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Sunlight and Breast Cancer Incidence in the USSR
Abstract
Epidemiological and laboratory evidence suggest that vitamin D may play a role in reducing risk of breast cancer. Lack of
exposure to ultraviolet sunlight can increase the prevalence of vitamin D deficiency, and may place some populations at higher
risk of breast cancer. The association between total average annual sunlight energy striking the ground and age-adjusted breast
cancer incidence rates in the USSR was evaluated. Breast cancer had a threefold range of incidence. Sunlight levels varied
from 210 to 400 calories per cm2 per day. A statistically significant negative association was found between breast cancer incidence rates and total sunlight
levels (R = −0.75, p = 0.001). The slope of the regression line corresponded to two additional cases per 100 000 per year
for each reduction of 35 calories per cm2 of sunlight. The pattern of increased breast cancer incidence in regions of low solar radiation in the USSR is consistent
with the geographical pattern seen for breast cancer mortality in the US and worldwide. A positive relationship between socioeconomic
status and breast cancer incidence was also present in the Soviet Union, based on an approximate socioeconomic measure, the
number of doctors per 1000 population (R = +0.89, p = 0.0001). The possibility that correlates of socioeconomic status, such
as dietary, ethnic, or behavioural factors, could account for the association is discussed.
... Present epidemiological studies of ultraviolet radiation (UVR) exposure and BC risk have been inconsistent. Some studies found that exposure to solar UVR may lower BC risk (Bilinski et al. 2012;Garland et al. 1990;Gorham et al. 1990;Grant 2012Grant , 2014Hiller et al. 2020), while other studies suggested no statistical association between any measure of UVR exposure and BC risk (Edvardsen et al. 2011;Kuper et al. 2009;Zamoiski et al. 2016). Moreover, previous studies have shown that wind speed had an impact on human health (Bernard et al. 2001;Wu et al. 2008). ...
... We selected 10 proxy variables from four aspects in this study: air quality, meteorological conditions, vegetation conditions, and socio-economic conditions, including respirable particulate matter (PM 10 ), fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ), accumulative sunlight (SUN), average annual wind speed (WIND), normalized difference vegetation index (NDVI), urbanization rate (UR), real GDP per capita (PGDP), average years of school attainment (AYSA), and number of health technicians per thousand people (NHT). The selection of these variables is based on the environmental risk factors of BC (Bernard et al. 2001;Bilinski et al. 2012;Garland et al. 1990;Gorham et al. 1990;Grant 2012Grant , 2014Hiller et al. 2020;Katuwal et al. 2022;Keramatinia et al. 2016;Loomis et al. 2013;Terre-Torras et al. 2022;Wu et al. 2008). The proxy variable of potential factors that could affect the BCI are shown in Fig. 1. ...
Breast cancer (BC) had the highest incidence of all cancers in Chinese women. However, studies on spatial pattern and environmental drivers of BC were still lacked as they were either limited in a small area or few considered the comprehensive impact of multiple risk factors. In this study, we firstly performed spatial visualization and the spatial autocorrelation analysis based on Chinese women breast cancer incidence (BCI) data of 2012-2016. Then, we explored the environmental drivers related to BC by applying univariate correlation analysis and geographical detector model. We found that the BC high-high clusters were mainly distributed in the eastern and central regions, such as Liaoning, Hebei, Shandong, Henan, and Anhui Provinces. The BCI in Shenzhen was significantly higher than other prefectures. Urbanization rate (UR), per capita GDP (PGDP), average years of school attainment (AYSA), and average annual wind speed (WIND) had higher explanatory power on spatial variability of the BCI. PM10, NO2, and PGDP had significant nonlinear enhanced effect on other factors. Besides, normalized difference vegetation index (NDVI) was negatively associated with BCI. Therefore, high socioeconomic status, serious air pollution, high wind speed, and low vegetation cover were the risk factors for BC. Our study may able to provide evidence for BC etiology research and precise identification of areas requiring focused screening.
... A negative correlation between available sunlight and breast cancer death rates has been shown. Because sunlight exposure is a measure of vitamin D produced in the skin, it has been hypothesized that vitamin D formed in the skin may reduce the risk of breast cancer [1][2][3]. Breast cancer is the most frequent cause of cancer death in women in the western world. Many studies have tried to identify the casual factors responsible for the uncontrolled growth of the tumor cells. ...
... Regulation of the number of VDR may affect the cellular responsiveness to 1,25(OH) 2 D 3 . In several different systems including MCF-7 and T47-D breast cancer cells, upregulation of the VDR by 1,25(OH) 2 D 3 itself (homologous upregulation) and by hormones (estradiol) and growth factors (epidermal growth factor (EGF), insulin, insulin-like growth factor-1 (IGF-1)) has been demonstrated (heterologous upregulation) [2,[32][33][34][35][36][37]. Because VDR mediates the biological effects of calcitriol and analogs on differentiation and proliferation in target cells, VDR upregulation may indicate an increased sensitivity of breast cancer to endogenously or therapeutically applied calcitriol. ...
