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Vitamin D, PTH, and calcium and tumor aggressiveness in prostate cancer: a prospective nested case–control study

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Abstract

Purpose

Epidemiological studies suggest that low levels of vitamin D (25OHD) constitute a risk factor for more aggressive prostate cancer. We examined the relationship between pre-diagnostic serum levels of vitamin D, parathyroid hormone (PTH), and calcium and risk of prostate cancer according to tumor aggressiveness.

Methods

We performed a nested case–control study within the Malmö Diet and Cancer Study on 943 incident prostate cancer cases. Tumor aggressiveness was defined by Gleason score, TNM stage, and serum levels of total prostate-specific antigen. Odds ratios (OR) were calculated for different quartiles of serum levels of 25OHD, PTH, and calcium, and for interactions between them.

Results

We found no significant association when comparing aggressive to non-aggressive disease regarding vitamin D, PTH, or calcium. There was a trend toward an increased risk in low-grade tumors, i.e., Gleason score ≤6, and a significant association regarding Gleason score 7 tumors with OR 1.70 (1.09–2.65) in the highest quartile of vitamin D. Stratifying the analysis yielded several significant findings demonstrating a nonspecific interaction between the metabolites. In men with PTH above median, the risk of aggressive prostate cancer was double in the highest vitamin D quartile, OR 2.01 (1.24–3.25), and for non-aggressive cancer 1.82 (1.25–2.66). There was an inverse effect on risk of prostate cancer in men with PTH above median and vitamin D ≤50 nmol/L, OR 0.25 (0.09–0.71) and calcium ≤2.37 mmol/L, OR 0.53 (0.34–0.82) for aggressive cancer.

Conclusions

This study showed no significant association when comparing aggressive to non-aggressive disease. There was a possible relationship between vitamin D and low-risk tumors. There were both positive and negative interactions between PTH, calcium, and vitamin D and risk of prostate cancer. These results were similar for low-risk and aggressive cases.

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References

  1. Gronberg H (2003) Prostate cancer epidemiology. Lancet 361(9360):859–864

    Article  PubMed  Google Scholar 

  2. Schwartz GG, Hulka BS (1990) Is vitamin D deficiency a risk factor for prostate cancer? (Hypothesis). Anticancer Res 10(5A):1307–1311

    PubMed  CAS  Google Scholar 

  3. Giovannucci E (2005) The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control CCC 16(2):83–95. doi:10.1007/s10552-004-1661-4

    Article  PubMed  Google Scholar 

  4. Willis MS, Wians FH (2003) The role of nutrition in preventing prostate cancer: a review of the proposed mechanism of action of various dietary substances. Clin Chim Acta 330(1–2):57–83

    Article  PubMed  CAS  Google Scholar 

  5. Stewart LV, Weigel NL (2004) Vitamin D and prostate cancer. Exp Biol Med (Maywood) 229(4):277–284

    CAS  Google Scholar 

  6. Corder EH, Guess HA, Hulka BS, Friedman GD, Sadler M, Vollmer RT, Lobaugh B, Drezner MK, Vogelman JH, Orentreich N (1993) Vitamin D and prostate cancer: a prediagnostic study with stored sera. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 2(5):467–472

    CAS  Google Scholar 

  7. Braun MM, Helzlsouer KJ, Hollis BW, Comstock GW (1995) Prostate cancer and prediagnostic levels of serum vitamin D metabolites (Maryland, United States). Cancer Causes Control CCC 6(3):235–239

    Article  PubMed  CAS  Google Scholar 

  8. Jacobs ET, Giuliano AR, Martinez ME, Hollis BW, Reid ME, Marshall JR (2004) Plasma levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and the risk of prostate cancer. J Steroid Biochem Mol Biol 89–90(1–5):533–537

    Article  PubMed  CAS  Google Scholar 

  9. Nomura AM, Stemmermann GN, Lee J, Kolonel LN, Chen TC, Turner A, Holick MF (1998) Serum vitamin D metabolite levels and the subsequent development of prostate cancer (Hawaii, United States). Cancer Causes Control CCC 9(4):425–432

    Article  PubMed  CAS  Google Scholar 

  10. Tuohimaa P, Tenkanen L, Ahonen M, Lumme S, Jellum E, Hallmans G, Stattin P, Harvei S, Hakulinen T, Luostarinen T, Dillner J, Lehtinen M, Hakama M (2004) Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case–control study in the Nordic countries. Int J Cancer J Int Cancer 108(1):104–108

