New study below [1].
"The Alpha-Tocopherol, Beta-Carotene (ATBC) Lung Cancer Prevention Study was a randomized, double-blind, placebo-controlled, 2 x 2 factorial design, primary prevention trial testing the hypothesis that alpha-tocopherol (50 mg/day) and beta-carotene (20 mg/day) supplements reduce the incidence of lung cancer and possibly other cancers. Total and disease-specific mortality and incidence of various diseases and symptoms were monitored for safety. Between 1985 and 1993, 29,133 eligible male smokers aged 50 to 69 years at entry were randomized to receive daily active supplements or placebo capsules for 5 to 8 years" [2]
The study was jointly sponsored by the U.S. National Cancer Institute and the Finnish National Public Institute. The NCI continues to mine the data.
The smokers were from Finland, where vitamin D deficiency/insufficiency would be common for many months of the year. & ~thirty years ago, when blood was drawn, there would not have been access to the megadose supplements that are now common.
"While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. ... Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up"
"Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76 ... for highest vs. lowest quintile ...)"
"Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74 ...), kidney (HR = 0.59 ...), and melanoma (HR = 0.39 ...), but increased mortality from lung cancer (HR = 1.28 ...)".
My guess is that the men with better 25-D status included those with outside jobs. All of the men were smokers, but perhaps there was some occupational risk that explains increased lung cancer mortality. After all, the lowest quintile (the reference point) would have been 25-D deficient, IMO, & the highest quintile not high at all.
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/300...
Eur J Epidemiol. 2018 Aug 2. doi: 10.1007/s10654-018-0428-2. [Epub ahead of print]
Circulating 25-hydroxyvitamin D up to 3 decades prior to diagnosis in relation to overall and organ-specific cancer survival.
Weinstein SJ1, Mondul AM2, Yu K3, Layne TM3, Abnet CC3, Freedman ND3, Stolzenberg-Solomon RZ3, Lim U4, Gail MH3, Albanes D3.
Author information
1
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA. weinstes@mail.nih.gov.
2
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
3
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
4
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
Abstract
While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. We examined the accepted biomarker of vitamin D status, serum 25-hydroxyvitamin D [25(OH)D], and cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up and 1732 survived or died of other causes. Proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnostic 25(OH)D and overall and site-specific survival. Serum 25(OH)D was significantly lower among cases who subsequently died from their malignancy compared with those who did not (medians 34.7 vs. 36.5 nmol/L, respectively; p = 0.01). Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76, 95% CI 0.67-0.85 for highest vs. lowest quintile, p-trend < 0.0001). Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74, 95% CI 0.55-1.01, p-trend = 0.005), kidney (HR = 0.59, 95% CI 0.35-0.98, p-trend = 0.28), and melanoma (HR = 0.39, 95% CI 0.20-0.78, p-trend = 0.01), but increased mortality from lung cancer (HR = 1.28, 95% CI 1.02-1.61, p-trend = 0.19). Improved survival was also suggested for head and neck, gastric, pancreatic, and liver cancers, though not statistically significantly, and case numbers for the latter two organ sites were small. Higher 25(OH)D status years prior to diagnosis was related to improved survival for overall and some site-specific cancers, associations that should be examined in other prospective populations that include women and other racial-ethnic groups.
KEYWORDS:
Cancer; Mortality; Prospective cohort; Survival analysis; Vitamin D
PMID: 30073448 DOI: 10.1007/s10654-018-0428-2
Overall Survival in Men With Bone Metastases From Castration-Resistant Prostate Cancer Treated With Bone-Targeting Radioisotopes 
