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Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?
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 ch...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256562/ https://www.ncbi.nlm.nih.gov/pubmed/34218809 http://dx.doi.org/10.1186/s12889-021-11089-w |
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author | Purushothaman, Vidya Lakshmi Cuomo, Raphael E. Garland, Cedric F. Mackey, Timothy K. |
author_facet | Purushothaman, Vidya Lakshmi Cuomo, Raphael E. Garland, Cedric F. Mackey, Timothy K. |
author_sort | Purushothaman, Vidya Lakshmi |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11089-w. |
format | Online Article Text |
id | pubmed-8256562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82565622021-07-06 Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? Purushothaman, Vidya Lakshmi Cuomo, Raphael E. Garland, Cedric F. Mackey, Timothy K. BMC Public Health Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11089-w. BioMed Central 2021-07-05 /pmc/articles/PMC8256562/ /pubmed/34218809 http://dx.doi.org/10.1186/s12889-021-11089-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Purushothaman, Vidya Lakshmi Cuomo, Raphael E. Garland, Cedric F. Mackey, Timothy K. Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title | Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title_full | Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title_fullStr | Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title_full_unstemmed | Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title_short | Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? |
title_sort | could age increase the strength of inverse association between ultraviolet b exposure and colorectal cancer? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256562/ https://www.ncbi.nlm.nih.gov/pubmed/34218809 http://dx.doi.org/10.1186/s12889-021-11089-w |
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