    Article  CAS  Google Scholar 

  11. Baron JA, Beach M, Wallace K, Grau MV, Sandler RS, Mandel JS, Heber D, Greenberg ER (2005) Risk of prostate cancer in a randomized clinical trial of calcium supplementation. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 14(3):586–589. doi:10.1158/1055-9965.EPI-04-0319

    Article  CAS  Google Scholar 

  12. Li H, Stampfer MJ, Hollis JB, Mucci LA, Gaziano JM, Hunter D, Giovannucci EL, Ma J (2007) A prospective study of plasma vitamin D metabolites, vitamin D receptor polymorphisms, and prostate cancer. PLoS Med 4(3):e103

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  13. Ahn J, Peters U, Albanes D, Purdue MP, Abnet CC, Chatterjee N, Horst RL, Hollis BW, Huang WY, Shikany JM, Hayes RB (2008) Serum vitamin D concentration and prostate cancer risk: a nested case–control study. J Natl Cancer Inst 100(11):796–804

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  14. Faupel-Badger JM, Diaw L, Albanes D, Virtamo J, Woodson K, Tangrea JA (2007) Lack of association between serum levels of 25-hydroxyvitamin D and the subsequent risk of prostate cancer in Finnish men. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 16(12):2784–2786. doi:10.1158/1055-9965.EPI-07-0672

    Article  CAS  Google Scholar 

  15. Gilbert R, Metcalfe C, Fraser WD, Donovan J, Hamdy F, Neal DE, Athene Lane J, Martin RM (2011) Associations of circulating 25-hydroxyvitamin D with prostate cancer diagnosis, stage and grade. Int J Cancer J Int Cancer. doi:10.1002/ijc.27327

    Google Scholar 

  16. Mikhak B, Hunter DJ, Spiegelman D, Platz EA, Hollis BW, Giovannucci E (2007) Vitamin D receptor (VDR) gene polymorphisms and haplotypes, interactions with plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D, and prostate cancer risk. Prostate 67(9):911–923. doi:10.1002/pros.20570

    Article  PubMed  CAS  Google Scholar 

  17. Barnett CM, Nielson CM, Shannon J, Chan JM, Shikany JM, Bauer DC, Hoffman AR, Barrett-Connor E, Orwoll E, Beer TM (2010) Serum 25-OH vitamin D levels and risk of developing prostate cancer in older men. Cancer Causes Control CCC 21(8):1297–1303. doi:10.1007/s10552-010-9557-y

    Article  PubMed  PubMed Central  Google Scholar 

  18. Park SY, Cooney RV, Wilkens LR, Murphy SP, Henderson BE, Kolonel LN (2010) Plasma 25-hydroxyvitamin D and prostate cancer risk: the multiethnic cohort. Eur J Cancer 46(5):932–936. doi:10.1016/j.ejca.2009.12.030

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Travis RC, Crowe FL, Allen NE, Appleby PN, Roddam AW, Tjonneland A, Olsen A, Linseisen J, Kaaks R, Boeing H, Kroger J, Trichopoulou A, Dilis V, Trichopoulos D, Vineis P, Palli D, Tumino R, Sieri S, Bueno-de-Mesquita HB, van Duijnhoven FJ, Chirlaque MD, Barricarte A, Larranaga N, Gonzalez CA, Arguelles MV, Sanchez MJ, Stattin P, Hallmans G, Khaw KT, Bingham S, Rinaldi S, Slimani N, Jenab M, Riboli E, Key TJ (2009) Serum vitamin D and risk of prostate cancer in a case–control analysis nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Epidemiol 169(10):1223–1232. doi:10.1093/aje/kwp022

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fang F, Kasperzyk JL, Shui I, Hendrickson W, Hollis BW, Fall K, Ma J, Gaziano JM, Stampfer MJ, Mucci LA, Giovannucci E (2011) Prediagnostic plasma vitamin D metabolites and mortality among patients with prostate cancer. PLoS ONE 6(4):e18625. doi:10.1371/journal.pone.0018625

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Freedman DM, Looker AC, Abnet CC, Linet MS, Graubard BI (2010) Serum 25-hydroxyvitamin D and cancer mortality in the NHANES III study (1988–2006). Cancer Res 70(21):8587–8597. doi:10.1158/0008-5472.CAN-10-1420

