Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?
| Autor: | Vidya Purushothaman, Cedric F. Garland, Tim K. Mackey, Raphael E. Cuomo |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Inverse Association Aging Colorectal cancer Ultraviolet Rays vitamin D deficiency 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine Vitamin D and neurology Humans Climate-Related Exposures and Conditions Vitamin D Aged Ultraviolet B rays Cancer Nutrition business.industry Incidence (epidemiology) Incidence Prevention Food fortification Public Health Environmental and Occupational Health Ecological study Middle Aged Crude incidence rates medicine.disease Vitamin D Deficiency Colo-Rectal Cancer 030104 developmental biology Good Health and Well Being 030220 oncology & carcinogenesis Public Health and Health Services Public Health Public aspects of medicine RA1-1270 business Colorectal Neoplasms UVB Digestive Diseases Research Article |
| Zdroj: | BMC public health, vol 21, iss 1 BMC Public Health BMC Public Health, Vol 21, Iss 1, Pp 1-19 (2021) |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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