Clinical Chemistry March 2013
Shoaib Afzal 1, Stig E. Bojesen 1,2,3 and Børge G. Nordestgaard 1,2,3,*
1 The Department of Clinical Biochemistry, Herlev Hospital,
2 The Copenhagen City Heart study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark;
3 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
↵*Address correspondence to this author at: Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark. Fax +45-38683311; e-mail Boerge.Nordestgaard at regionh.dk.
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.
Received for publication January 7, 2013. Accepted for publication January 9, 2013.
© 2013 The American Association for Clinical Chemistry
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