... Our results are in accordance with international studies that show a positive association between risk of, or mortality from, breast cancer and latitude [2,4,41] or measures of inadequate UV radiation [9,41,42]. We found that at latitudes south of 30 ∘ S, a line that runs parallel to the equator from north of Perth on the west coast of Australia to approximately midway between Sydney and Brisbane on the east coast of Australia (Figure 1), there was almost double the risk of breast cancer compared with latitudes north of 30 ∘ S. Similarly, a study of 9778 USA Caucasian women aged 20-79 years showed that after adjusting for recognized risk and prognostic factors, mortality rates (per 100 000 individuals) among women aged 50-79 years in the west, Midwest, and Northeast were 1.13 (95% CI, 1.04-1.23), ...
... Similarly, a study that looked at sunlight levels found a significant negative association between breast cancer incidence rates and sunlight levels ( = −0.75; = 0.001) [42]. ...
Aim. To investigate whether breast cancer incidence increases with increasing latitude in mainland Australian women. Methods. A cross-sectional study of female breast cancer and cutaneous melanoma incidence 2002–2006 by 5-year age group and local government area. Latitude, Accessibility/Remoteness Index of Australia (ARIA), and Index of Relative Socioeconomic Disadvantage (IRSD) were assigned to local government areas. Latitude was grouped into bands (≤27°S; >27–30°S; >30–33°S; >33–36°S, and >36°S), and IRSD was divided into quintiles and ARIA into four categories. Breast cancer rates were age standardized using the direct method. The joint effects of latitude, age, IRSD, and ARIA on incidence of breast cancer and cutaneous melanoma were assessed using multiple logistic regressions. Results. At latitudes south of 30°S, rates of breast cancer were over double that north of 27°S (76.4 versus 160.2–176.5). Age-adjusted odds ratios of breast cancer were increased in all latitudes south of 30°S compared with north of 27°S within each IRSD and ARIA category (all
P
<
0.001
). After adjusting for age, IRSD, and ARIA, the odds ratio of breast cancer south of 30°S was 1.92 (95% CI 1.84–2.09;
P
<
0.001
), whereas cutaneous melanoma was 0.65 (95% CI 0.61–0.68;
P
<
0.001
) times north of 30°S. Discussion. Increasing latitude is positively associated with breast cancer and negatively associated with cutaneous melanoma incidence. These findings support suggestions that increased risk of breast cancer might be explained by lower ultraviolet radiation-induced vitamin D synthesis.
... Furthermore, it is important to remember that sun exposure shows a protective effect against many other types of cancer. [315][316][317][318][319] The lack of sufficient UV-B radiation is considered the cause for a large proportion of twelve types of cancers. 320;321 The ideal case would, therefore, be to find a way of obtaining the beneficial effects of UVB exposure without suffering the increased incidence of skin cancer. ...
... Furthermore, it is worthy to remember that sun exposure shows a protective effect against many other types of cancer. 315 Interrelationship between the external agent of ultraviolet exposure and personal characteristics of the subject is the central issue in many aetiological researches in melanoma. ...
... Recently, the influence of RAD on non-skin cancer has aroused increasing attention (12,13). A growing body of epidemiologic studies have explored the correlation between a variety of cancers and RAD, such as breast (14), colonic (15,16), prostatic (17), pancreatic (18), ovarian (19) and lung cancer (20,21). And the study of Yoshiharu Fukuda et al. (22) using ecological data in Japan shows that RAD is significantly inversely associated with most gastrointestinal cancers and male lung cancer and this study supports the preventive measures of RAD on several types of cancer. ...
Background
Recently, the impact of solar radiation (RAD) on diseases worldwide has garnered growing attention. However, the association between RAD and lung cancer remains largely unknow and no consensus has been reached. The aim of this study was to investigate the lag exposure-response of RAD on lung cancer and provide robust scientific evidence for updating prevention and treatment strategies of lung cancer.
Methods
Data of RAD were obtained from Google Earth Engine, which was post-processed by European Centre for Medium-Range Weather Forecasts (ECMWF). Lung cancer incidence, smoking prevalence and socio-demographic index (SDI) were obtained from Global Burden of Disease (GBD). Spearman’s rank correlation tests and linear regression analyses were performed to investigate the relationship between RAD and lung cancer incidence. Additionally, a distributed lag non-linear model (DLNM) was utilized to reveal the lag effects of RAD on lung cancer incidence.
