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Title: Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study
Authors: Jenab, Mazda
Bueno de Mesquita, H Bas
Ferrari, Prieto
van Duijnhoven, Franzel J B
Norat, Teresa
Pischon, Tobias
Jansen, Eugène H J M
Slimani, Nadia
Byrnes, Graham
Tjønneland, Anne
Olsen, Anja
Overvad, Kim
Boutron-Ruault, Marie Christine
Clavel-Chapelon, Françoise
Morois, Sophie
Kaaks, Rudolf
Linseisen, Jakob
Boeing, Heiner
Bergmann, Manuela M
Trichopoulou, Antonia
Misirli, Gesthimani
Trichopoulou, Antonia
Berrino, Franco
Vineis, Paolo
Panico, Salvatore
Palli, Domenico
Tumino, Rosario
Martine, M Ros
van Gils, Carla H
Peeters, Petra H
Brustad, Magritt
Lund, Eiliv
Tormo, María José
Ardanaz, Eva
Rodríguez, Laudina
Sánchez, María José
Dorronsoro, Miren
González, Carlos A
Hallmans, Göran
Palmqvist, Richard
Roddam, Andrew
Key, Timothy J
Khaw, Kay Tee
Autier, Philippe
Hainaut, Pierre
Riboli, Elio
metadata.dc.contributor.authoraffiliation: [Jenab M, Ferrari P, Slimani N, Byrnes G, Rinaldi S, Autier P, Hainaut P] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Bueno-de-Mesquita HB, van Duijnhoven FJB, Jansen EHJM, Ros MM] National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands. [Ferrari P] Data Collection and Exposure Unit, European Food Safety Authority (EFSA), Parma, Italy. [van Duijnhoven FJB, van Gils CH, Peeters PH] Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands. [Norat T, Vineis P, Riboli E] School of Public Health, Imperial College, London, UK. [Pischon T, Boeing H, Bergmann MM] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Tjonneland A, Olsen A] Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. [Overvad K] Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark. [Boutron-Ruault M-C, Clavel-Chapelon F, Morois S] Inserm (Institut National de la Santé et de la Recherche Médicale) ERI 20, EA. [Kaaks R, Linseisen J] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Trichopoulou A, Misirli G] Department of Hygiene and Epidemiology, University of Athens Medical School, Greece. [Trichopoulou A] Hellenic Health Foundation, Greece. [Trichopoulos D] Department of Epidemiology, Harvard School of Public Health, USA and Bureau of Epidemiologic Research, Academy of Athens, Greece. [Berrino F] Department of Preventive and Predictive Medicine, Etiologic Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (National Cancer Institute), Milan, Italy. [Vineis P] ISI Foundation, Turin, Italy. [Panico S] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Palli D] Molecular and Nutritional Epidemiology Unit, ISPO (Cancer Research and Prevention Institute), Florence, Italy. [Tumino R] Ragusa Cancer Registry and Histopathology Unit, “Civile M.P.Arezzo” Hospital, ASP 7 Ragusa, Italy. [Ros MM] Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. [Brustad M, Lund E] Centre for Sami Health Research, Institute of Community Medicine, University of Tromsø, Tromsø, Norway. [Tormo MJ] Epidemiology Service, Murcia Regional Health Authority, Spain. [Ardanaz E] Public Health Institute of Navarra, Pamplona, Spain. [Ardanaz E, Sánchez MJ] CIBER Epidemiología y Salud Pública (CIBERESP), Spain. [Rodríguez L] Health Information Section, Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain. [Sánchez MJ] Andalusian School of Public Health-Granada (Spain). [Dorronsoro M] Epidemiology Unit, Public Health Division of Guipuzkoa, San Sebastian, Spain. [Gonzalez CA] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Hallmans G] Department of Public Health and Clinical Medicine, Nutritional Research, Umeå, Sweden. [Palmqvist R] Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. [Roddam A, Key TJ] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. [Khaw KT] Clinical Gerontology Unit, University of Cambridge, Cambridge, UK. [Bueno-de-Mesquita HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands. [Linseisen J] Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
Keywords: Neoplasias colorrectales;Vitamina D;Estudios de Casos y Controles;Europa
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Secosteroids::Vitamin D
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies
Medical Subject Headings::Geographicals::Geographic Locations::Europe
Issue Date: 21-Jan-2010
Publisher: BMJ Publishing Group
Citation: Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, Pischon T, et al. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ. 2010 Jan 21; 340:b5500
Abstract: Objective. To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. Design Nested case-control study. Setting. The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. Participants: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls. Main outcome measures. Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders. Results. 25-(OH)D concentration showed a strong inverse linear dose-response association with risk of colorectal cancer (P for trend <0.001). Compared with a pre-defined mid-level concentration of 25-(OH)D (50.0-75.0 nmol/l), lower levels were associated with higher colorectal cancer risk (<25.0 nmol/l: incidence rate ratio 1.32 (95% confidence interval 0.87 to 2.01); 25.0-49.9 nmol/l: 1.28 (1.05 to 1.56), and higher concentrations associated with lower risk (75.0-99.9 nmol/l: 0.88 (0.68 to 1.13); ≥100.0 nmol/l: 0.77 (0.56 to 1.06)). In analyses by quintile of 25-(OH)D concentration, patients in the highest quintile had a 40% lower risk of colorectal cancer than did those in the lowest quintile (P<0.001). Subgroup analyses showed a strong association for colon but not rectal cancer (P for heterogeneity=0.048). Greater dietary intake of calcium was associated with a lower colorectal cancer risk. Dietary vitamin D was not associated with disease risk. Findings did not vary by sex and were not altered by corrections for season or month of blood donation. Conclusions The results of this large observational study indicate a strong inverse association between levels of pre-diagnostic 25-(OH)D concentration and risk of colorectal cancer in western European populations. Further randomised trials are needed to assess whether increases in circulating 25-(OH)D concentration can effectively decrease the risk of colorectal cancer.
metadata.dc.identifier.doi: 10.1136/bmj.b5500
Appears in Collections:01- Artículos - EASP. Escuela Andaluza de Salud Pública

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