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Calcium, vitamin D, dairy products, and mortality among colorectal cancer survivors: the Cancer Prevention Study-II Nutrition Cohort.

Abstract

PURPOSE

Higher calcium, vitamin D, and dairy product intakes are associated with lower colorectal cancer incidence, but their impacts on colorectal cancer survival are unclear. We evaluated associations of calcium, vitamin D, and dairy product intakes before and after colorectal cancer diagnosis with all-cause and colorectal cancer-specific mortality among colorectal cancer patients.

PATIENTS AND METHODS

This analysis included 2,284 participants in a prospective cohort who were diagnosed with invasive, nonmetastatic colorectal cancer after baseline (1992 or 1993) and up to 2009. Mortality follow-up was through 2010. Prediagnosis risk factor information was collected on the baseline questionnaire. Postdiagnosis information was collected via questionnaires in 1999 and 2003 and was available for 1,111 patients.

RESULTS

A total of 949 participants with colorectal cancer died during follow-up, including 408 from colorectal cancer. In multivariable-adjusted Cox proportional hazards regression models, postdiagnosis total calcium intake was inversely associated with all-cause mortality (relative risk [RR] for those in the highest relative to the lowest quartiles, 0.72; 95% CI, 0.53-0.98; Ptrend = .02) and associated with marginally statistically significant reduced colorectal cancer-specific mortality (RR, 0.59; 95% CI, 0.33 to 1.05; Ptrend = .01). An inverse association with all-cause mortality was also observed for postdiagnosis milk intake (RR, 0.72; 95% CI, 0.55 to 0.94; Ptrend = .02), but not vitamin D intake. Prediagnosis calcium, vitamin D, and dairy product intakes were not associated with any mortality outcomes.

CONCLUSION

Higher postdiagnosis intakes of total calcium and milk may be associated with lower risk of death among patients with nonmetastatic colorectal cancer.

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  • Authors+Show Affiliations

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    ,

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA.

    Baiyu Yang, Marjorie L. McCullough, Susan M. Gapstur, Eric J. Jacobs, and Peter T. Campbell, American Cancer Society; Roberd M. Bostick, Veronika Fedirko, and W. Dana Flanders, Winship Cancer Institute, Emory University; Baiyu Yang, Emory University, Atlanta, GA. Peter.Campbell@cancer.org.

    Source

    MeSH

    Aged
    Calcium, Dietary
    Cohort Studies
    Colorectal Neoplasms
    Dairy Products
    Female
    Humans
    Male
    Middle Aged
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Survivors
    United States
    Vitamin D

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24958826

    Citation

    Yang, Baiyu, et al. "Calcium, Vitamin D, Dairy Products, and Mortality Among Colorectal Cancer Survivors: the Cancer Prevention Study-II Nutrition Cohort." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 32, no. 22, 2014, pp. 2335-43.
    Yang B, McCullough ML, Gapstur SM, et al. Calcium, vitamin D, dairy products, and mortality among colorectal cancer survivors: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol. 2014;32(22):2335-43.
    Yang, B., McCullough, M. L., Gapstur, S. M., Jacobs, E. J., Bostick, R. M., Fedirko, V., ... Campbell, P. T. (2014). Calcium, vitamin D, dairy products, and mortality among colorectal cancer survivors: the Cancer Prevention Study-II Nutrition Cohort. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 32(22), pp. 2335-43. doi:10.1200/JCO.2014.55.3024.
    Yang B, et al. Calcium, Vitamin D, Dairy Products, and Mortality Among Colorectal Cancer Survivors: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol. 2014 Aug 1;32(22):2335-43. PubMed PMID: 24958826.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Calcium, vitamin D, dairy products, and mortality among colorectal cancer survivors: the Cancer Prevention Study-II Nutrition Cohort. AU - Yang,Baiyu, AU - McCullough,Marjorie L, AU - Gapstur,Susan M, AU - Jacobs,Eric J, AU - Bostick,Roberd M, AU - Fedirko,Veronika, AU - Flanders,W Dana, AU - Campbell,Peter T, Y1 - 2014/06/23/ PY - 2014/6/25/entrez PY - 2014/6/25/pubmed PY - 2014/11/8/medline SP - 2335 EP - 43 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 32 IS - 22 N2 - PURPOSE: Higher calcium, vitamin D, and dairy product intakes are associated with lower colorectal cancer incidence, but their impacts on colorectal cancer survival are unclear. We evaluated associations of calcium, vitamin D, and dairy product intakes before and after colorectal cancer diagnosis with all-cause and colorectal cancer-specific mortality among colorectal cancer patients. PATIENTS AND METHODS: This analysis included 2,284 participants in a prospective cohort who were diagnosed with invasive, nonmetastatic colorectal cancer after baseline (1992 or 1993) and up to 2009. Mortality follow-up was through 2010. Prediagnosis risk factor information was collected on the baseline questionnaire. Postdiagnosis information was collected via questionnaires in 1999 and 2003 and was available for 1,111 patients. RESULTS: A total of 949 participants with colorectal cancer died during follow-up, including 408 from colorectal cancer. In multivariable-adjusted Cox proportional hazards regression models, postdiagnosis total calcium intake was inversely associated with all-cause mortality (relative risk [RR] for those in the highest relative to the lowest quartiles, 0.72; 95% CI, 0.53-0.98; Ptrend = .02) and associated with marginally statistically significant reduced colorectal cancer-specific mortality (RR, 0.59; 95% CI, 0.33 to 1.05; Ptrend = .01). An inverse association with all-cause mortality was also observed for postdiagnosis milk intake (RR, 0.72; 95% CI, 0.55 to 0.94; Ptrend = .02), but not vitamin D intake. Prediagnosis calcium, vitamin D, and dairy product intakes were not associated with any mortality outcomes. CONCLUSION: Higher postdiagnosis intakes of total calcium and milk may be associated with lower risk of death among patients with nonmetastatic colorectal cancer. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/24958826/Calcium_vitamin_D_dairy_products_and_mortality_among_colorectal_cancer_survivors:_the_Cancer_Prevention_Study_II_Nutrition_Cohort_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2014.55.3024?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -