Table 2:
Association between prospectively-measured, circulating 25(OH)D and overall and site-specific cancer mortality
| Season-Specific Quintile of Serum 25(OH)Da | ||||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | p-trend | |
| All Cases (n=4,616) | ||||||
| Number of deaths/survivors | 618/309 | 579/346 | 579/344 | 569/353 | 539/380 | |
| Survival time (years, median) | 1.68 | 2.27 | 2.29 | 2.68 | 3.22 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.84 (0.75–0.94) | 0.83 (0.74–0.93) | 0.79 (0.70–0.89) | 0.71 (0.63–0.80) | <0.0001 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.84 (0.75–0.94) | 0.88 (0.78–0.99) | 0.82 (0.73–0.92) | 0.76 (0.67–0.85) | <0.0001 |
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.88 (0.78–0.98) | 0.89 (0.80–1.00) | 0.87 (0.77–0.97) | 0.76 (0.68–0.86) | <0.0001 |
| Prostate (n=1,294) | ||||||
| Number of deaths/survivors | 83/146 | 83/170 | 82/158 | 67/209 | 91/205 | |
| Survival time (years, median) | 3.99 | 5.02 | 6.08 | 6.12 | 5.90 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.76 (0.56–1.04) | 0.75 (0.55–1.02) | 0.51 (0.37–0.71) | 0.71 (0.52–0.95) | 0.003 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.83 (0.61–1.13) | 0.86 (0.63–1.18) | 0.53 (0.38–0.74) | 0.74 (0.55–1.01) | 0.005 |
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.88 (0.65–1.21) | 0.87 (0.64–1.19) | 0.59 (0.43–0.82) | 0.77 (0.56–1.05) | 0.02 |
| Lung (n=989) | ||||||
| Number of deaths/survivors | 163/46 | 171/25 | 153/44 | 165/40 | 149/33 | |
| Survival time (years, median) | 0.57 | 0.61 | 0.55 | 0.59 | 0.48 | |
| Age-adjusted HR (95% CI)b | 1.00 | 1.20 (0.96–1.48) | 1.06 (0.85–1.32) | 1.05 (0.84–1.30) | 1.21 (0.97–1.51) | 0.35 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 1.22 (0.98–1.53) | 1.10 (0.88–1.38) | 1.08 (0.87–1.34) | 1.28 (1.02–1.61) | 0.19 |
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 1.26 (1.01–1.58) | 1.11 (0.88–1.39) | 1.14 (0.91–1.42) | 1.34 (1.06–1.69) | 0.08 |
| Bladder (n=833) | ||||||
| Number of deaths/survivors | 18/57 | 15/67 | 11/67 | 21/59 | 16/52 | |
| Survival time (years, median) | 6.09 | 5.93 | 7.33 | 5.33 | 3.83 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.87 (0.44–1.73) | 0.64 (0.30–1.35) | 1.15 (0.61–2.16) | 1.08 (0.55–2.11) | 0.59 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.81 (0.40–1.63) | 0.64 (0.30–1.38) | 1.09 (0.57–2.09) | 0.98 (0.49–1.97) | 0.73 |
| Colorectal (n=497) | ||||||
| Number of deaths/survivors | 40/60 | 35/57 | 38/51 | 40/64 | 49/63 | |
| Survival time (years, median) | 2.14 | 4.40 | 2.35 | 2.88 | 3.60 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.80 (0.51–1.26) | 1.02 (0.66–1.59) | 0.86 (0.56–1.33) | 0.92 (0.61–1.40) | 0.86 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.79 (0.50–1.24) | 1.08 (0.68–1.70) | 0.87 (0.56–1.37) | 0.97 (0.63–1.50) | 0.95 |
