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Purushothaman VL, Cuomo RE, Garland CF, Mackey TK. Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? BMC Public Health 2021; 21:1238. [PMID: 34218809 PMCID: PMC8256562 DOI: 10.1186/s12889-021-11089-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/18/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin D has been identified as a potential protective factor in the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition) model postulates various stages of cancer development due to vitamin D deficiency and the associated latency period. The purpose of this study is to examine this age-dependent inverse relationship globally. METHODS In this ecological study, a series of linear and polynomial regression tests were performed between country-specific UVB estimates adjusted for cloud cover and crude incidence rates of CRC for different age groups. Multiple linear regression was used to investigate the association between crude incidence rates of colorectal cancer and UVB estimate adjusting for urbanization, skin pigmentation, smoking, animal consumption, per capita GDP, and life expectancy. Statistical analysis was followed by geospatial visualization by producing choropleth maps. RESULTS The inverse relationship between UVB exposure and CRC crude rates was stronger in older age groups at the country level. Quadratic curve fitting was preferred, and these models were statistically significant for all age groups. The inverse association between crude incidence rates of CRC and UVB exposure was statistically significant for age groups above 45 years, after controlling for covariates. CONCLUSION The age-dependent inverse association between UVB exposure and incidence of colorectal cancer exhibits a greater effect size among older age groups in global analyses. Studying the effect of chronic vitamin D deficiency on colorectal cancer etiology will help in understanding the necessity for population-wide screening programs for vitamin D deficiency, especially in regions with inadequate UVB exposure. Further studies are required to assess the need for adequate public health programs such as selective supplementation and food fortification.
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Affiliation(s)
- Vidya Lakshmi Purushothaman
- Department of Anesthesiology, University of California, San Diego, USA
- Global Health Policy Institute, San Diego, USA
| | - Raphael E Cuomo
- Department of Anesthesiology, University of California, San Diego, USA
- Global Health Policy Institute, San Diego, USA
- Division of Extended Studies, University of California, San Diego, USA
| | - Cedric F Garland
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Timothy K Mackey
- Department of Anesthesiology, University of California, San Diego, USA.
- Global Health Policy Institute, San Diego, USA.
- Division of Extended Studies, University of California, San Diego, USA.
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Yun S, Bae J, Kim H, Park B, Kim J, Seo S, Ahn H, Lee D, Kim Y, Park H, Chung K. Non‐melanoma skin cancer as a clinical marker for internal malignancies: a nationwide population‐based cohort study. J Eur Acad Dermatol Venereol 2020; 34:746-753. [DOI: 10.1111/jdv.15936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/26/2019] [Indexed: 12/29/2022]
Affiliation(s)
- S.J. Yun
- Department of Dermatology Chonnam National University Medical School Gwangju Korea
| | - J.M. Bae
- Department of Dermatology College of Medicine The Catholic University of Korea Seoul Korea
| | - H. Kim
- Department of Dermatology Catholic Kwandong University College of Medicine Incheon Korea
| | - B.C. Park
- Department of Dermatology Dankook University College of Medicine Cheonan Korea
| | - J.S. Kim
- Department of Dermatology Hanyang University College of Medicine Guri Korea
| | - S.H. Seo
- Department of Dermatology Korea University College of Medicine Seoul Korea
| | - H.H. Ahn
- Department of Dermatology Korea University College of Medicine Seoul Korea
| | - D.Y. Lee
- Department of Dermatology Sungkyunkwan University School of Medicine Seoul Korea
| | - Y.C. Kim
- Department of Dermatology Ajou University School of Medicine Suwon Korea
| | - H.J. Park
- Department of Dermatology Gacheon University School of Medicine Incheon Korea
| | - K.Y. Chung
- Department of Dermatology Yonsei University College of Medicine Seoul Korea
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Abstract
The Ultraviolet (UV) radiation contained in sunlight is a powerful mutagen and immune suppressant which partly explains why exposure to solar UV is the biggest risk factor for the development of cutaneous tumours. Evidence is building that sunlight may be protective against some internal malignancies. Because patients with these tumours are often vitamin D deficient, this has led some to propose that vitamin D supplementation will be beneficial in the treatment of these cancers. However, the results from already completed trials have been disappointing which has given weight to the argument that there must be something else about sunlight that explains its cancer-protecting properties.
