Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?

BMC Public Health

Vidya Lakshmi Purushothaman¹  Raphael E. Cuomo²  Timothy K. Mackey²  Cedric F. Garland³ 

[1] Department of Anesthesiology, University of California, San Diego, USA;Global Health Policy Institute, San Diego, USA;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;Department of Family Medicine and Public Health, University of California, San Diego, USA;

关键词: Colorectal cancer;    Ultraviolet B rays;    UVB;    Vitamin D;    Aging;    Crude incidence rates;   

DOI  :  10.1186/s12889-021-11089-w

来源: Springer

【 摘 要 】

BackgroundVitamin 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.MethodsIn 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.ResultsThe 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.ConclusionThe 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.

【 授权许可】

CC BY