Objective To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study.
Design Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort.
Setting Nine public health centre areas across Japan.
Participants 3301 incident cases of cancer and 4044 randomly selected subcohort participants.
Exposure Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference.
Main outcome measure Incidence of overall or site specific cancer.
Results Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios.
Conclusions In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites.

中文翻译：

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血浆25-羟基维生素D浓度以及日本人群总和特定部位癌症的后续风险：基于日本公共卫生中心前瞻性研究队列的大型病例队列研究

目的在一项大型队列研究中，评估诊断前循环维生素D浓度与随后发生的整体和部位特异性癌症风险之间的关系。在基于日本公共卫生中心的前瞻性研究队列中
设计嵌套案例研究。在日本
设置9个公共卫生中心区域。
参与者3301例癌症病例和4044例随机选择的亚队列参与者。
接触通过酶免疫测定法测定的血浆25-羟基维生素D浓度。根据亚人群中25-羟基维生素D的性别和季节特定分布，将参与者分为四分之一。加权Cox比例风险模型用于计算25-羟基维生素D浓度类别中总体和特定地点癌症的多变量调整风险比，以最低的四分之一作为参考。
主要结局指标总体或部位特异性癌症的发生率。
结果血浆25-羟基维生素D浓度与总癌症风险成反比，第二至第四季度的多变量调整风险比与最低季度的0.81（95％置信区间0.70至0.94），0.75（0.75（0.65至0.87））相比较，分别为0.78（0.67至0.91）（趋势的P = 0.001）。在特定部位的癌症发现中，发现肝癌呈负相关，相应的危险比分别为0.70（0.44至1.13），0.65（0.40至1.06）和0.45（0.26至0.79）（趋势P = 0.006） ）。敏感性分析表明，从总癌症病例中交替去除一个特定部位的癌症病例并不会实质改变总体危险比。
结论在这项大型的前瞻性研究中，较高的维生素D浓度与较低的总癌症风险相关。这些发现支持以下假设：维生素D在许多部位具有预防癌症的作用。