Prediagnostic serum calcium concentrations and risk of colorectal cancer development in 2 large European prospective cohorts.
Am J Clin Nutr
; 117(1): 33-45, 2023 01.
Article
en En
| MEDLINE
| ID: mdl-36789942
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 ORQ5vs.Q1 0.69; 95% CI 0.47, 1.00; P-trend = 0.03; UK-BB ORQ5vs.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 ORQ5vs.Q1 0.63, 95% CI 0.39, 1.02; P-trend = 0.05; UK-BB ORQ5vs.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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias Colorrectales
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Neoplasias del Colon
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Am J Clin Nutr
Año:
2023
Tipo del documento:
Article
País de afiliación:
Suiza