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Affiliation(s)
- Jacqueline E Marshall
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School at the Charles Perkins Centre, University of Sydney, Australia.
| | - Scott N Byrne
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School at the Charles Perkins Centre, University of Sydney, Australia.
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Makarova AM, Frascari F, Davari P, Gorouhi F, Dutt P, Wang L, Dhawan A, Wang G, Green JE, Epstein EH. Ultraviolet Radiation Inhibits Mammary Carcinogenesis in an ER-Negative Murine Model by a Mechanism Independent of Vitamin D3. Cancer Prev Res (Phila) 2018; 11:383-392. [DOI: 10.1158/1940-6207.capr-17-0195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 02/06/2018] [Accepted: 04/03/2018] [Indexed: 11/16/2022]
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Irving AA, Duchow EG, Plum LA, DeLuca HF. Vitamin D deficiency in the ApcPirc/+ rat does not exacerbate colonic tumorigenesis, while low dietary calcium might be protective. Dis Model Mech 2018; 11:11/3/dmm032300. [PMID: 29590632 PMCID: PMC5897728 DOI: 10.1242/dmm.032300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/07/2018] [Indexed: 12/12/2022] Open
Abstract
Human studies have shown that individuals with colon cancer tend to have lower serum 25-hydroxy-vitamin D3 [25(OH)D3] levels compared with healthy controls, but whether this link is causative, a result of the disease or an indicator of another factor altogether has yet to be demonstrated. In humans, vitamin D, calcium and UV exposure are inextricably linked; therefore, understanding the individual and combined roles of each of these will require animal models specifically designed to address these questions. To begin to untangle this network, our group has employed the ApcPirc/+ rat, which contains a truncating mutation in the Apc gene, leading to the development of colonic tumors. Our group previously utilized this model to demonstrate that vitamin D supplementation above normal does not reduce colonic tumor burden and, in fact, increased tumor multiplicity in a dose-dependent manner. In the current study, we tested whether vitamin D deficiency plays a causative role in tumor development using two strains which differ in their susceptibility to intestinal tumorigenesis. In the colon, vitamin D deficiency did not increase the development of tumors in either strain, and was actually protective in one strain. Unexpectedly, low dietary calcium combined with vitamin D deficiency significantly suppressed tumor development in the small intestine and colon of both strains. The vast majority of tumors in the human intestine occur in the colon, and we find no evidence to support a direct role of vitamin D deficiency in increasing colonic tumorigenesis, and low calcium might protect against tumor development.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Amy A Irving
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Elizabeth G Duchow
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Lori A Plum
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Hector F DeLuca
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
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Fleischer AB, Fleischer SE. Solar radiation and the incidence and mortality of leading invasive cancers in the United States. DERMATO-ENDOCRINOLOGY 2016; 8:e1162366. [PMID: 27195056 PMCID: PMC4862378 DOI: 10.1080/19381980.2016.1162366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/15/2016] [Accepted: 03/02/2016] [Indexed: 02/06/2023]
Abstract
Invasive cancer risk is inversely related to ultraviolet light exposure. This study explores relationships between cancer and the satellite-derived sunlight energy. We obtained the North America Land Data Assimilation System (NLDAS) daily average sunlight for the continental United States from 1999-2011. US Cancer Statistics age-adjusted-incidence and mortality was also obtained from the Centers for Disease Control and Prevention (CDC). We found that cancer incidence for all invasive cancers and for 11 of 22 leading cancers significantly decreased with increased solar radiation. Cancer mortality for all invasive cancers was not significantly associated with solar radiation, but for 7 of 22 leading cancers, including cancers of the uterus, leukemias, lung, ovary, and urinary bladder, increased solar radiation predicted decreased mortality. With increasing solar radiation, increased incidence and cancer mortality was observed for liver cancer and increased incidence but not mortality was observed for cervical cancer. The current study confirms studies relating UV radiation to the incidence and mortality of a variety of cancer types. We find associations between solar radiation energy and the incidence and mortality of a number of types of cancers.
