Circulating vitamin D concentrations and risk of breast and prostate cancer: a Mendelian randomization study
File(s)02.VD_BrCaPrCa_MR_MarkChanges.docx (154.56 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Background: Observational studies have suggested an association between circulating vitamin D concentrations [25(OH)D] and risk of breast and prostate cancer, which was not supported by a recent Mendelian randomization (MR) analysis comprising 15 748 breast and 22 898 prostate-cancer cases. Demonstrating causality has proven challenging and one common limitation of MR studies is insufficient power. Methods: We aimed to determine whether circulating concentrations of vitamin D are causally associated with the risk of breast and prostate cancer, by using summary-level data from the largest ever genome-wide association studies conducted on vitamin D (N = 73 699), breast cancer (Ncase = 122 977) and prostate cancer (Ncase = 79 148). We constructed a stronger instrument using six common genetic variants (compared with the previous four variants) and applied several two-sample MR methods. Results: We found no evidence to support a causal association between 25(OH)D and risk of breast cancer [OR per 25 nmol/L increase, 1.02 (95% confidence interval: 0.97-1.08), P = 0.47], oestrogen receptor (ER)+ [1.00 (0.94-1.07), P = 0.99] or ER- [1.02 (0.90-1.16), P = 0.75] subsets, prostate cancer [1.00 (0.93-1.07), P = 0.99] or the advanced subtype [1.02 (0.90-1.16), P = 0.72] using the inverse-variance-weighted method. Sensitivity analyses did not reveal any sign of directional pleiotropy. Conclusions: Despite its almost five-fold augmented sample size and substantially improved statistical power, our MR analysis does not support a causal effect of circulating 25(OH)D concentrations on breast- or prostate-cancer risk. However, we can still not exclude a modest or non-linear effect of vitamin D. Future studies may be designed to understand the effect of vitamin D in subpopulations with a profound deficiency.
Date Issued
2019-10-01
Date Acceptance
2018-12-06
Citation
International Journal of Epidemiology, 2019, 48 (5), pp.1416-1424
ISSN
1464-3685
Publisher
Oxford University Press (OUP)
Start Page
1416
End Page
1424
Journal / Book Title
International Journal of Epidemiology
Volume
48
Issue
5
Copyright Statement
© The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association. This is a pre-copy-editing, author-produced version of an article accepted for publication in International Journal of Epidemiology following peer review. The definitive publisher-authenticated version is available online at: https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyy284/5265299
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30597039
PII: 5265299
Subjects
Mendelian randomization
breast
malignancy
prostate
serum vitamin D concentrations
PRACTICAL, CRUK, BPC3, CAPS and PEGASUS consortia
0104 Statistics
1117 Public Health and Health Services
Epidemiology
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2018-12-28