Vitamin D3 supplementation, low-risk prostate cancer, and health disparities

Hollis, Bruce W.; Marshall, David T.; Savage, Stephen J.; Garrett‐Mayer, Elizabeth; Kindy, Mark S.; Gattoni‐Celli, Sebastiano

doi:10.1016/j.jsbmb.2012.11.012

Cited by 27 publications

(27 citation statements)

References 41 publications

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“…More than half of the study subjects remained stable or improved with supplementation, compared to a fifth of the control group who did not receive supplementation (p = 0.025). Conversely, vitamin D3 supplementation did not benefit 40% of the subjects in this open-label clinical trial [28]. Another study involves the randomization of 37 patients with histologically proven adenocarcinoma of the prostate who had selected prostatectomy as primary therapy.…”

Section: Discussionmentioning

confidence: 95%

“…Therefore, the effect of local synthesis of 1,25(OH)D3 in the prostate might not be captured in epidemiological studies based on circulating levels of vitamin D. This phenomenon might help to explain the heterogeneous conclusions in other studies exploring the relationship between vitamin D with prostate cancer [23]–[27]. Whilst there is lack of conclusive evidence on the benefit of vitamin D supplementation in the development of prostate cancer, previous studies on the effect of pre-existing prostate cancer have so far produced ambiguous results [28], [29]. A research team in the United States explored the influence of vitamin D3 supplementation at 4000 IU daily for one year on the outcome of early stage, low-risk prostate cancer (Gleason score ≤6, prostate-specific antigen [PSA] ≤10, clinical stage T1c or T2a).…”

Section: Discussionmentioning

confidence: 99%

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In Older Men, Lower Plasma 25-Hydroxyvitamin D Is Associated with Reduced Incidence of Prostate, but Not Colorectal or Lung Cancer

et al. 2014

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Context and objectiveProstate, colorectal and lung cancers are common in men. In this study, we aimed to determine whether vitamin D status is associated with the incidence of these cancers in older men.DesignProspective cohort study.Setting and participants4208 older men aged 70–88 years in Perth, Western AustraliaMain outcome measuresPlasma 25-hydroxyvitamin D [25(OH)D] concentration was measured by immunoassay. New diagnoses of prostate, colorectal and lung cancers were determined via electronic record linkage.ResultsDuring a mean follow-up of 6.7±1.8 years, there were 315, 117 and 101 new diagnoses of prostate, colorectal and lung cancer. In multivariate competing risks proportional hazards models, every 10 nmol/l decrease in 25(OH)D concentration was associated with a 4% reduction in prostate cancer incidence (sub-hazard ratio [SHR] 0.96, 95% confidence interval [CI] 0.92–1.00). Every halving of 25(OH)D concentration was associated with a 21% reduction in incident prostate cancer in multivariate analysis (SHR 0.79, 95% CI 0.63–0.99). Following exclusion of prostate cancer cases diagnosed within 3 years of blood sampling, low 25(OH)D <50 nmol/l was associated with lower incident prostate cancer, and higher 25(OH)D >75 nmol/l was associated with higher incidence, when compared to the reference range 50–75 nmol/l, respectively (p = 0.027). Significant associations were also observed when 25(OH)D was modeled as a quantitative variable. No associations were observed between plasma 25(OH)D concentration with incidence of colorectal or lung cancer.ConclusionLower levels of vitamin D may reduce prostate cancer risk in older men. By contrast, levels of vitamin D did not predict incidence of colorectal or lung cancers. Further studies are needed to determine whether a causal relationship exists between vitamin D and prostate cancer in ageing men.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

In Older Men, Lower Plasma 25-Hydroxyvitamin D Is Associated with Reduced Incidence of Prostate, but Not Colorectal or Lung Cancer

et al. 2014

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“…[12] In a study of early stage low risk prostate cancer patients given vitamin D3 4000 IU/d for one year, a decrease in the number of positive cores at repeat biopsy was observed in more than half of the participants without a change in PSA. [15]…”

Section: Discussionmentioning

confidence: 99%

Null Association between Vitamin D and PSA Levels among Black Men in a Vitamin D Supplementation Trial

Chandler

Giovannucci

Scott

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Black men exhibit a high prevalence of vitamin D deficiency as well as higher incidence of prostate cancer and higher mortality rates from prostate cancer than Whites. There are few data about the effect of vitamin D3 (cholecalciferol) supplementation on prostate specific antigen (PSA) in healthy Black men. Methods During 3 winters from 2007–2010, 105 Black men (median age, 48.9 years) of Boston, MA were randomized into a 4-arm, double-blind trial for 3 months of placebo, 1000, 2000, or 4000 IU of vitamin D3. At baseline and 3 months, free and total PSA were measured. Results With vitamin D supplementation, no significant differences in free and total PSA were observed; free PSA: −0.0004 ng/mL (p=0.94) and total PSA: −0.004 ng/mL (p=0.92) for each additional 1000 IU/d of vitamin D3. Conclusion Within an unselected population of healthy Black men without a cancer diagnosis, we found no effect of vitamin D supplementation on free or total PSA. Impact These findings support prior findings of no change in PSA with vitamin D supplementation and emphasize the need for new methods to assess the influence of vitamin D supplementation on prostate cancer prevention.