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Affiliation(s)
- Alan B Fleischer
- Department of Surgery, University of Kentucky College of Medicine , Lexington, KY, USA
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Garland CF, Cuomo RE, Gorham ED, Zeng K, Mohr SB. Cloud cover-adjusted ultraviolet B irradiance and pancreatic cancer incidence in 172 countries. J Steroid Biochem Mol Biol 2016; 155:257-63. [PMID: 25864626 DOI: 10.1016/j.jsbmb.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 03/24/2015] [Accepted: 04/04/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Controversy exists regarding whether vitamin D deficiency could influence the etiology of pancreatic cancer. Several cohort studies have found that high serum 25-hydroxyvitamin D [25(OH)D] concentrations are associated with low risk of pancreatic cancer, while others have not. HYPOTHESIS Low ultraviolet B irradiance is associated with high incidence of pancreatic cancer. METHODS Age-standardized pancreatic cancer incidence rates were obtained from GLOBOCAN in 2008. The association between cloud-adjusted UVB irradiance and age-standardized incidence rates of pancreatic cancer was analyzed using regression. RESULTS Overall, the lower the cloud-adjusted UVB irradiance, the higher the incidence rate of pancreatic cancer. Residents of countries with low UVB irradiance had approximately 6 times the incidence rates as those in countries with high UVB irradiance (p<0.0001 for males and p<0.0001 for females). This association persisted after adjustment for traditional risk factors of pancreatic cancer (p=0.0182 for males and p=0.0029 for females). CONCLUSIONS There was an inverse association of cloud-adjusted UVB irradiance with incidence of pancreatic cancer that persisted after adjustment. This result is consistent with an inverse association of overall vitamin D deficiency in countries with lower UVB irradiance with risk of pancreatic cancer. Further research on the role of 25(OH)D in reduction of pancreatic cancer in individuals would be desirable to expand the limited avenues available for prevention of this highly fatal disease. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.
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Affiliation(s)
- Cedric F Garland
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Raphael E Cuomo
- Division of Global Health, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA; Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Edward D Gorham
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Kenneth Zeng
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Sharif B Mohr
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
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Cuomo RE, Garland CF, Gorham ED, Mohr SB. Low Cloud Cover-Adjusted Ultraviolet B Irradiance Is Associated with High Incidence Rates of Leukemia: Study of 172 Countries. PLoS One 2015; 10:e0144308. [PMID: 26637119 PMCID: PMC4670097 DOI: 10.1371/journal.pone.0144308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 11/15/2015] [Indexed: 12/31/2022] Open
Abstract
There are 52,380 cases of leukemia and 24,090 deaths from it in the US annually. Its causes are unknown and no preventive strategies have been implemented. We hypothesized that leukemia is due mainly to vitamin D deficiency, which is due mainly to low solar ultraviolet B (UVB) irradiance. To test this hypothesis, we estimated age-standardized cloud-cover-adjusted winter UVB irradiance using cloud cover data from the International Satellite Cloud Climatology Project, latitudes of population centroids, and standard astronomical calculations. Incidence rates for 172 countries, available from the International Agency for Cancer Research, were plotted according to cloud-adjusted UVB irradiance. We used multiple regression to account for national differences in elevation and average life expectancy. Leukemia incidence rates were inversely associated with cloud-adjusted UVB irradiance in males (p ≤ 0.01) and females (p ≤ 0.01) in both hemispheres. There were few departures from the trend line, which was parabolic when plotted with the equator at the center of the display, northern hemisphere countries on the right side and southern hemisphere countries on the left. The bivariate association displayed by the polynomial trend line indicated that populations at higher latitudes had at least two times the risk of leukemia compared to equatorial populations. The association persisted in males (p ≤ 0.05) and females (p ≤ 0.01) after controlling for elevation and life expectancy. Incidence rates of leukemia were inversely associated with solar UVB irradiance. It is plausible that the association is due to vitamin D deficiency. This would be consistent with laboratory studies and a previous epidemiological study. Consideration should be given to prudent use of vitamin D for prevention of leukemia.
