Abstract
BackgroundAfrican Americans have disproportionately higher burden of prostate cancer compared to European Americans. However, the cause of prostate cancer disparities is still unclear. Several roles have been proposed for calcium and vitamin D in prostate cancer pathogenesis and progression, but epidemiologic studies have been conducted mainly in European descent populations. Here we investigated the association of calcium and vitamin D intake with prostate cancer in multiethnic samples.MethodsA total of 1,657 prostate cancer patients who underwent screening and healthy controls (888 African Americans, 620 European Americans, 111 Hispanic Americans, and 38 others) from Chicago, IL and Washington, D.C. were included in this study. Calcium and vitamin D intake were evaluated using food frequency questionnaire. We performed unconditional logistic regression analyses adjusting for relevant variables.ResultsIn the pooled data set, high calcium intake was significantly associated with higher odds for aggressive prostate cancer (ORQuartile 1 vs. Quartile 4 = 1.98, 95% C.I.: 1.01–3.91), while high vitamin D intake was associated with lower odds of aggressive prostate cancer (ORQuartile 1 vs. Quartile 4 = 0.38, 95% C.I.: 0.18–0.79). In African Americans, the association between high calcium intake and aggressive prostate cancer was statistically significant (ORQuartile 1 vs. Quartile 4 = 4.28, 95% C.I.: 1.70–10.80). We also observed a strong inverse association between total vitamin D intake and prostate cancer in African Americans (ORQuartile 1 vs. Quartile 4 = 0.06, 95% C.I.: 0.02–0.54). In European Americas, we did not observe any significant associations between either calcium or vitamin D intake and prostate cancer. In analyses stratifying participants based on Body Mass Index (BMI), we observed a strong positive association between calcium and aggressive prostate cancer and a strong inverse association between vitamin D intake and aggressive prostate cancer among men with low BMI (<27.8 kg/m2), but not among men with high BMI (≥27.8 kg/m2). Interactions of race and BMI with vitamin D intake were significant (PInteraction < 0.05).ConclusionCalcium intake was positively associated with aggressive prostate cancer, while vitamin D intake exhibited an inverse relationship. However, these associations varied by race/ethnicity and BMI. The findings from this study may help develop better prostate cancer prevention and management strategies.
Highlights
African Americans have disproportionately higher burden of prostate cancer compared to European Americans
We investigated whether calcium and vitamin D intake were associated with Prostate cancer (PCa) diagnosis and aggressiveness in men from a multiethnic population from Chicago, IL and Washington, D.C., and if associations of calcium and vitamin D intake differed based on race/ethnicity and body mass index (BMI)
We evaluated whether the Institute of Medicine (IOM)-recommended dosage amount, Recommended Dietary Allowance (RDA), for calcium and vitamin D intake, were beneficial for PCa prevention
Summary
African Americans have disproportionately higher burden of prostate cancer compared to European Americans. Several roles have been proposed for calcium and vitamin D in prostate cancer pathogenesis and progression, but epidemiologic studies have been conducted mainly in European descent populations. Most epidemiologic studies have been conducted mainly in European descent populations, and only a few have explored the association of calcium and vitamin D intake with PCa in AAs [7, 13]. In one of these studies, Rowland et al [13] found that high calcium intake in AA men increases PCa risk. It is necessary to further explore this relationship in this high risk population
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