Results
There were 204 countries and territories and selected subnational locations with information recorded in GBD and radiation exposure was calculated in 272 countries and territories. After excluding missing and abnormal data, as well as Kashmir and Western Sahara which were two disputed districts, this study included 186 countries from 1992 to 2019. After adjusted for smoking and SDI, the Spearman’s correlation coefficient ranged from −0.630 to −0.581. In the DLNM for lung cancer adjusted for smoking and SDI, the maximum relative risk (RR) was 1.013 [95% confidence interval (CI): 1.011–1.014], at RAD exposure of 12,760,000 with 5.8 lag years, while the minimum RR was 0.973 (95% CI: 0.947–0.992) at RAD exposure of 12,845,000 with 8.0 lag years.
Conclusions
The global rise in lung cancer incidence has been notably associated with low exposure to RAD, whereas the defensive influence of sunlight against lung cancer demonstrated hysteresis. This study shows that properly exposure to sunlight is a possible strategy for lung cancer prevention, which provides scientific support for the formulation of future health strategies. It is also crucial in epidemiological research as it offers a novel pattern for identifying additional potential risk factors for diseases.
... Ecological studies have associated increased sunlight exposure with low breast cancer incidence and mortality [8][9][10][11][12]. The above-mentioned studies laid the foundation for examining the hypothesis that vitamin D deficiency increases cancer risk and mortality, including breast cancer. ...
... (8,9) In addition, better exposure to sunlight is related to decreased incidence of several types of cancers. (10) Breast cancer in India is a common problem and studies regarding its association with Vitamin D levels among diabetics remain inconclusive. Early epidemiologic research showed that incidence and death rates for certain cancers were lower among individuals living in southern latitudes, where levels of sunlight exposure are relatively high, than among those living at northern latitudes. ...
... Although traditionally vitamin D is known for its role in bone metabolism and calcium homeostasis, research has shown VDR activation to exhibit anti-proliferative, anti-inflammatory, and pro-apoptotic activity [23,24]. In terms of its effect on cancers, past literature has shown vitamin D to inhibit growth on breast, colon, prostate, and pancreatic cancer cells [25][26][27][28]. ...
The role of vitamin D in modulating several cancer-related pathways has received an increasing amount of attention in the past several years. Previous literature has found an abundance of evidence of vitamin D exerting an anti-proliferative, anti-inflammatory, and pro-differentiation effect in various types of cancers including breast, colon, prostate, and pancreatic cancer. Although the link between vitamin D and thyroid cancer remains controversial, both biochemical evidence and clinical studies have attempted to establish a link between papillary thyroid carcinoma (PTC) and vitamin D status. Furthermore, the use of vitamin D as a prognostic marker has received increased attention, both in regards to clinical outcomes and cancer staging. In this review, we briefly discuss the metabolism and proposed mechanism of action of vitamin D in the context of PTC, and explore links between modulators in the vitamin D pathway and progression of PTC. We provide evidence from both clinical studies as well as molecular studies of metabolic targets, including vitamin D receptor and activating enzymes exerting an effect on PTC tissue, which indicate that vitamin D may play a significant prognostic role in PTC.
... The impact of environment on breast cancer shows that exposure to the environment along with genetic background, age, and hormonal factors have an overall impact on breast cancer risk [7]. These ecological studies, despite their limitations, generally support the hypothesis that exposure to the sun's ultraviolet rays may play a significant role in the risk of breast cancer [2,4,11,12,15,18]. Studies have also been conducted on women's health and resilience to climate change and natural and environmental disasters [5,[19][20][21]. ...
Objective
By studying the effect of environmental factors on health, it is clear that geographical, climatic and environmental factors have a significant impact on human health. This study, based on the data of the patients with breast cancer in Iran since 2010 to 2014 and using the statistical methods has determined the effect of geographical features of Iran (solar radiation status, radiation angle) on the frequency and distribution of this disease.
Results
The maximum amount of total solar radiation occurs in the vicinity (surrounding) of the tropic of cancer, which covers some parts of the south of Iran and in the atmosphere of the northern latitudes of Iran. The amount of humidity and cloudiness is more than the southern latitudes, which causes more reflection of short waves of the sun during the day. Findings showed that the rate of breast cancer in low latitudes is higher than high latitudes. It was also found that with increasing longitude, the rate of cancer increases significantly due to the high thickness of the atmosphere and receiving more sunlight in the electromagnetic spectrum, as well as dry air and low water vapor in low altitude areas of eastern and southeastern Iran.
... Several ecologic studies have examined the relationship between breast cancer incidence and latitude or measures of ambient UVR (Bilinski et al. 2014;Boscoe and Schymura 2006;Gorham et al. 1990;Grant 2012Grant , 2013Mandal et al. 2009;Mohr et al. 2008). These ecologic studies, despite their limitations, in general support the hypothesis that greater levels of solar UVR exposure may reduce an individual's risk of breast cancer. ...
Background:
A protective relationship has been hypothesized between exposure to solar ultraviolet radiation (UVR) and the development of breast cancer.
Objective:
The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the association of exposure to solar UVR and breast cancer risk.
