Vitamin D deficiency may raise aggressive prostate cancer odds

African-American and European-American men at high risk of prostate cancer have greater odds of being diagnosed with an aggressive form of the disease if they have vitamin D deficiency, researchers from Chicago’s Northwestern Medicine and the University of Illinois at Chicago (UIC) reported in a recently published study.

“Vitamin D deficiency could be a biomarker of advanced prostate tumor progression in large segments of the general population,” said lead study author Adam B. Murphy, MD, of Northwestern University Feinberg School of Medicine. “More research is needed, but it would be wise for men to be screened for vitamin D deficiency and treated.”

Results of the study were published in Clinical Cancer Research (2014; 20:2289-99).

“This is the first study to look at vitamin D deficiency and biopsy outcomes in men at high risk of prostate cancer,” added senior author Rick Kittles, PhD, of UIC. “Previous studies focused on vitamin D levels in men either with or without prostate cancer.”

The researchers examined data collected from a diverse group of more than 600 men from the Chicago area who had elevated PSA levels or other risk factors for prostate cancer. Each man was screened for vitamin D deficiency before undergoing a prostate biopsy.

To their surprise, the authors found that vitamin D deficiency seemed to be a predictor of aggressive forms of prostate cancer diagnosis in African-American and European-American men, even after adjusting for potential confounders, including diet, smoking habits, obesity, family history, and calcium intake.

“These men with severe vitamin D deficiency had greater odds of advanced grade and advanced stage of tumors within or outside the prostate,” Dr. Murphy said.

European-American men and African-American men had 3.66 times and 4.89 times increased odds of having aggressive prostate cancer, respectively and 2.42 times and 4.22 times increased odds of having tumor stage T2b or higher, respectively.

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African-American men with severe vitamin D deficiency also had 2.43 times increased odds of being diagnosed with prostate cancer.

“Vitamin D deficiency is more common and severe in people with darker skin and it could be that this deficiency is a contributor to prostate cancer progression among African-Americans,” Dr. Murphy said. “Our findings imply that vitamin D deficiency is a bigger contributor to African-American prostate cancer.”

In related news, men with signs of chronic inflammation in non-cancerous prostate tissue may have nearly twice the risk of actually having prostate cancer than those with no inflammation, according to a study led by researchers from the Johns Hopkins Kimmel Cancer Center in Baltimore.

The link between persistent inflammation and cancer was even stronger for men with high-grade prostate cancer-those with a Gleason score between 7 and 10-indicating the presence of the most aggressive and rapidly growing prostate cancers, the researchers reported online in Cancer Epidemiology, Biomarkers & Prevention (April 18, 2014).

Lead author Elizabeth A. Platz, ScD, MPH, and colleagues examined benign tissue samples taken from the biopsies of 191 men with prostate cancer and 209 men without cancer, examining the samples for the prevalence and extent of immune cells that indicate inflammation. Eighty-six percent of the prostate cancer patients had at least one tissue sample with signs of inflammation, compared to 78% of men without cancer.

Ultimately, men with at least one tissue sample showing signs of chronic inflammation had 1.78 times higher odds of having prostate cancer and 2.24 times higher odds of having an aggressive cancer, the researchers concluded. The association held firm even in men with low PSA levels at the time of their biopsies.

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