Circulating vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort.
Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747 participants with blood samples between 1992 and 2000. This analysis includes 497 case-control pairs of the head and neck and oesophagus, as well as 443 additional controls. Circulating 25(OH)D3were measured in pre-diagnostic samples and evaluated in relation to HNC and oesophagus cancer risk and post-diagnosis all-cause mortality. After controlling for risk factors, a doubling of 25(OH)D3was associated with 30% lower odds of HNC (OR 0.70, 95% confidence interval [95% CI] 0.56-0.88, Ptrend= 0.001). Subsequent analyses by anatomical sub-site indicated clear inverse associations with risk of larynx and hypopharynx cancer combined (OR 0.55, 95CI% 0.39-0.78) and oral cavity cancer (OR 0.60, 95CI% 0.42-0.87). Low 25(OH)D3concentrations were also associated with higher risk of death from any cause among HNC cases. No clear association was seen with risk or survival for oesophageal cancer. Study participants with elevated circulating concentrations of 25(OH)D3had decreased risk of HNC, as well as improved survival following diagnosis.
International Agency for Research on Cancer, Lyon, France.
Anouar
A
Fanidi
International Agency for Research on Cancer, Lyon, France.
David C
DC
Muller
Bevital AS, Bergen, Norway.
Øivind
Ø
Midttun
Section of Pharmacology, Institute of Medicine, University of Bergen, Bergen, Norway.|Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
Per Magne
PM
Ueland
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.|Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway.
Stein Emil
SE
Vollset
Institute for Ageing and Health, Newcastle University, Newcastle, United Kingdom.
Caroline
C
Relton
School of Public Health, Imperial College London, London, United Kingdom.|HuGeF Foundation, Turin, Italy.
Paolo
P
Vineis
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
Elisabete
E
Weiderpass
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.|The Arctic University of Norway, Tromsø, Norway.
Guri
G
Skeie
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.|The Arctic University of Norway, Tromsø, Norway.
Magritt
M
Brustad
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
Domenico
D
Palli
Cancer Registry and Histopathology Unit, "Civile M.P.Arezzo" Hospital, ASP Ragusa, Italy.
Rosario
R
Tumino
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Sara
S
Grioni
CPO-Piemonte and HuGeF Foundation, Torino Turin, Italy.
Carlotta
C
Sacerdote
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.|Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
H B As
HB
Bueno-de-Mesquita
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.
Petra H
PH
Peeters
Nutrition, Hormones and Women's Health team, Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Villejuif, France.|Université Paris Sud, UMRS 1018, Villejuif, France.|Institut Gustave-Roussy (IGR), Villejuif, France.
Marie-Christine
MC
Boutron-Ruault
Nutrition, Hormones and Women's Health team, Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Villejuif, France.|Université Paris Sud, UMRS 1018, Villejuif, France.|Institut Gustave-Roussy (IGR), Villejuif, France.
Marina
M
Kvaskoff
Nutrition, Hormones and Women's Health team, Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Villejuif, France.|Université Paris Sud, UMRS 1018, Villejuif, France.|Institut Gustave-Roussy (IGR), Villejuif, France.
Claire
C
Cadeau
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.|Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
José María
JM
Huerta
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.|Andalusian School of Public Health, Granada, Spain.
Maria-José
MJ
Sánchez
Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
Antonio
A
Agudo
Oviedo University, Oviedo, Spain.
Cristina
C
Lasheras
Public Health Directorate Asturias, Oviedo, Spain.
J Ramón
JR
Quirós
Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastian, Spain.
Saioa
S
Chamosa
School of Public Health, Imperial College London, London, United Kingdom.
Elio
E
Riboli
Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
Ruth C
RC
Travis
School of Public Health, Imperial College London, London, United Kingdom.
Heather
H
Ward
School of Public Health, Imperial College London, London, United Kingdom.
Neil
N
Murphy
School of Clinical Medicine, University of Cambridge, United Kingdom.
Kay-Tee
KT
Khaw
Hellenic Health Foundation, Athens, Greece.|WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
Antonia
A
Trichopoulou
WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.|Department of Epidemiology, Harvard School of Public Health, Boston, USA.|Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
Pagona
P
Lagiou
Hellenic Health Foundation, Athens, Greece.
Eleni-Maria
EM
Papatesta
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Heiner
H
Boeing
German Cancer Research Center DKFZ, Heidelberg, Germany.
Tilman
T
Kuehn
German Cancer Research Center DKFZ, Heidelberg, Germany.
Verena
V
Katzke
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Annika
A
Steffen
Nutritrional Research/Molecular Periodontology Umeå University, Umeå, Sweden.
Anders
A
Johansson
International Agency for Research on Cancer, Lyon, France.
Paul
P
Brennan
International Agency for Research on Cancer, Lyon, France.
Mattias
M
Johansson
D000328:Adult; D000368:Aged; D002112:Calcifediol / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D005060:Europe / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D002112:Calcifediol