Risk of prostate cancer in a randomized clinical trial of calcium supplementation

被引:79
作者
Baron, JA
Beach, M
Wallace, K
Grau, MV
Sandler, RS
Mandel, JS
Heber, D
Greenberg, ER
机构
[1] Dartmouth Coll Sch Med, Evergreen Ctr, Dept Community & Family Med, Epidemiol & Biostat Sect, Lebanon, NH 03766 USA
[2] Dartmouth Coll Sch Med, Dept Med, Lebanon, NH 03766 USA
[3] Dartmouth Coll Sch Med, Dept Anesthesia, Lebanon, NH 03766 USA
[4] Dartmouth Coll Sch Med, Norris Cotton Canc Ctr, Lebanon, NH 03766 USA
[5] Univ N Carolina, Dept Med, Chapel Hill, NC USA
[6] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA
[7] Univ Calif Los Angeles, Med Ctr, Ctr Human Nutr, Los Angeles, CA 90024 USA
关键词
D O I
10.1158/1055-9965.EPI-04-0319
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: In some studies, high calcium intake has been associated with an increased risk of prostate cancer, but no randomized studies have investigated this issue. Methods: We randomly assigned 672 men to receive either 3 g of calcium carbonate (1,200 mg of calcium), or placebo, daily for 4 years in a colorectal adenoma chemoprevention trial. Participants were followed for up to 12 years and asked periodically to report new cancer diagnoses. Subject reports were verified by medical record review. Serum samples, collected at randomization and after 4 years, were analyzed for 1,25-(OH)(2) vitamin D, 25-(OH) vitamin D, and prostate-specific antigen (PSA). We used life table and Cox proportional hazard models to compute rate ratios for prostate cancer incidence and generalized linear models to assess the relative risk of increases in PSA levels. Results: After a mean follow-up of 10.3 years, there were 33 prostate cancer cases in the calcium-treated group and 37 in the placebo-treated group [unadjusted rate ratio, 0.83; 95%. confidence interval (95% CI), 0.52-1.32]. Most cases were not advanced; the mean Gleason's score was 6.2. During the first 6 years (until 2 years post-treatment), there were significantly fewer cases in the calcium group (unadjusted rate ratio, 0.52; 95% Cl, 0.28-0.98). The calcium risk ratio for conversion to PSA >4.0 ng/mL was 0.63 (95% Cl, 0.33-1.21). Baseline dietary calcium intake, plasma 1,25(OH)(2) vitamin D and 25-(OH) vitamin D levels were not materially associated with risk. Conclusion: In this randomized controlled clinical trial, there was no increase in prostate cancer risk associated with calcium supplementation and some suggestion of a protective effect.
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收藏
页码:586 / 589
页数:4
相关论文
共 29 条
[1]   Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (Finland) [J].
Ahonen, MH ;
Tenkanen, L ;
Teppo, L ;
Hakama, M ;
Tuohimaa, P .
CANCER CAUSES & CONTROL, 2000, 11 (09) :847-852
[2]   Calcium supplements for the prevention of colorectal adenomas [J].
Baron, JA ;
Beach, M ;
Mandel, JS ;
van Stolk, RU ;
Haile, RW ;
Sandler, RS ;
Rothstein, R ;
Summers, RW ;
Snover, DC ;
Beck, GJ ;
Bond, JH ;
Greenberg, ER .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (02) :101-107
[3]   Calcium intake and prostate cancer risk in a long-term aging study: The Baltimore Longitudinal Study of Aging [J].
Berndt, SI ;
Carter, HB ;
Landis, PK ;
Tucker, KL ;
Hsieh, LJ ;
Metter, EJ ;
Platz, EA .
UROLOGY, 2002, 60 (06) :1118-1123
[4]   A DATA-BASED APPROACH TO DIET QUESTIONNAIRE DESIGN AND TESTING [J].
BLOCK, G ;
HARTMAN, AM ;
DRESSER, CM ;
CARROLL, MD ;
GANNON, J ;
GARDNER, L .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1986, 124 (03) :453-469
[5]   PROSTATE-CANCER AND PREDIAGNOSTIC LEVELS OF SERUM VITAMIN-D METABOLITES (MARYLAND, UNITED-STATES) [J].
BRAUN, MM ;
HELZLSOUER, KJ ;
HOLLIS, BW ;
COMSTOCK, GW .
CANCER CAUSES & CONTROL, 1995, 6 (03) :235-239
[6]  
Breslow NE, 1987, STAT METHODS CANC RE, VII
[7]   Diet and prostate cancer risk in a cohort of smokers, with a specific focus on calcium and phosphorus (Finland) [J].
Chan, JM ;
Pietinen, P ;
Virtanen, M ;
Malila, N ;
Tangrea, J ;
Albanes, D ;
Virtamo, J .
CANCER CAUSES & CONTROL, 2000, 11 (09) :859-867
[8]  
Chan JM, 2001, AM J CLIN NUTR, V74, P549
[9]   Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer (Sweden) [J].
Chan, JM ;
Giovannucci, E ;
Andersson, SO ;
Yuen, J ;
Adami, HO ;
Wolk, A .
CANCER CAUSES & CONTROL, 1998, 9 (06) :559-566
[10]  
CORDER EH, 1993, CANCER EPIDEM BIOMAR, V2, P467