Abstract
PurposeVarious studies have examined the association between serum vitamin D levels and different cancers; however, this is the first prospective study of this association with melanoma risk. The aim of this study is to investigate the association between serum vitamin D [25(OH)D] levels and melanoma in a cohort of older, middle-aged Finnish male smokers.MethodsWe conducted a nested case-control study within the Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Study. From the ATBC cohort, 368 subjects were chosen for our study; 92 participants that developed melanoma and 276 matched control subjects. At study baseline, lifestyle questionnaires and blood samples were collected. Serum 25(OH)D was modeled as three sets of categorical variables: clinically-defined categories, season-specific quartiles and season-adjusted residual quartiles. Conditional logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (95% CIs) to estimate the association between circulating vitamin D and melanoma risk.ResultsOverall no association of serum 25(OH)D and melanoma risk was observed. A decreased risk of developing melanoma was observed in the middle categories compared to the lowest category, albeit not significant.ConclusionResults indicate no association between serum 25(OH)D levels and melanoma. Additional studies, including possibly consortium efforts, are needed to investigate the association between serum 25(OH)D levels and risk of melanoma in larger, more diverse study populations.
Highlights
Skin cancer is the most common cancer in the United States, with malignant melanoma being the most lethal and clinically invasive form resulting from transformation of melanocytes in skin [1]
The primary etiologic factor for melanoma is solar ultraviolet (UV) radiation exposure [3,4,5], but interest in the potential role of circulating high vitamin D concentrations has increased owing in part to recently observed associations with reduced melanoma tumor progression and improved survival [6,7,8]
Vitamin D is first metabolized in the liver to 25-hydroxyvitamin D [25(OH)D], and in the kidney and other organs to its active form, 1,25-dihydroxycholecalciferol [1,25(OH)D]. 1,25(OH)D is essential to calcium homeostasis and functions by regulating cell proliferation and differentiation in various organs [11]
Summary
Skin cancer is the most common cancer in the United States, with malignant melanoma being the most lethal and clinically invasive form resulting from transformation of melanocytes in skin (ocular and intestinal primaries occur) [1]. Circulating levels of 25(OH)D serves as a marker of vitamin D status based on its accessibility and precursor function to hormonal form, 1,25(OH)D [12,13]. Some prospective studies suggest that high levels of circulating 25(OH)D may be associated with decreased risk of colorectal cancer, and possibly breast cancer [9], the relation with incident melanoma is unclear. There is a need, to further examine this relation in prospective studies in which serum vitamin D levels were measured prior to disease development. The purpose of this study was to examine the association between prediagnostic serum vitamin D [25(OH)D] and subsequent risk of melanoma in a prospective study of older, middle-aged Finnish men
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