Prediagnostic serum calcium concentrations and risk of colorectal cancer development in 2 large European prospective cohorts
Year: 2022
Type: article
Abstract: Background Higher dietary calcium consumption is associated with lower colorectal cancer (CRC) risk. However, little data are available on the association between circulating calcium concentrations and CRC risk. Objectives To explore the association between circulating calcium concentrations and CRC risk using data from 2 large European prospective cohort studies. Methods Conditional logistic regression models were used to calculate multivariable-adjusted ORs and 95% CIs in case-control studies nested within the European Prospective Investigation into Cancer and Nutrition (EPIC; n -cases = 947, n -controls = 947) and the UK Biobank (UK-BB; n -cases = 2759, n -controls = 12,021) cohorts. Results In EPIC, nonalbumin-adjusted total serum calcium (a proxy of free calcium) was not associated with CRC (OR: 0.94; 95% CI: 0.85, 1.03; modeled as continuous variable, per 1 mg/dL increase), colon cancer (OR: 0.93; 95% CI: 0.82, 1.05) or rectal cancer (OR: 1.01; 95% CI: 0.84, 1.20) risk in the multivariable adjusted model. In the UK-BB, serum ionized calcium (free calcium, most active form) was inversely associated with the risk of CRC (OR: 0.85; 95% CI: 0.76, 0.95; per 1 mg/dL) and colon cancer (OR: 0.78; 95% CI: 0.68, 0.90), but not rectal cancer (OR: 1.02; 95% CI: 0.83, 1.24) in multivariable adjusted models. Meta-analysis of EPIC and UK-BB CRC risk estimates showed an inverse risk association for CRC in the multivariable adjusted model (OR: 0.90; 95%CI: 0.84, 0.97). In analyses by quintiles, in both cohorts, higher levels of serum calcium were associated with reduced CRC risk (EPIC: OR Q5vs.Q1 : 0.69; 95% CI: 0.47, 1.00; P- trend = 0.03; UK-BB: OR Q5vs.Q1 : 0.82; 95% CI: 0.72, 0.94; P- trend < 0.01). Analyses by anatomical subsite showed an inverse cancer risk association in the colon (EPIC: OR Q5vs.Q1 : 0.63, 95% CI: 0.39, 1.02; P- trend = 0.05; UK-BB: OR Q5vs.Q1 : 0.75; 95% CI: 0.64, 0.88; P- trend < 0.01) but not the rectum. Conclusions In UK-BB, higher serum ionized calcium levels were inversely associated with CRC, but the risk was restricted to the colon. Total serum calcium showed a null association in EPIC. Additional prospective studies in other populations are needed to better investigate these associations.
Authors: Nena Karavasiloglou, David J. Hughes, Neil Murphy, Lutz Schomburg, Qian Sun, Vartiter Seher, Sabine Rohrmann, Elisabete Weiderpass, Anne Tjønneland, Anja Olsen, Kim Overvad, Marie-Christine Boutron-Ruault, Francesca Romana Mancini, Yahya Mahamat-Saleh, Rudolf Kaaks, Tilman Kuhn, Matthias B. Schulze, Rosario Tumino, Salvatore Panico, Giovanna Masala, Valeria Pala, Carlotta Sacerdote, Jeroen W.G. Derksen, Guri Skeie, Anette Hjartåker, Cristina Lasheras, Antonio Agudo, Maria-José Sánchez, Maria-Dolores Chirlaque, Eva Ardanaz, Pilar Amiano, Bethany Van Guelpen, Björn Gylling, Kathryn E. Bradbury, Keren Papier, Heinz Freisling, Elom K. Aglago, Amanda J. Cross, Elio Riboli, Dagfinn Aune, Marc J. Gunter, Mazda Jenab
Institutions: University of Zurich, Centre international de recherche sur le cancer, University College Dublin, Charité – Universitätsmedizin Berlin, University of Copenhagen, Danish Cancer Society, Aarhus University, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Institut Gustave Roussy, Centre de recherche en Epidémiologie et Santé des Populations, German Cancer Research Center, Queen's University Belfast, University of Potsdam, German Institute of Human Nutrition, Associazione Iblea per la Ricerca Epidemiologica E.T.S., Federico II University Hospital, University of Naples Federico II, Fondazione IRCCS Istituto Nazionale dei Tumori, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Utrecht University, University Medical Center Utrecht, UiT The Arctic University of Norway, University of Oslo, Universidad de Oviedo, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Universidad de Granada, Instituto de Investigación Biosanitaria de Granada, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Andalusian School of Public Health, Instituto Murciano de Investigación Biosanitaria, Universidad de Murcia, Instituto de Salud Pública de Navarra, Navarre Institute of Health Research, Basque Government, Ministry of Health, Biogipuzkoa Health Research Institute, University of Auckland, University of Oxford, Imperial College London, Umeå University
Language: English
Topic: Nutritional Studies and Diet
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,815
Funders: World Health Organization, Deutsches Krebsforschungszentrum, Wellcome Trust, Cancer Research UK, National Institute for Health and Care Research, Imperial College London, Deutsche Forschungsgemeinschaft, Institut National de la Santé et de la Recherche Médicale, Bundesministerium für Bildung und Forschung, Cancerfonden, Ligue Contre le Cancer, Vetenskapsrådet, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Institut Gustave-Roussy, Region Skåne, Swiss Cancer Research Foundation, Medical Research Council, World Cancer Research Fund, Health Research Council of New Zealand, Instituto de Salud Carlos III, Rijksinstituut voor Volksgezondheid en Milieu, NIHR Imperial Biomedical Research Centre, School of Public Health, Imperial College London
Awards: G1055973116, Aetiology of type 2 diabetes and related metabolic disorders, G1192877484, G1437520050, G1767199718, G1993546569, G2131326840, G219746026, G2235605558, G2314068187, G2409987178, G2539064604, G2572521044, G2714613917, G2742323354, G29072894, G2933204024, G3077395769, G3090701621, G3189789075, G3216658785, G3328679326, G3523705848, G3544161537, G3747421453, G375319704, G382879149, G4089957676, G4187108342, G4213141252, G423933611, G4289084031, G4303038735, G4409035895, G4495613716, Health of vegetarians, G4573424940, G459595259, G476366190, G4767603723, G4844208673, G4875452947, G4879533352, The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population, G5004963360, G5078184151, G5116888081, G5271742736, G5315906942, G558017500, G5763196120, G5783272435, G5897142711, G5990830295, G6022976577, G6085534252, G6089501056, G6324679927, G6376359690, G6442500046, G6594529311, G6766485657, G6883270616, G6957823285, G7334201930, G7426181285, G7447125227, G7597388277, G7646326732, G8020903098, G8050896463, G8139206928, G8164184896, G8279237360, G8375904625, G8544555571, G8637022941, G8846336397, G8900174105, G8914830642, G8959392569, G896962615, G8978728421, G899966268, G9000040826
OpenAlex ID: W4311512500