Methods:
We searched Medline, EMBASE, and Web of Science for all studies investigating exposure to solar UVR and breast cancer risk. Separate analyses were performed using estimates of time spent in the sun, and ambient UVR. Associations were estimated using DerSimonian and Laird random-effect models. Heterogeneity was investigated through subgroup analyses and
I
2
statistics.
Results:
Fourteen studies were included in the review and 13 in the meta-analysis, with the majority (
n
=
8
) conducted in North America. We observed a decreased risk of breast cancer for individuals spending
≥
1
h
/
d
in the sun during summer months over a lifetime or usual adulthood compared with
<
1
h
/
d
[
pooled
relative
risk
(
RR
)
=
0.84
; 95% CI: 0.77, 0.91]. Spending
≥
2
h
/
d
in the sun had a similar protective effect as 1 to
<
2
h
/
d
when compared with
<
1
h
/
d
(
RR
=
0.83; 95% CI: 0.75, 0.93 vs. 0.83; 95% CI: 0.78, 0.89). Exposure during adolescence was suggestive of a lower risk of breast cancer than exposure later in life (
≥
45
years
of age) (
RR
=
0.83; 95% CI: 0.71, 0.98 vs. 0.97; 95% CI: 0.85, 1.11). Ambient UVR was not associated with the risk of breast cancer (
RR
=
1.00; 95% CI: 0.93, 1.09).
Discussion:
To our knowledge, this was the first meta-analysis to estimate the risk of developing breast cancer associated with time spent in the sun. The results suggest that obtaining greater than an hour a day in the sun during the summer months could decrease the risk of developing breast cancer. https://doi.org/10.1289/EHP4861.
... In addition, vitamin D is reported to have anticancer activities against many cancer types, including breast cancer [4]. Reports from epidemiologic [5,6] and mechanistic studies [7] have demonstrated that vitamin D inhibits cancer cell proliferation, induces apoptosis, and decreases angiogenesis. ...
Emerging evidence associates vitamin D deficiency and vitamin D receptor (VDR) genetic variations with risk for breast cancer. This study investigated the prevalence of vitamin D deficiency and its association with tumor characteristics and the implications of VDR genetic variations for risk of breast cancer in Ethiopia. This unmatched case-control study involved 392 female breast cancer patients and 193 controls. The plasma 25-hydroxyvitamin D (25(OH)D 3) level was quantified in chemotherapy-naïve (N = 112) and tamoxifen-treated patients (N = 89). Genotyping for the VDR common variant alleles rs7975232 (ApaI), rs2228570 (FokI), and rs731236 (TaqI) was done. Eighty-six percent of the patients were vitamin D deficient (<50 nmol/L). Chemotherapy-naïve breast cancer patients had a higher prevalence of vitamin D deficiency (91.9% vs. 78.3%) compared to the tamoxifen-treated group (p < 0.001). The prevalence of severe vitamin D deficiency (<25 nmol/L) was significantly higher in chemotherapy-naïve (41.1%) than tamoxifen-treated (11.2%) patients. Vitamin D deficiency was not significantly associated with tumor characteristics or VDR genotype. The rs2228570 GG genotype was associated with increased risk of breast cancer (OR = 1.44, 95% confidence interval = 1.01−2.06). Our result indicates that rs2228570 might be a moderate risk factor for breast cancer development in the Ethiopian population. The high prevalence of severe vitamin D deficiency in treatment-naïve breast cancer patients indicates the need for nutritional supplementation of vitamin D at the time of chemotherapy initiation.
... Like aforementioned agents, there are strong biologic and animal studies suggest anti-cancer properties [61,63,74,82,105]. Several studies have reported an association between elevated levels of sunlight exposure and breast cancer incidence and mortality [10, 48,76]. In these studies, women with higher sun exposure had half the incidence of breast cancer (RR 0.50 CI 0.29-0.86) ...
Purpose of review
Potential strategies for prevention of breast cancer include lifestyle modification, preventive therapies (i.e., chemoprevention), and surgical prevention. Several therapies (such as selective estrogen response modifiers and aromatase inhibitors) have been shown to prevent breast cancer. However, tolerability and toxicity limit use and these therapies only prevent estrogen receptor–positive (ER) disease. There is emerging data regarding prevention properties of several non-hormonal agents. These agents generally have lower toxicities and seem to be effective for reduction of both ER+ and ER− disease and are often approved for use in other diseases. The purpose of this review is to discuss the data supporting the potential role of these non-hormonal agents for breast cancer prevention.
Recent findings
Several studies have demonstrated the potential of aspirin, vitamin D, metformin, and bisphosphonates to prevent breast cancer.
Summary
The outlined studies support biological mechanisms and show epidemiologic associations but randomized controlled trials are necessary before any of these agents can be recommended for breast cancer prevention. Given the wide spread use of these agents, significant consideration to trial design is needed (i.e., focus on high-risk populations and use of biomarker endpoints). Another important consideration may be the investigation of combinations of agents as suggested by others.
