Journal of Gastrointestinal & Digestive System
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Introduction & Objectives:
Studies inconsistently show a correlation between serum vitamin D and prostate cancer risk in European
Americans. Vitamin D deficiency and prostate cancer risk have several overlapping biological and environmental modifiers, including
African ancestry, age, and BMI. This study evaluates the relationship between serum vitamin D levels, and predictors of prostate cancer
(PCa) risk in African American men, in a low UV environment.
This study is a case-control study assessing biological and environmental mediators of vitamin D and PCa among 40- to 79-
year old ambulatory-, unrelated- AA men, prospectively enrolled through outpatient urology clinics from numerous urban, academic
medical centers and cancer screening events in Chicago, IL. PCa cases were biopsy confirmed by genitourinary pathologist at our
institution, and healthy men with negative DRE and PSA levels below 2.5 ng/ml were enrolled as controls. We examined the relationship
between 25(OH)D serum levels and PCa risk using logistic regression models adjusted for age and known covariates of PCa.
The mean age of PCa cases was 61.3 years and 54.7 years for controls (p<0.01). On average, serum 25(OH)D was 16.4 and 20.7
for PCa cases and controls, respectively (p<0.001). Age-adjusted binary logistic regressions controlled for family history, degree of West
African ancestry, finasteride use, tobacco and alcohol consumption, and BMI demonstrated an increased odds ratio of PCa associated
with 25(OH)D levels below 12 ng/ml [OR 3.53, 95% CI (1.81, 6.89), p<0.01], 16 ng/ml [OR 3.67, 95% CI (2.03, 6.64), p<0.01], and 20
ng/ml [OR 3.19, 95% CI (1.75, 5.84), p<0.01]. Socioeconomic variables failed to reach statistical significance (p>0.2). Similarly, 25(OH)
D levels below 16 ng/ml were associated with increased risk of high-grade (Gleason score ≥7) PCa (OR 3.25, p=0.03). There were few
AA men (1.2%) in our cohort with elevated levels of 25(OH)D greater than 55 ng/ml.
25(OH)D deficiency was associated with increased risk of PCa and high-grade PCa among AA men in our cohort. This
relationship remained strong in spite of controlling for known covariates of PCa among the men in our cohort.
Adam B. Murphy earned his M.D. and MBA from University of Chicago in 2004. He completed his General Surgery Internship and Urology Residency
at Northwestern University in June 2010. Currently, he is a faculty at Northwestern University in the Department of Urology and Jesse Brown VA
Medical Center. He received a DOD Physician Research Training Award under the mentorship of Dr.Rick Kittles in Cancer Genetics and Epidemiology
and under Dr.William Catalona in Clinical Prostate Cancer Research in 2010. He is also a new investigator in the office of AIDS research looking at
potential treatment disparities in prostate cancer associated with HIV positive status. He has over 15 publications in established journals, several
review articles and book chapters. He is positioning himself as a Surgeon-Scientist focusing on biological, environmental and genetic sources for
health disparities in urologic diseases.
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