Prediagnostic serum calcium concentrations and risk of colorectal cancer development in 2 large European prospective cohorts

Research output: Contribution to journalJournal articleResearchpeer-review

  • Nena Karavasiloglou
  • David J. Hughes
  • Neil Murphy
  • Lutz Schomburg
  • Qian Sun
  • Vartiter Seher
  • Sabine Rohrmann
  • Elisabete Weiderpass
  • 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

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.

Original languageEnglish
Book seriesAmerican Journal of Clinical Nutrition
Volume117
Issue number1
Pages (from-to)33-45
Number of pages13
ISSN0002-9165
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2022

    Research areas

  • cancer, cohort, colorectal, risk, serum calcium

ID: 362681347