... Epidemiologic studies by Gorham et al. [3,4] and Garland et al. [5] were the first to propose that vitamin D prevents breast cancer. Since then, the mechanisms by which vitamin D might prevent the development and growth of breast cancer have been well documented [6] and numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations, the physiological measure of vitamin D status, and a lower risk of breast cancer [7][8][9][10][11][12][13][14][15][16][17][18]. ...
Background
While numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml.
Objective
To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older.
Methods
Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements.
Results
Within the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20–39, 40–59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin.
Conclusions
Higher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.
... [13] Effects of geographical latitude have also been reported for schizophrenia, neural tube defects, and prostate, breast and other cancers. [14][15][16][17][18] This effect of latitude on various disease incidences has been found to increase with increasing distance from the Equator in both the Northern and Southern hemispheres. [13] Variations in temperature from the Equa tor to the poles would, by extension, determine the soil content/texture and atmospheric content of the environment. ...
Background:
Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down the length of Africa.
Objectives:
To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN 2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools were used to depict regional variations in cancer morbidity and mortality.
Methods:
Data on 13 African countries between longitude 20⁰ and 30⁰ east and latitude 35⁰ north and 35⁰ south were examined for variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the 13 countries were compared.
Results:
Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors.
Conclusions:
Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental organisations and international agencies.
... [13] Effects of geographical latitude have also been reported for schizophrenia, neural tube defects, and prostate, breast and other cancers. [14][15][16][17][18] This effect of latitude on various disease incidences has been found to increase with increasing distance from the Equator in both the Northern and Southern hemispheres. [13] Variations in temperature from the Equa tor to the poles would, by extension, determine the soil content/texture and atmospheric content of the environment. ...
Background. Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is
a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that
the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down
the length of Africa.
Objectives. To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN
2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools
were used to depict regional variations in cancer morbidity and mortality.
Methods. Data on 13 African countries between longitude 20⁰ and 30⁰ east and latitude 35⁰ north and 35⁰ south were examined for
variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer
development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the
13 countries were compared.
Results. Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers
vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors.
Conclusions. Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in
Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental
organisations and international agencies.
... Als wichtigster exogen auslösender Faktor für die Melanomentstehung wir die UV-Exposition angesehen, insbesondere wenn eine kurzzeitige, intermittierende, intensive UV-Exposition gegeben ist ( Gilchrest et al., 1999;Nelemans et al., 1993) Zudem wurde auch eine Beziehung zwischen Vitamin D-Defizienz und dem vermehrtem Auftreten von verschiedenen Krebsleiden (u.a. Colon-, Prostata-, Mamma-und Ovarialkarzinomen) beschrieben ( Gorham et al., 1990;Garland et al., 1989Garland et al., , 1991Grant, 2002). Dass Sonnenexposition auch für Patienten, die bereits an einem malignen Melanom erkrankt sind, von Bedeutung sein könnte, haben Berwick et al. ...
... 42,43 Similar associations have been found with prostate cancers too. [43][44][45][46][47] CONCLUSION Various sun-avoidance strategies like use of sunscreen, staying indoors increases the risk of vitamin D deficiency, which is otherwise completely preventable. Since, it has been shown in various studies that vitamin D has a wide and varied role in the body; vitamin D deficiency is destined to have serious consequences. ...
Vitamin D deficiency is highly prevalent in Indians. The role of vitamin D in infectious diseases is a well-known fact. However, more recently, several studies have linked vitamin D deficiency with various non-communicable diseases like hypertension, cardiovascular diseases, diabetes, cancer and psychiatric illnesses amongst others. Indians are known to be prone to developing non-communicable diseases so a co-existing vitamin D deficiency will lead to a synergistic effect towards developing the same. Since vitamin D deficiency is completely preventable, opportunistic screening of people, screening the vulnerable population like the pregnant women and the elderly, patients with hepatic or renal failure, patients on retroviral or immunosuppressant therapy can be useful. Health education and promotion activities should be done to bring awareness in the community. This might as well reduce the growing burden of non-communicable diseases in India.
... Mammographic breast density is one of the strongest breast cancer risk indicators. As for breast density, observational studies have seen reduced risk of breast cancer with increased vitamin D exposure [increased sun exposure (27)(28)(29), vitamin D intake (30,31), or status (31,32)]. Several mechanisms have been proposed by which vitamin D could plausibly impair cancer development and growth (33). ...
Background: This double-blind, placebo-controlled parallel group trial assessed whether oral supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 over one year reduces percent mammographic breast density in premenopausal women.
Methods: The trial was conducted between October 2012 and June 2015, among premenopausal female volunteers from Quebec City (Quebec, Canada). Women were randomized with ratio 1:1:1:1 to one of four study arms (1,000, 2,000, or 3,000 IU/day vitamin D3 or placebo). The primary outcome was mean change in percent mammographic breast density. Participants and research team were blinded to study arm assignment.
