Trude Eid Robsahm,1 Steinar Tretli,1 Peter Abusdal Torjesen,2 Ronnie Babigumira,1 Gary G Schwartz31The Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway; 2The Hormone Laboratory, Department of Endocrinology, Oslo University Hospital Health Authority, Oslo, Norway; 3Department of Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USAPurpose: Circulating 25-hydroxyvitamin D (25-OHD) levels have been inversely associated with cancer death, but the nature of this relationship is unclear. We investigated this association using repeated measurements of serum 25-OHD.Patients and methods: Pre-diagnostic serum samples were collected in population health surveys in Norway (1973–2004). Participants who subsequently developed cancer (1984–2004) provided a second serum sample at the time of cancer diagnosis. Samples were stored in the Janus Serum Bank. Repeated samples existed from 202 breast cancers, 193 lung cancers, 124 lymphomas, and 37 colon cancers. Serum 25-OHD was measured via competitive radioimmunoassay. Cox regression models assessed associations between 25-OHD and cancer-specific death (case fatality) through 2012, given as hazard ratios (HRs) with 95% confidence intervals (CIs).Results: The median time between pre-diagnostic and diagnostic samples was 14.4 years. The median 25-OHD levels were 63.3 and 62.5 nmol/L, respectively. During follow-up, 313 cancer deaths occurred. Compared to low pre-diagnostic 25-OHD levels (
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