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Affiliation(s)
- Raphael E. Cuomo
- Division of Global Health, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
- * E-mail:
| | - Cedric F. Garland
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Edward D. Gorham
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Sharif B. Mohr
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
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9
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Baggerly CA, Cuomo RE, French CB, Garland CF, Gorham ED, Grant WB, Heaney RP, Holick MF, Hollis BW, McDonnell SL, Pittaway M, Seaton P, Wagner CL, Wunsch A. Sunlight and Vitamin D: Necessary for Public Health. J Am Coll Nutr 2015; 34:359-65. [PMID: 26098394 PMCID: PMC4536937 DOI: 10.1080/07315724.2015.1039866] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Raphael E. Cuomo
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California
| | | | - Cedric F. Garland
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California
| | - Edward D. Gorham
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California
| | - William B. Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, California
| | | | - Michael F. Holick
- Department of Medicine, Boston University Medical Center, Boston, Massachusetts
| | - Bruce W. Hollis
- Medical University South Carolina, Charleston, South Carolina
| | | | | | - Paul Seaton
- Alaska State House of Representatives, Juneau, Alaska
| | - Carol L. Wagner
- Medical University South Carolina, Charleston, South Carolina
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10
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Mohr SB, Gorham ED, Kim J, Hofflich H, Cuomo RE, Garland CF. Could vitamin D sufficiency improve the survival of colorectal cancer patients? J Steroid Biochem Mol Biol 2015; 148:239-44. [PMID: 25533386 DOI: 10.1016/j.jsbmb.2014.12.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 11/11/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine whether a higher serum 25-hydroxyvitamin D [25(OH)D] concentration at diagnosis is associated with longer survival of colorectal cancer patients. METHODS A meta-analysis was performed of studies of the relationship between 25(OH)D and mortality of patients with colorectal cancer. A random-effects model was used to calculate a pooled hazards ratio. Homogeneity was evaluated through a DerSimonian-Laird test. RESULTS Higher serum concentrations of 25(OH)D were associated with lower mortality in patients with colorectal cancer. Patients in the highest quintile of 25(OH)D had 37% lower mortality from colorectal cancer compared to those in the lowest quintile of 25(OH)D (pooled odds ratio=0.63, p<0.0001). Dose-response curves showed lower hazard ratios for mortality with higher serum 25(OH)D through at least 40ng/ml. There were no exceptions. CONCLUSIONS Higher serum 25(OH)D was associated with lower mortality of patients with colorectal cancer. These results suggest that colorectal cancer patients with deficient levels of serum 25(OH)D should have their levels restored to a normal range (30-80ng/ml). This could be done with regular testing of serum 25(OH)D to be confident that an adequate serum level is being maintained. Additional studies would be worthwhile to evaluate confounding or the possibility of reverse causation.
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Affiliation(s)
- Sharif B Mohr
- Department of Family and Preventive Medicine 0620, University of California, San Diego, La Jolla CA 92093, USA
| | - Edward D Gorham
- Department of Family and Preventive Medicine 0620, University of California, San Diego, La Jolla CA 92093, USA
| | - June Kim
- Department of Family and Preventive Medicine 0620, University of California, San Diego, La Jolla CA 92093, USA
| | - Heather Hofflich
- Department of Medicine, Internal Medical Group, University of California, San Diego, La Jolla CA 92093, USA
| | - Raphael E Cuomo
- Department of Medicine, Division Global Health, University of California, San Diego, La Jolla CA 92093, USA; Graduate School of Public Health, San Diego State University, San Diego CA 92182, USA.
| | - Cedric F Garland
- Department of Family and Preventive Medicine 0620, University of California, San Diego, La Jolla CA 92093, USA
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Mohr SB, Gorham ED, Garland CF, Grant WB, Garland FC, Cuomo RE. Are low ultraviolet B and vitamin D associated with higher incidence of multiple myeloma? J Steroid Biochem Mol Biol 2015; 148:245-52. [PMID: 25500072 DOI: 10.1016/j.jsbmb.2014.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to determine whether an inverse association exists between latitude, solar ultraviolet B (UVB) irradiance, and incidence rates of multiple myeloma.Methods Associations of latitude and UVB irradiance with age-standardized incidence rates of multiple myeloma were analyzed for 175 countries while controlling for sex-specific obesity prevalence, cigarette consumption, and alcohol consumption using multiple linear regression.Results Incidence rates of multiple myeloma were greater at higher latitudes (R(2) for latitude for males=0.31, p<0.0001; females R(2)=0.27, p<0.0001). In regression models for males (R(2)=0.62, p<0.0001) and females (R(2)=0.51, p<0.0001), UVB irradiance was independently inversely associated with incidence rates.Conclusions Age-adjusted incidence rates of multiple myeloma were higher in countries with lower solar UVB irradiance. Further investigation is warranted in individuals of the association of prediagnostic serum 25(OH)D with risk.
