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Serum calcium and incident and fatal prostate cancer in the Swedish AMORIS study

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Abstract

Background

Observational studies have shown a positive association between intake of dairy products as well as serum levels of calcium and prostate cancer (PCa) risk. We studied the association between serum calcium and PCa while also accounting for levels of albumin, a protein to which calcium is bound.

Methods

A cohort based on 196,022 men with baseline information on calcium (mmol/L) and albumin (g/L) was selected from the Swedish Apolipoprotein MOrtality RISk study. Age-stratified multivariable Cox proportional hazard models were used to analyze associations between calcium and incident and fatal PCa risk.

Results

A total of 6,353 men were diagnosed with PCa and 731 died of PCa during mean follow-up of 12 years. A weak negative association was found between levels of calcium or albumin-corrected calcium and PCa risk (HR for quartiles of albumin-corrected calcium: 0.95 (0.89–1.02), 0.93 (0.86–1.00), and 0.91 (0.85–0.98) for the 2nd, 3rd, and 4th quartile compared to the 1st; p for trend: 0.012). BMI did not affect these findings. No association was found between calcium levels and fatal PCa. A positive association between Ca and death was observed when censoring for PCa [HR per SD: 1.14 (1.13–1.16)].

Conclusion

The weak negative association between Ca and PCa risk is likely explained by the relation between Ca and death. This illustrates the need to handle competing risks when defining whether Ca is involved in PCa etiology or whether it acts as a marker of other metabolic events in the causal pathway.

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Authors and Affiliations

  1. Cancer Epidemiology Group, Research Oncology, Division of Cancer Studies, School of Medicine, Guy’s Hospital, King’s College London, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK

    Mieke Van Hemelrijck, Ruben Hermans, Jennifer Melvin, Hans Garmo & Lars Holmberg

  2. Institute for Surgical Sciences, Orthopaedics, Uppsala Clinical Research Centre, Uppsala, Sweden

    Karl Michaelsson

  3. Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden

    Jennifer Melvin, Hans Garmo & Lars Holmberg

  4. Department of Epidemiology, Insitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Niklas Hammar

  5. AstraZeneca Sverige, Södertalje, Sweden

    Niklas Hammar

  6. Clinical Epidemiological Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Ingmar Jungner & Göran Walldius

  7. CALAB Research, Stockholm, Sweden

    Ingmar Jungner

Authors
  1. Mieke Van Hemelrijck
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  2. Ruben Hermans
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  3. Karl Michaelsson
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  4. Jennifer Melvin
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  5. Hans Garmo
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  6. Niklas Hammar
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  7. Ingmar Jungner
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  8. Göran Walldius
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  9. Lars Holmberg
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Corresponding author

Correspondence to Mieke Van Hemelrijck.

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Van Hemelrijck, M., Hermans, R., Michaelsson, K. et al. Serum calcium and incident and fatal prostate cancer in the Swedish AMORIS study. Cancer Causes Control 23, 1349–1358 (2012). https://doi.org/10.1007/s10552-012-0015-x

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  • DOI: https://doi.org/10.1007/s10552-012-0015-x

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