Results: Participants (n = 405) were randomized to receive 1,000 (n = 101), 2,000 (n = 104), or 3,000 IU/day (n = 101) vitamin D3, or a placebo (n = 99). The primary analysis included 391 participants (96, 99, 100, and 96, respectively). After the one-year intervention, mean ± SE change in percent breast density in the arms 1,000 IU/day (–5.5% ± 0.5%) and 2,000 IU/day (–5.9% ± 0.5%) vitamin D3 was similar to that in the placebo arm (−5.7% ± 0.5%) (P values = 1.0). In the 3,000 IU/day vitamin D3 arm, percent breast density also declined but slightly less (–3.8% ± 0.5%) compared with placebo arm (P = 0.03). Adherence to intervention was excellent (92.8%), and reporting of health problems was comparable among study arms (P ≥ 0.95). All participants had normal serum calcium.
Conclusions: In premenopausal women, one-year supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 resulted in a reduction of percent breast density no greater than that seen with the placebo.
Impact: At doses of 1,000–3,000 IU/day, vitamin D supplementation will not reduce breast cancer risk through changes in breast density. Cancer Epidemiol Biomarkers Prev; 26(8); 1233–41. ©2017 AACR.
... The strongest and most consistently identified individual risk factors include age, reproduction-related factors (e.g., parity, age at menarche, age at first childbirth, exogenous hormone use), family history of breast cancer, and lifestyle factors such as alcohol consumption, anthropometry, and physical activity (Claus et al., 1991;Kelsey, 1979). Ecological studies have found decreasing breast cancer incidence with increasing proximity to the Equator (Gorham et al., 1990;Mandal et al., 2009;Mohr et al., 2008). Since latitude is an influential determinant of cutaneous vitamin D production, these ecologic findings supported the hypothesis that exposure to vitamin D reduces breast cancer risk. ...
Although there are few environmental risk factors for breast cancer, some epidemiologic studies found that exposure to solar UV radiation (UVR) may lower risk. Prior epidemiologic studies are limited by narrow ambient UVR ranges and lack lifetime exposure assessment. To address these issues, we studied a cohort with residences representing a wide range of ambient UVR. Using the nationwide U.S. Radiologic Technologists study (USRT), we examined the association between breast cancer risk and UVR based on ambient UVR, time outdoors, a combined variable of ambient UVR and time outdoors (combined UVR), and sun susceptibility factors. Participants reported location of residence and hours spent outdoors during five age periods. Ambient UVR was derived by linking satellite-based annual UVR estimates to self-reported residences. Lifetime values were calculated by averaging these measures accounting for years spent in that location. We examined the risk of breast cancer among 36,725 participants (n=716 cases) from baseline questionnaire completion (2003-2005) through 2012-2013 using Cox proportional hazards models. Breast cancer risk was unrelated to ambient UVR (HR for lifetime 5th vs 1st quintile=1.22, 95% CI: 0.95-1.56, p-trend=0.36), time outdoors (HR for lifetime 5th vs 1st quintile=0.87, 95% confidence interval (CI): 0.68-1.10, p-trend=0.46), or combined UVR (HR lifetime 5th vs 1st quintile =0.85, 95% CI: 0.67-1.08, p-trend=0.46). Breast cancer risk was not associated with skin complexion, eye or hair color, or sunburn history. This study does not support the hypothesis that UVR exposure lowers breast cancer risk.
... 25(OH)D has therefore emerged as a promising regimen to treat cancers with CYP27B1 expression. This concept is supported by the epidemiological studies showing Vitamin D deficiency is associated with higher incidence of cancers [20][21][22][23], for which the explanation was Vitamin D deficiency represented lower circulated 25(OH)D concentration, leading to the fewer converted 1α,25(OH) 2 D 3 in the extra-renal tissues due to the fewer substrates for CYP27B1 to convert. Our data clearly showed that 25(OH)D could effectively repress growth of SNU308 cells in vitro ( Figure 1A). ...
Cholangiocarcinoma (CCA) is a devastating disease without effective treatments. 1α,25(OH)2D3, the active form of Vitamin D, has emerged as a new anti-cancer regimen. However, the side effect of hypercalcemia impedes its systemic administration. 25(OH)D is biologically inert and needs hydroxylation by CYP27B1 to form 1α,25(OH)2D3, which is originally believed to only take place in kidneys. Recently, the extra-renal expression of CYP27B1 has been identified and in vitro conversion of 25(OH)D to 1α,25(OH)2D3 has been found in some cancer cells with CYP27B1 expression. In this study, CYP27B1 expression was demonstrated in CCA cells and human CCA specimens. 25(OH)D effectively represses SNU308 cells growth, which was strengthened or attenuated as CYP27B1 overexpression or knockdown. Lipocalcin-2 (LCN2) was also found to be repressed by 25(OH)D. After treatment with 800 ng/mL 25(OH)D, the intracellular 1α,25(OH)2D3 concentration was higher in SNU308 cells with CYP27B1 overexpression than wild type SNU308 cells. In a xenograft animal experiment, 25(OH)D, at a dose of 6 μg/kg or 20 μg/kg, significantly inhibited SNU308 cells’ growth without inducing obvious side effects. Collectively, our results indicated that SNU308 cells were able to convert 25(OH)D to 1α,25(OH)2D3 and 25(OH)D CYP27B1 gene therapy could be deemed as a promising therapeutic direction for CCA.