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Affiliation(s)
- Sharif B Mohr
- Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Naval Health Research Center, San Diego, CA, United States
| | - Edward D Gorham
- Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Naval Health Research Center, San Diego, CA, United States
| | - Cedric F Garland
- Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States
| | - William B Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, CA, United States
| | - Frank C Garland
- Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Naval Health Research Center, San Diego, CA, United States
| | - Raphael E Cuomo
- Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Graduate School of Public Health, San Diego State University, San Diego, CA, United States.
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Khan I, Bangash M, Baeesa S, Jamal A, Carracedo A, Alghamdi F, Qashqari H, Abuzenadah A, AlQahtani M, Damanhouri G, Chaudhary A, Hussein D. Epidemiological trends of histopathologically WHO classified CNS tumors in developing countries: systematic review. Asian Pac J Cancer Prev 2015; 16:205-16. [PMID: 25640353 DOI: 10.7314/apjcp.2015.16.1.205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many developing countries are lagging behind in reporting epidemiological data for individual central nervous system (CNS) tumors. This paper aimed to elicit patterns for the epidemiology of individual World Health Organization (WHO) classified CNS tumors in countries registered by WHO as "developing". MATERIALS AND METHODS Cyber search was carried out through 66 cancer networks/registries and 181 PubMed published papers that reported counts of CNS tumors for the period of 2009-2012. The relationship between the natural log of incidence Age Standardized Rate (ASR) reported by Globocan and Latitude/ Longitude was investigated. RESULTS Registries for 21 countries displayed information related to CNS tumors. In contrast tends for classified CNS tumor cases were identified for 38 countries via 181 PubMed publications. Extracted data showed a majority of unclassified reported cases [PubMed (38 countries, 45.7%), registries (21 countries, 96.1%)]. For classified tumors, astrocytic tumors were the most frequently reported type [PubMed (38 countries, 1,245 cases, 15.7%), registries (21 countries, 627 cases, 1.99%]. A significant linear regression relationship emerged between latitudes and reported cases of CNS tumors. CONCLUSIONS Previously unreported trends of frequencies for individually classified CNS tumors were elucidated and a possible link of CNS tumors occurrence with geographical location emerged.
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Affiliation(s)
- Ishaq Khan
- Center of Excellence in Genomic Medicine, King Abdulaziz University, Jeddah, Saudi Arabia E-mail :
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A multicountry ecological study of cancer incidence rates in 2008 with respect to various risk-modifying factors. Nutrients 2013; 6:163-89. [PMID: 24379012 PMCID: PMC3916854 DOI: 10.3390/nu6010163] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 12/12/2013] [Accepted: 12/14/2013] [Indexed: 02/06/2023] Open
Abstract
Observational and ecological studies are generally used to determine the presence of effect of cancer risk-modifying factors. Researchers generally agree that environmental factors such as smoking, alcohol consumption, poor diet, lack of physical activity, and low serum 25-hdyroxyvitamin D levels are important cancer risk factors. This ecological study used age-adjusted incidence rates for 21 cancers for 157 countries (87 with high-quality data) in 2008 with respect to dietary supply and other factors, including per capita gross domestic product, life expectancy, lung cancer incidence rate (an index for smoking), and latitude (an index for solar ultraviolet-B doses). The factors found to correlate strongly with multiple types of cancer were lung cancer (direct correlation with 12 types of cancer), energy derived from animal products (direct correlation with 12 types of cancer, inverse with two), latitude (direct correlation with six types, inverse correlation with three), and per capita gross national product (five types). Life expectancy and sweeteners directly correlated with three cancers, animal fat with two, and alcohol with one. Consumption of animal products correlated with cancer incidence with a lag time of 15–25 years. Types of cancer which correlated strongly with animal product consumption, tended to correlate weakly with latitude; this occurred for 11 cancers for the entire set of countries. Regression results were somewhat different for the 87 high-quality country data set and the 157-country set. Single-country ecological studies have inversely correlated nearly all of these cancers with solar ultraviolet-B doses. These results can provide guidance for prevention of cancer.
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