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Associations of serum 25-hydroxyvitamin D level with incidence of lung cancer and histologic types in Norwegian adults: a case-cohort analysis of the HUNT study

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Abstract

Previous prospective studies have shown inconsistent associations between serum 25-hydroxyvitamin D [25(OH)D] level and lung cancer incidence. The aim of the present study was to explore the associations of serum 25(OH)D levels with incidence of lung cancer overall and different histologic types. We performed a population-based prospective case-cohort study including 696 incident lung cancer cases and 5804 individuals in a subcohort who participated in the second survey of the Nord-Trøndelag Health Study in Norway. Cox proportional hazards regression models counting for the case-cohort design were used to estimate hazard ratios (HRs) with 95% confidence interval (CIs) for lung cancer overall or histologic types in relation to serum 25(OH)D levels. Compared with the fourth season-specific quartile of 25(OH)D (median 68.0 nmol/L), lower 25(OH)D levels were not associated with the incidence of overall, small or squamous cell lung cancer. However, the risk of adenocarcinoma was lower in the second and third quartiles (median 39.9 and 51.5 nmol/L) compared with the fourth quartile, with HRs of 0.63 (95% CI 0.41–0.98) and 0.58 (0.38–0.88), respectively. The associations of lower levels of 25(OH)D with a reduced risk of adenocarcinoma were only observed in the overweight/obese subjects [HRs for second and third quartiles: 0.40 (0.22–0.72) and 0.50 (0.27–0.92)] but not in the normal weight subjects [HRs: 0.95 (0.52–1.75) and 0.60 (0.32–1.10)]. Serum 25(OH)D levels were not associated with the risk of lung cancer in general. The observation that lower 25(OH)D levels were associated with a lower risk of adenocarcinoma should be interpreted with caution.

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Acknowledgements

The Nord-Trøndelag Health Study (HUNT) is a collaboration between the HUNT Research Centre (Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology), the Nord-Trøndelag County Council, and the Norwegian Institute of Public Health. The authors especially thank the HUNT Research Centre laboratory personnel for the measurement of serum 25(OH)D levels. We are also grateful to Professor Margaret May at University of Bristol for statistical consultation.

Funding

This work was supported by The Norwegian Cancer Society (project ID 5769155-2015) and The Research Council of Norway “Gaveforsterkning”.

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Authors and Affiliations

  1. Department of Clinical and Molecular Medicine (IKOM), NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Yi-Qian Sun & Frank Skorpen

  2. Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Arnulf Langhammer, Tom Ivar Lund Nilsen, Pål Richard Romundstad & Xiao-Mei Mai

  3. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Chunsen Wu

  4. Odense University Hospital, Odense, Denmark

    Chunsen Wu

  5. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Yue Chen

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  1. Yi-Qian Sun
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Contributions

YQS, AL, YC and XMM contributed to the study design. XMM and AL contributed to data collection. CW contributed to statistical analyses. YQS conducted statistical analyses, interpreted results and wrote the initial draft of the manuscript. AL, CW, FS, YC, TILN, PRR and XMM participated in the data interpretation and helped to write the final draft of the manuscript.

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Correspondence to Yi-Qian Sun.

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Conflicts of interests

YQS reports grants from The Norwegian Cancer Society during the conduct of the study. All other authors declare that they have no conflict of interest.

Additional information

Disclaimer: The study has used data from the Cancer Registry of Norway. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway is intended nor should be inferred.

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Sun, YQ., Langhammer, A., Wu, C. et al. Associations of serum 25-hydroxyvitamin D level with incidence of lung cancer and histologic types in Norwegian adults: a case-cohort analysis of the HUNT study. Eur J Epidemiol 33, 67–77 (2018). https://doi.org/10.1007/s10654-017-0324-1

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