title: Low plasma 25-hydroxyvitamin D and risk of tobacco-related cancer.
abstract: BACKGROUND
  Tobacco smoke chemicals may influence vitamin D metabolism and function, and conversely vitamin D may modify the carcinogenicity of tobacco smoke chemicals. We tested the hypothesis that lower plasma 25-hydroxyvitamin D [25(OH)D] is associated with a higher risk of tobacco-related cancer in the general population.
  
  
  METHODS
  A prospective population-based cohort of 9791 individuals from the Copenhagen City Heart Study who were free of cancer at baseline was followed from 1981-1983 until December 2008 with 100% complete follow-up.
  
  
  RESULTS
  During up to 28 years of follow-up, 1081 participants developed a tobacco-related cancer and 1506 developed other cancers. Decreasing 25(OH)D concentrations, subdivided by clinical categories or by seasonally adjusted percentile categories, were associated with increasing cumulative incidence of tobacco-related cancer (log-rank trend P = 2 × 10(-6) and P = 5 × 10(-9)). Multivariable adjusted hazard ratios of tobacco-related cancer were 1.75 (95% CI, 1.33-2.30) for 25(OH)D <5 vs ≥20 ng/mL, and 2.07 (1.63-2.62) for ≤5th vs >66th percentile. Also, multivariable adjusted hazard ratios for a 50% reduction in 25(OH)D were 1.20 (1.13-1.28) for any tobacco-related cancer, 1.19 (95% CI, 1.09-1.31) for lung cancer, 1.44 (1.19-1.73) for head and neck cancer, 1.28 (1.06-1.54) for bladder cancer, 1.34 (1.04-1.73) for kidney cancer, and 0.95 (0.89-1.01) for other cancers.
  
  
  CONCLUSIONS
  Lower plasma 25(OH)D was associated with higher risk of tobacco-related cancers, but not with risk of other cancers.
authors.affiliation: The Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark.
authors.forename: Shoaib
authors.initials: S
authors.lastname: Afzal
authors.forename: Stig E
authors.initials: SE
authors.lastname: Bojesen
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
mesh_terms: D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012907:Smoking / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D