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  22. Zlotta AR, Egawa S, Pushkar D, Govorov A, Kimura T, Kido M, Takahashi H, Kuk C, Kovylina M, Aldaoud N, Fleshner N, Finelli A, Klotz L, Sykes J, Lockwood G, van der Kwast TH (2013) Prevalence of prostate cancer on autopsy: cross-sectional study on unscreened Caucasian and Asian men. J Natl Cancer Inst 105(14):1050–1058. doi:10.1093/jnci/djt151

    Article  PubMed  CAS  Google Scholar 

  23. samverkan Rci (2012) Nationell kvalitetsrapport för diagnosår 2012 från Nationella prostatacancerregistret (NPCR)

  24. Ritchie CK, Thomas KG, Andrews LR, Tindall DJ, Fitzpatrick LA (1997) Effects of the calciotrophic peptides calcitonin and parathyroid hormone on prostate cancer growth and chemotaxis. Prostate 30(3):183–187

    Article  PubMed  CAS  Google Scholar 

  25. Murray RM, Grill V, Crinis N, Ho PW, Davison J, Pitt P (2001) Hypocalcemic and normocalcemic hyperparathyroidism in patients with advanced prostatic cancer. J Clin Endocrinol Metab 86(9):4133–4138

    Article  PubMed  CAS  Google Scholar 

  26. Schwartz GG, Hall MC, Stindt D, Patton S, Lovato J, Torti FM (2005) Phase I/II study of 19-nor-1alpha-25-dihydroxyvitamin D2 (paricalcitol) in advanced, androgen-insensitive prostate cancer. Clin Cancer Res Off J Am Assoc Cancer Res 11(24 Pt 1):8680–8685. doi:10.1158/1078-0432.CCR-05-1237

    Article  CAS  Google Scholar 

  27. Tucci M, Mosca A, Lamanna G, Porpiglia F, Terzolo M, Vana F, Cracco C, Russo L, Gorzegno G, Tampellini M, Torta M, Reimondo G, Poggio M, Scarpa RM, Angeli A, Dogliotti L, Berruti A (2009) Prognostic significance of disordered calcium metabolism in hormone-refractory prostate cancer patients with metastatic bone disease. Prostate Cancer Prostatic Dis 12(1):94–99. doi:10.1038/pcan.2008.10

    Article  PubMed  CAS  Google Scholar 

  28. Silverberg SJ (2000) Natural history of primary hyperparathyroidism. Endocrinol Metab Clin N Am 29(3):451–464

    Article  CAS  Google Scholar 

  29. Giovannucci E, Rimm EB, Wolk A, Ascherio A, Stampfer MJ, Colditz GA, Willett WC (1998) Calcium and fructose intake in relation to risk of prostate cancer. Cancer Res 58(3):442–447

    PubMed  CAS  Google Scholar 

  30. Skinner HG, Schwartz GG (2009) A prospective study of total and ionized serum calcium and fatal prostate cancer. Cancer Epidemiol Biomark Prev 18(2):575–578

    Article  CAS  Google Scholar 

  31. Skinner HG, Schwartz GG (2008) Serum calcium and incident and fatal prostate cancer in the National Health and Nutrition Examination Survey. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 17(9):2302–2305. doi:10.1158/1055-9965.EPI-08-0365

    Article  CAS  Google Scholar 

  32. Schwartz GG, Skinner HG (2012) A prospective study of total and ionized serum calcium and time to fatal prostate cancer. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 21(10):1768–1773. doi:10.1158/1055-9965.EPI-12-0585

    Article  CAS  Google Scholar 

  33. Brandstedt J, Almquist M, Manjer J, Malm J (2012) Vitamin D, PTH, and calcium and the risk of prostate cancer: a prospective nested case–control study. Cancer Causes Control CCC 23(8):1377–1385. doi:10.1007/s10552-012-9948-3

    Article  PubMed  Google Scholar 

  34. Manjer J, Carlsson S, Elmstahl S, Gullberg B, Janzon L, Lindstrom M, Mattisson I, Berglund G (2001) The Malmo Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev 10(6):489–499

    Article  PubMed  CAS  Google Scholar 

  35. Wallstrom (2002) Diet, lifestyle, antioxidants and biomarkers of cancer risk. An epidemiological report from the Malmö Diet and cancer cohort. Thesis, Lund University, Malmö

  36. Anker P, Wieland E, Ammann D, Dohner RE, Asper R, Simon W (1981) Neutral carrier based ion-selective electrode for the determination of total calcium in blood serum. Anal Chem 53(13):1970–1974

    Article  PubMed  CAS  Google Scholar 

  37. Wittekind C, Compton CC, Greene FL, Sobin LH (2002) TNM residual tumor classification revisited. Cancer 94(9):2511–2516. doi:10.1002/cncr.10492

