5 p-trend=========================================================Case/controls, n 27/80 34/80 47/80 35/81 57/79Crude OR (95% CI) 1.00 (referent) 1.28 (0.71-2.31) 1.91 (1.06-3.42) 1.34 (0.74-2.41) 2.43 (1.34-4.38) 0.006Multivariable adjusted OR (95% CI)^c 1.00 (referent) 1.30 (0.70-2.40) 2.12 (1.15-3.90) 1.50 (0.81-2.76) 2.92 (1.56-5.48) 0.001Winter season^c,d Case/controls, n 22/59 24/55 24/47 23/44 25/24 Crude OR (95% CI) 1.00 (referent) 1.12 (0.56-2.22) 1.45 (0.71-2.94) 1.41 (0.71-2.81) 2.46 (1.15-5.30) 0.02 Multivariable adjusted OR (95% CI)^c 1.00 (referent) 1.19 (0.59-2.46) 1.95 (0.92-4.14) 1.84

(0.88-3.84) 3.37 (1.47-7.77) 0.003Spring, summer, and fall seasonl^d,e Case/controls, n 5/21 10/25 23/33 12/37 32/55 Crude OR (95% CI) 1.00 (referent) 1.99 (0.59-6.69) 3.30 (1.06-10.27) 1.38 (0.42-4.49) 2.86 (0.98-8.33) 0.15 Multivariable adjusted OR (95% CI)^c 1.00 (referent) 1.47 (0.43-5.78) 2.18 (0.66-7.18) 0.93 (0.27-3.24) 2.13 (0.68-6.60) 0.29========================================================= a From Stolzenberg- et al. (52). b All odds ratios should be considered adjusted for the matching factors age and month of blood draw. c Adjusted for years smoked, number of cigarettes smoked per day, reporting to have quit smoking >3 consecutive visits (>1 year) during the trial (1985-1993), occupational physical activity, education, and serum retinol. d Vitamin D quintiles based on distribution of all controls. e Season, sunny season based on

blood drawn during May, June, August, September, October, and November (n = 118 cases) vs. darker season based on blood drawn during December, January, February, March, and April (n = 82).