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.89 (0.56–1.42) | 0.86 (0.54–1.37) | 0.81 (0.52–1.28) | 0.96 (0.61–1.49) | 0.77 |
| Head & Neck (n=398) | ||||||
| Number of deaths/survivors | 35/47 | 31/65 | 21/62 | 17/45 | 22/53 | |
| Survival time (years, median) | 3.12 | 2.48 | 3.81 | 4.40 | 4.48 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.74 (0.45–1.20) | 0.52 (0.30–0.90) | 0.61 (0.34–1.08) | 0.56 (0.33–0.95) | 0.02 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.87 (0.53–1.45) | 0.59 (0.33–1.05) | 0.76 (0.41–1.39) | 0.74 (0.42–1.30) | 0.21 |
| Kidney (n=378) | ||||||
| Number of deaths/survivors | 36/34 | 29/41 | 44/40 | 38/34 | 30/52 | |
| Survival time (years, median) | 1.43 | 3.11 | 2.25 | 2.97 | 2.35 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.64 (0.39–1.05) | 0.86 (0.56–1.34) | 0.84 (0.53–1.33) | 0.64 (0.39–1.04) | 0.27 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.62 (0.37–1.05) | 0.89 (0.57–1.41) | 0.94 (0.58–1.52) | 0.59 (0.35–0.98) | 0.28 |
| Hematological (n=349) | ||||||
| Number of deaths/survivors | 28/30 | 40/32 | 48/26 | 40/27 | 45/33 | |
| Survival time (years, median) | 2.26 | 2.19 | 1.62 | 2.87 | 3.85 | |
| Age-adjusted HR (95% CI)b | 1.00 | 1.12 (0.69–1.81) | 1.46 (0.91–2.33) | 1.04 (0.64–1.69) | 0.95 (0.59–1.53) | 0.58 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 1.08 (0.66–1.76) | 1.48 (0.92–2.39) | 1.10 (0.66–1.81) | 0.97 (0.60–1.58) | 0.77 |
| Gastric (n=339) | ||||||
| Number of deaths/survivors | 50/28 | 45/20 | 38/37 | 43/29 | 30/19 | |
| Survival time (years, median) | 0.80 | 0.94 | 1.15 | 0.79 | 1.74 | |
| Age-adjusted HR (95% CI)b | 1.00 | 0.95 (0.63–1.42) | 0.65 (0.43–1.00) | 0.81 (0.54–1.22) | 0.77 (0.49–1.21) | 0.14 |
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.95 (0.62–1.46) | 0.65 (0.42–1.01) | 0.80 (0.52–1.22) | 0.76 (0.47–1.23) | 0.14 |
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.72 (0.46–1.12) | 0.53 (0.34–0.83) | 0.73 (0.48–1.12) | 0.66 (0.41–1.07) | 0.11 |
| Liver (n=206) | ||||||
| Number of deaths/survivors | 59/20 | 60/15 | 42/10 | |||
| Survival time (years, median) | 0.14 | 0.19 | 0.29 | |||
| Age-adjusted HR (95% CI)b | 1.00 | 0.91 (0.63–1.32) | 0.75 (0.50–1.13) | 0.18 | ||
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.91 (0.62–1.33) | 0.75 (0.49–1.17) | 0.21 | ||
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.94 (0.64–1.38) | 0.70 (0.45–1.09) | 0.13 | ||
| Pancreas (n=143) | ||||||
| Number of deaths/survivors | 45/3 | 45/6 | 40/4 | |||
| Survival time (years, median) | 0.24 | 0.26 | 0.21 | |||
| Age-adjusted HR (95% CI)b | 1.00 | 0.91 (0.60–1.37) | 0.81 (0.52–1.25) | 0.34 | ||
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.91 (0.57–1.46) | 0.79 (0.48–1.30) | 0.36 | ||
| Multivariate and stage-adjusted HR (95% CI) d |