    Article  PubMed  Google Scholar 

  38. Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann A (2007) The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr 85(3):649–650

    PubMed  CAS  Google Scholar 

  39. Albanes D, Mondul AM, Yu K, Parisi D, Horst RL, Virtamo J, Weinstein SJ (2011) Serum 25-hydroxy vitamin D and prostate cancer risk in a large nested case–control study. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 20(9):1850–1860. doi:10.1158/1055-9965.EPI-11-0403

    Article  CAS  Google Scholar 

  40. Ross LE, Coates RJ, Breen N, Uhler RJ, Potosky AL, Blackman D (2004) Prostate-specific antigen test use reported in the 2000 National Health Interview Survey. Prev Med 38(6):732–744. doi:10.1016/j.ypmed.2004.01.005

    Article  PubMed  Google Scholar 

  41. Kristal AR, Till C, Song X, Tangen CM, Goodman PJ, Neuhauser ML, Schenk JM, Thompson IM, Meyskens FL Jr, Goodman GE, Minasian LM, Parnes HL, Klein EA (2014) Plasma vitamin D and prostate cancer risk: results from the Selenium and Vitamin E Cancer Prevention Trial. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 23(8):1494–1504. doi:10.1158/1055-9965.EPI-14-0115

    Article  CAS  Google Scholar 

  42. Schenk JM, Till CA, Tangen CM, Goodman PJ, Song X, Torkko KC, Kristal AR, Peters U, Neuhouser ML (2014) Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: results from the Prostate Cancer Prevention Trial. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 23(8):1484–1493. doi:10.1158/1055-9965.EPI-13-1340

    Article  CAS  Google Scholar 

  43. Schwartz GG (2014) Vitamin D in blood and risk of prostate cancer: lessons from the Selenium and Vitamin E Cancer Prevention Trial and the Prostate Cancer Prevention Trial. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 23(8):1447–1449. doi:10.1158/1055-9965.EPI-14-0520

    Article  CAS  Google Scholar 

  44. Schwartz GG (2008) Prostate cancer, serum parathyroid hormone, and the progression of skeletal metastases. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 17(3):478–483. doi:10.1158/1055-9965.EPI-07-2747

    Article  CAS  Google Scholar 

  45. Gd L (1962) Hypocalcemia and hypophosphatemia accompanying osteoblastic osseous metastases: studies of calcium and phosphate metabolism and parathyroid function. Ann Intern Med 1962(56):676–677

    Google Scholar 

  46. Liao J, Schneider A, Datta NS, McCauley LK (2006) Extracellular calcium as a candidate mediator of prostate cancer skeletal metastasis. Cancer Res 66(18):9065–9073

    Article  PubMed  CAS  Google Scholar 

  47. Iwamura M, Abrahamsson PA, Foss KA, Wu G, Cockett AT, Deftos LJ (1994) Parathyroid hormone-related protein: a potential autocrine growth regulator in human prostate cancer cell lines. Urology 43(5):675–679

    Article  PubMed  CAS  Google Scholar 

  48. Gensure RC, Gardella TJ, Juppner H (2005) Parathyroid hormone and parathyroid hormone-related peptide, and their receptors. Biochem Biophys Res Commun 328(3):666–678. doi:10.1016/j.bbrc.2004.11.069

    Article  PubMed  CAS  Google Scholar 

  49. Skinner HG, Schwartz GG (2009) The relation of serum parathyroid hormone and serum calcium to serum levels of prostate-specific antigen: a population-based study. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 18(11):2869–2873. doi:10.1158/1055-9965.EPI-09-0730

    Article  CAS  Google Scholar 

  50. Aydin O, Eren E, Yalcinkaya S, Yilmaz N, Eroglu M, Ellidag HY (2014) Positive correlation of serum parathormone and prostate specific antigen levels in prostate cancer. Bratisl Lek Listy 115(3):171–174

    PubMed  CAS  Google Scholar 

  51. Kim WT, Choi YD, Park C, Kim YW, Yun SJ, Kim IY, Kim WJ (2011) Parathyroid hormone is not involved in prostate growth in patients with benign prostatic hyperplasia. Prostate 71(11):1210–1215. doi:10.1002/pros.21336

    Article  PubMed  CAS  Google Scholar 

  52. Pero RW, Olsson A, Bryngelsson C, Carlsson S, Janzon L, Berglund G, Elmstahl S (1998) Quality control program for storage of biologically banked blood specimens in the Malmo Diet and Cancer Study. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 7(9):803–808