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“…All-cause mortality rates for men with prostate cancer are 25% to 40% lower for those with low compared with those with high serum 25(OH)D levels, whereas prostate cancer-specific mortality rates are about 10% to 20% higher for AA men than white American men (WA) after consideration of socioeconomic status, stage at diagnosis, and treatment (7). In addition, a vitamin D 3 supplementation study of patients on active surveillance with early-stage, low-risk prostate cancer found that among men given 4,000 IU/d of vitamin D 3 , half had fewer positive cores at repeat biopsy 1 year after enrollment in the study (8). The authors suggest that such vitamin D 3 supplementation could reduce prostate cancer-related health disparities in AA men.…”

Section: William B Grantmentioning

confidence: 99%

Vitamin D Status: Ready for Guiding Prostate Cancer Diagnosis and Treatment?

Grant

2014

Clinical Cancer Research

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Vitamin D deficiency is associated with increased risk of prostate cancer for those with elevated prostatespecific antigen (PSA) level or abnormal digital rectal examination. Vitamin D deficiency is also associated with aggressive prostate cancer. Vitamin D level could be added as an additional factor to consider before ordering a biopsy. Clin Cancer Res; 20(9); 2241-3. Ó2014 AACR. This study offers further evidence that vitamin D deficiency is a risk factor for aggressive prostate cancer. Gilbert and colleagues associated low 25(OH)D levels with a 2-fold increased risk of advanced versus localized prostate cancer or high-grade versus low-grade prostate cancer (2). As with most observational studies (2), this study also found no correlation of serum 25(OH)D level with overall prostate cancer risk. In this issue ofThese findings have important benefits in helping men decide what to do after learning they have an elevated PSA level or an abnormal digital rectal examination. The authors note, "Most men who are diagnosed with localized prostate cancer attempt curative therapy with surgery or radiation, although observation may be appropriate for men with lowrisk cancers or limited life expectancy" (3). Biopsies are associated with inconveniences as well as risk factors such as bloodstream infections (4).For nonaggressive prostate cancer, watchful waiting or active surveillance is often a better option than invasive treatment, which can affect sexual function, urinary function, and fertility, and can slightly increase risk of colorectal cancer (5). The UK National Institute for Health and Care Excellence recently issued new guidelines for active surveillance, which involve a 5-year program of PSA testing followed by MRI if the PSA changes irregularly during this time (5). A recent study evaluated tools being developed and used to select and monitor patients on active surveillance for low-risk prostate cancer (6): MRI, serum markers, urinary markers, histopathology markers, and germline genetic markers. All have pros and cons, and no indications of long-term outcomes are yet apparent. Serum 25(OH)D levels seem to be another tool for this purpose.These tools offer further evidence that vitamin D deficiency helps explain the black-white prostate cancer disparities. All-cause mortality rates for men with prostate cancer are 25% to 40% lower for those with low compared with those with high serum 25(OH)D levels, whereas prostate cancer-specific mortality rates are about 10% to 20% higher for AA men than white American men (WA) after consideration of socioeconomic status, stage at diagnosis, and treatment (7). In addition, a vitamin D 3 supplementation study of patients on active surveillance with early-stage, low-risk prostate cancer found that among men given 4,000 IU/d of vitamin D 3 , half had fewer positive cores at repeat biopsy 1 year after enrollment in the study (8). The authors suggest that such vitamin D 3 supplementation could reduce prostate cancer-related health disparities in AA men. However, based on evidenc...

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Vitamin D3 supplementation, low-risk prostate cancer, and health disparities

Cited by 27 publications

References 41 publications

In Older Men, Lower Plasma 25-Hydroxyvitamin D Is Associated with Reduced Incidence of Prostate, but Not Colorectal or Lung Cancer

In Older Men, Lower Plasma 25-Hydroxyvitamin D Is Associated with Reduced Incidence of Prostate, but Not Colorectal or Lung Cancer

Null Association between Vitamin D and PSA Levels among Black Men in a Vitamin D Supplementation Trial

Vitamin D Status: Ready for Guiding Prostate Cancer Diagnosis and Treatment?

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