... Colorectal cancer mortality rates in the United States are known to increase with increased latitude and decreased atmospheric penetration of UV light (Garland and Garland, 1980). Geographic investigations of breast cancer mortality in the United States and Eastern Europe have also found that risk of fatality due to this disease is inversely proportional to the regional intensity of sunlight Gorham et al., 1990;John et al., 1999). ...
Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol, 2016. © 2016 Wiley Periodicals, Inc.
... In 1980, Garland and Garland reported the association between latitude and colon cancer using sun exposure as a proxy for vitamin D status [7]. By 1990 it had been hypothesized that deficiency of vitamin D was the main cause of breast cancer [35][36][37]. ...
doi: 10.1080/07315724.2015.1039866
The major cause of vitamin D deficiency is the lack of proper and ample exposure to sunlight. Only certain foods naturally contain vitamin D, and foods fortified with vitamin D are often insufficient to satisfy vitamin D requirements. Advertently or inadvertently, people avoid taking adequate sunlight, which is essential to attain the required level. Given the colossal ramifications of vitamin D deficiency, people must optimize their daily intakes to protect themselves from diseases resulting from vitamin D shortage. Vitamin D is critically significant for the absorption of dietary calcium and phosphate in circulation; it enables bone mineralisation by providing pertinent minerals to bone-forming and maintaining sites. The need for vitamin D must be prevented from occurring to enjoy a healthy life. It is also important that social institutions play a crucial role in custodianship by providing education, nutritional guidelines, and adequately monitoring the appropriateness of the preparation of vitamin D supplements. In this article, we attempt to address various health benefits that vitamin D brings and the dramatic health consequences on children and adults alike when there is vitamin D deficiency.
Cancer is a disease which occurs when cells grow uncontrollably.Viruses, infections exposure to the chemicals and radiations, Unhealthy dietary & hereditary factors, and hormones are alsoamong the causative agents of cancer. Eat to beat cancer! There are various foods and nutrients that can kill cancer.Food plays avital role in preventing some cancers, diet is an important way by which one can use to reduce the risk of cancer. It has been reported through various studies regarding the fact that around 50 percent of all cancers can be prevented through lifestyle and dietary modifications.Obesity, junk foods such as concentrated sugars and refined products that contribute disruption of glucose metabolism which causes diabetes, low fiber intake, and imbalance of omega 3 and omega 6 fats all leads to increase cancer risk. Intake of flax seed, and abundant amount of fruits and vegetables will decrease the cancer risk. Green leafy vegetables are especiallyvery beneficial. selenium, folic acid, vitamin B-12, vitamin D, chlorophyll, and antioxidants they acts as supplements in enhancing the health status of the body consumptions of many digestive enzymes and probiotics can decrease the risk of cancer.
Background
Ambient ultraviolet (UV) radiation has been increasing due to climate change. While this may result in adverse health consequences such as an increased incidence of skin cancer, UV radiation is also a source of vitamin D, which has been hypothesized to be protective for breast cancer risk.
Methods
Using a spatiotemporal kriging model, we estimated residential UV exposure levels for the enrollment addresses (2003–2009) of breast cancer-free women aged 35–74 years participating in the Sister Study and living in the contiguous United States (N = 48,450). Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk associated with UV exposure levels (mW/m²) categorized in quintiles. We examined the association for breast cancer overall (invasive and ductal carcinoma in situ) and by estrogen receptor (ER) status of the tumor. We considered effect modification by regular (≥4 times/week) vitamin D supplement use.
Results
Over a median of 10.5 years of follow up, 3,510 incident breast cancer diagnoses were reported. We found no evidence of an association between living in areas with higher levels of UV radiation and overall breast cancer risk (HRQ5 vs. Q1 = 1.00, 95% CI: 0.90, 1.11). Higher UV levels were inversely associated with the risk of ER- breast cancer (HRQ5 vs. Q1 = 0.73, 95% CI: 0.55–0.99), but not ER+ (HR Q5 vs. Q1 = 1.04, 95% CI: 0.92–1.18). For ER- breast cancer, the inverse association was only evident in women who did not regularly take vitamin D supplements (HRQ5 vs. Q1 = 0.52, 95% CI: 0.33–0.81) compared with those who did regularly take vitamin D supplements (HRQ5 vs. Q1 = 1.02, 95% CI: 0.68–1.54; p-for-heterogeneity = 0.12).