    CAS  Google Scholar 

  53. Hollis BW (2008) Measuring 25-hydroxyvitamin D in a clinical environment: challenges and needs. Am J Clin Nutr 88(2):507S–510S

    PubMed  CAS  Google Scholar 

  54. Platz EA, Leitzmann MF, Hollis BW, Willett WC, Giovannucci E (2004) Plasma 1,25-dihydroxy- and 25-hydroxyvitamin D and subsequent risk of prostate cancer. Cancer Causes Control CCC 15(3):255–265

    Article  PubMed  Google Scholar 

  55. Meng JE, Hovey KM, Wactawski-Wende J, Andrews CA, Lamonte MJ, Horst RL, Genco RJ, Millen AE (2012) Intraindividual variation in plasma 25-hydroxyvitamin D measures 5 years apart among postmenopausal women. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 21(6):916–924. doi:10.1158/1055-9965.EPI-12-0026

    Article  CAS  Google Scholar 

  56. Ricos C, Alvarez V, Cava F, Garcia-Lario JV, Hernandez A, Jimenez CV, Minchinela J, Perich C, Simon M (1999) Current databases on biological variation: pros, cons and progress. Scand J Clin Lab Invest 59(7):491–500

    Article  PubMed  CAS  Google Scholar 

  57. Gallagher SK, Johnson LK, Milne DB (1989) Short-term and long-term variability of indices related to nutritional status. I: Ca, Cu, Fe, Mg, and Zn. Clin Chem 35(3):369–373

    PubMed  CAS  Google Scholar 

  58. Ankrah-Tetteh T, Wijeratne S, Swaminathan R (2008) Intraindividual variation in serum thyroid hormones, parathyroid hormone and insulin-like growth factor-1. Ann Clin Biochem 45(Pt 2):167–169

    Article  PubMed  CAS  Google Scholar 

  59. Viljoen A, Singh DK, Twomey PJ, Farrington K (2008) Analytical quality goals for parathyroid hormone based on biological variation. Clin Chem Lab Med 46(10):1438–1442

    Article  PubMed  CAS  Google Scholar 

  60. Barlow L, Westergren K, Holmberg L, Talback M (2009) The completeness of the Swedish Cancer Register: a sample survey for year 1998. Acta Oncol 48(1):27–33

    Article  PubMed  Google Scholar 

  61. Peterlik M, Boonen S, Cross HS, Lamberg-Allardt C (2009) Vitamin D and calcium insufficiency-related chronic diseases: an emerging world-wide public health problem. Int J Environ Res Public Health 6(10):2585–2607

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  62. Hoffman RM, Stone SN, Espey D, Potosky AL (2005) Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA. BMC Cancer 5:27

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This work was supported by grants from the Swedish Research Council (K2007-69X-20487-01-3), the Ernhold Lundström Foundation, the Einar and Inga Nilsson Foundation, Malmö University Hospital Cancer Research Fund, Malmö University Hospital Funds and Donations, the Crafoord Foundation, Region Skåne, the Mossfelt Foundation, Fundacion Federico S.A, the Swedish Cancer Society (CAN 2006/1554), and the Gunnar Nilsson Cancer Foundation.

Authors’ contribution

JB participated in the design of the study, collected some of the data, performed the statistical analysis, and drafted the manuscript. MA participated in the design of the study and helped to draft the manuscript. Jonas M participated in the design of the study and helped to draft the manuscript. DU collected the majority of the data. Johan M participated in the design of the study and helped to draft the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Urology, Skåne University Hospital Malmö, Lund University, 205 02, Malmö, Sweden

    Johan Brändstedt & David Ulmert

  2. Department of Surgery, Skåne University Hospital Lund, Lund University, Malmö, Sweden

    Martin Almquist

  3. Department of Translational Medicine in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden

    David Ulmert

  4. Department of Plastic Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden

    Jonas Manjer

  5. Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden

    Martin Almquist & Jonas Manjer

  6. Department of Laboratory Medicine, Section for Clinical Chemistry, Skåne University Hospital, Malmö, Sweden

    Johan Malm

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  1. Johan Brändstedt
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Brändstedt, J., Almquist, M., Ulmert, D. et al. Vitamin D, PTH, and calcium and tumor aggressiveness in prostate cancer: a prospective nested case–control study. Cancer Causes Control 27, 69–80 (2016). https://doi.org/10.1007/s10552-015-0684-3

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