1.00 | 0.72 (0.44–1.16) | 0.66 (0.40–1.10) | 0.12 | ||
| Esophagogastric iunctional (n=136) | ||||||
| Number of deaths/survivors | 31/11 | 38/8 | 32/16 | |||
| Survival time (years, median) | 0.68 | 0.60 | 1.03 | |||
| Age-adjusted HR (95% CI)b | 1.00 | 1.05 (0.65–1.71) | 0.74 (0.45–1.22) | 0.21 | ||
| Multivariate-adjusted HR (95% CI)c | 1.00 | 1.09 (0.41–1.21) | 0.70 (0.41–1.21) | 0.18 | ||
| Melanoma (n=135) | ||||||
| Number of deaths/survivors | 19/16 | 13/32 | 17/38 | |||
| Survival time (years, median) | 2.63 | 3.71 | 4.54 | |||
| Age-adjusted HR (95% CI)b | 1.00 | 0.44 (0.22–0.90) | 0.45 (0.23–0.86) | 0.02 | ||
| Multivariate-adjusted HR (95% CI)c | 1.00 | 0.47 (0.22–0.78) | 0.39 (0.20–0.78) | 0.01 | ||
| Esophageal (n=97) | ||||||
| Number of deaths/survivors | 40/4 | 29/2 | 19/3 | |||
| Survival time (years, median) | 0.66 | 0.65 | 0.37 | |||
| Age-adjusted HR (95% CI)b | 1.00 | 1.08 (0.67–1.75) | 1.63 (0.91–2.93) | 0.14 | ||
| Multivariate-adjusted HR (95% CI)c | 1.00 | 1.15 (0.65–2.05) | 1.94 (0.91–4.11) | 0.11 | ||
25(OH)D, 25-hydroxyvitamin D; CI, confidence intervals; HR, hazard ratio
Cutpoints for the 25(OH)D concentrations (nmol/L) were based on the distribution in each analysis set and season as follows:
Multi-site darker season (November-April): Q1: < 17.0; Q2 >17.0- < 24.2; Q3; >24.2 - < 33.1; Q4 >33.1 - < 45.4; Q5 >45.4.
Multi-site sunnier season (May-October): Q1: < 25.8; Q2 > 25.8- < 36.5; Q3; >36.5 - < 47.1; >Q4 47.1 - < 61.8; Q5 >61.8.
Liver set darker season: Q1: < 21.9; Q2 >21.9- < 29.8; Q3; >29.8 - < 36.7; Q4 >36.7 - < 46.9; Q5 >46.9.
Liver set sunnier season: Q1: < 26.9; Q2 >26.9- < 46.3; Q3; >46.3 - < 56.7; Q4 >56.7 - < 71.0; Q5 >71.0.
Lymphoma set darker season: Q1: < 31.6; Q2 > 31.6- < 39.5; Q3; />39.5 - < 50.6; >Q4 50.6 - < 65.8; Q5 > 65.8.
Lymphoma set sunnier season: Q1: < 40.0; Q2 >40.0- < 51.8; Q3; >51.8 - < 62.8; Q4 >62.8 - < 77.3; Q5 >77.3.
Addendum set darker season: Q1: < 25.1; Q2 >25.1- < 33.5; Q3; >33.5 - < 45.1; Q4 >45.1 - < 55.9; Q5 >55.9.
Addendum set sunnier season: Q1: < 37.2; Q2 >37.2- < 44.3; Q3; >44.3 - < 55.2; Q4 >55.2 - < 67.8; Q5 >67.8.
Adjusted for age at diagnosis.
Additionally adjusted for body mass index, number of cigarettes smoked per day, years of smoking, physical activity, serum cholesterol, history of diabetes, family history of cancer, systolic blood pressure, trial intervention group, and calendar year of diagnosis. Site-specific models are also adjusted for prior (yes/no) cancer diagnoses
Stage data available for 49% of overall cases, primarily for prostate (84% of prostate cases), lung (56% of lung cases), colorectal (42% of colorectal cases), gastric (51% of gastric cases), liver (47% of liver cases), and pancreatic cancer (76% of pancreatic cases). Stage-adjusted models are shown only for overall and these six cancer sites