Prediagnostic circulating parathyroid hormone concentration and colorectal cancer in the European prospective investigation into cancer and nutrition cohort

Veronika Fedirko, Elio Riboli, H. Bas Bueno-de-Mesquita, Sabina Rinaldi, Tobias Pischon, Teresa Norat, Eugène H J M Jansen, Fränzel J B Van Duijnhoven, Anne Tjønneland, Kim Overvad, Marie Christine Boutron-Ruault, Françoise Clavel-Chapelon, Pierre Engel, Rudolf Kaaks, Birgit Teucher, Heiner Boeing, Brian Buijsse, Antonia Trichopoulou, Dimitrios Trichopoulos, Pagona LagiouSabina Sieri, Paolo Vineis, Salvatore Panico, Domenico Palli, Rosario Tumino, Carla H. Van Gils, Petra H M Peeters, Maria Dolores Chirlaque, Aurelio Barricarte Gurrea, Laudina Rodríguez, Esther Molina-Montes, Miren Dorronsoro, Catalina Bonet, Richard Palmqvist, Göran Hallmans, Timothy J. Key, Konstantinos K. Tsilidis, Kay Tee Khaw, Isabelle Romieu, Kurt Straif, Petra A. Wark, Dora Romaguera, Mazda Jenab

    Research output: Contribution to journalArticlepeer-review

    21 Citations (Scopus)


    Background: Parathyroid hormone (PTH) has been proposed to play a promoting role in carcinogenesis. However, no epidemiologic studies have yet directly investigated its role in colorectal cancer (CRC). 

    Methods: A case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort was conducted with 1,214 incident, sporadic CRC cases matched to 1,214 controls. Circulating prediagnostic PTH and 25-hydroxy vitamin D [25(OH)D] concentrations were measured by enzyme-linked immunosorbent assays. Detailed dietary and lifestyle questionnaire data were collected at baseline. Multivariable conditional logistic regression was used to estimate the incidence rate ratio (RR) with 95% confidence intervals (95% CI) for the association between circulating PTH and CRC risk. 

    Results: In multivariate analyses [including adjustment for 25(OH)D concentration] with a priori defined cutoff points, high levels of serum PTH (≥65 ng/L) compared with medium PTH levels of 30-65 ng/L were associated with increasedCRCrisk (RR = 1.41,95%CI: 1.03-1.93). In analyses by sex, theCRCrisk was 1.77 (95% CI: 1.14-2.75) and 1.15 (95% CI: 0.73-1.84) in men and women, respectively (Pheterogeneity = 0.01). In subgroup analyses by anatomical subsite, the risk for colon cancer was RR = 1.56, 95% CI: 1.03-2.34, and for rectal cancer RR = 1.20, 95% CI: 0.72-2.01 (Pheterogeneity = 0.21). Effect modification by various risk factors was examined. 

    Conclusions: The results of this study suggest that high serum PTH levels may be associated with incident, sporadic CRC in Western European populations, and in particular among men. Impact: To our knowledge, this is the first study on PTH and CRC. The role of PTH in carcinogenesis needs to be further investigated. 

    Original languageEnglish
    Pages (from-to)767-778
    Number of pages12
    JournalCancer Epidemiology Biomarkers and Prevention
    Issue number5
    Early online date4 Mar 2011
    Publication statusPublished - May 2011

    ASJC Scopus subject areas

    • Epidemiology
    • Oncology


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