Conclusions
The findings from this study support a role for UV exposure and vitamin D in the etiology of ER- breast cancer.
This study is based on the statement that arid environment and type of mineral content of rocks work together as a catalyst for absorption of higher rates of solar irradiation that will inevitably increase vulnerability to cancer morbidity in the Northern State of Sudan. Sources are published data on climate and geology of Sudan, records of the Ministry of Health and National Population-based Cancer Registry (NCR), and the Internet. Analytical and derivational approaches were applied. The results reveal that the Northern State is a typical arid environment where four solar irradiation regions were distinguished, receiving the highest levels of solar irradiation over the Sudan. The population of the Northern State are susceptible to solar irradiation rates of 6.4 and 6.2 GHI respectively. The majority of rocks belong to silicate minerals groups with dominance of granite rocks with a chemical composition by weight of 72.04% of silica (SiO 2). The general average of the solar absorb factor for the three major rock groups was 63.33%. They are inherently acquiring higher ability of absorption of solar irradiation. A general conclusion is that the ecological approach for understanding the etiology of cancer in Sudan is critical.
Background
The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan.
Methods
A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration.
Results
Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43).
Conclusions and recommendation
Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer. In Pakistani women, where vitamin D deficiency is common, raising and maintaining serum vitamin D at population level is a safe and affordable strategy. It may play a role in reducing the incidence of both vitamin D deficiency and breast cancer, particularly among poor women where the breast cancer mortality is highest due to limited resources for early detection, diagnosis, and treatment. The effects of vitamin D with regard to breast cancer risk in Karachi Pakistan should be further evaluated.
During the last 15 years, it has become evident that the biologically most active form of vitamin D3, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], exerts effects on a variety of tissues apparently unrelated to calcium homeostasis. 1, 25(OH)2D3 has been shown to promote cellular differentiation and inhibit proliferation of hematopoietic cells, cancer cells, and keratinocytes. In addition, studies with animal models for cancer have shown that 1,25 (OH)2D3 administration can prolong the survival of leukemic mice and suppress the growth of tumors of different origin, including breast, colon, skin, and lung (1, 2).
The relationship between ß-carotene or carotenoids and the risk of BC has been assessed in different types of studies. Some cohort studies reported non significant RRs of 0.8–0.9 for the highest consumptions of carotenoids [1, 2]. A sample of women analyzed in the Women’s Health Initiative study reported that the analyses of repeated measurements indicated that serum α-carotene and ß-carotene were inversely associated with BC [3].
In order to give personalized preventive recommendations, on a basis of country-specific research findings and putative risk and protective factors which are mostly modifiable, we developed an individual risk profile report oriented to lower the woman’s risk level of breast cancer as much as possible. The available data are requested through a thorough questionnaire on sociodemographics, family history of cancers, reproductive history, diet, lifestyle and occupation, completed with a detailed anthropometric assessment, which allows calculation of body composition and somatotype. Additional information is obtained from non-clinical tests as mammography and selected laboratory results. A series of 20 items – which includes family history of cancer; reproductive factors; intake of: red meat, white meat, dairy foods, oils and fats, high glycemic load foods, vegetables and fruits; alcohol consumption; physical activity; psychosocial stressors; metabolic disturbances; other medical factors; fat-to-muscle ratio; serum vitamin D level; urine 2:16 α-OH estrogens ratio; serum triglycerides/HDL ratio; fasting insulinemia, and mammographic density – is taken into account to compose a tailored risk profile, which enables us to give the patient a number of useful guidelines. Patients should undergo a follow-up during a minimum time of 1 year, with the aim of checking whether the expected changes are having place or not. Although generalizability of the proposal is limited in the case by populational features of Uruguayan women, it is feasible from a practical viewpoint, taking into account the necessary resources for its application.
The occurrence of cancer of the breast has long been known [1–4] and the disease affects women of all races and nationalities and the incidence of has increased 30–40 % since the 1970s [2, 4–7]. This already dismal picture is worsened by the gradual increase in breast cancer incidence in most Western countries and in societies that recently became westernized or that are in the process of westernization [8, 9]. Epidemiological observations that daughters of women who migrate from low-incidence to high-incidence countries acquire the breast cancer risk prevailing in the new country [10], suggest that aspects of lifestyle or the environment are major determinants of breast cancer risk. A study of population-attributable risks has estimated that at least 45 % to 55 % of breast cancer cases in the United States may be explained by the following factors: advanced age at the time of the first full-term pregnancy, nulliparity, family history of breast cancer, higher socioeconomic status, earlier age at menarche, and prior benign breast disease [11]. Other statistical models appear to explain an even higher proportion of breast cancer on the basis of known risk factors [12]. Studies of atomic bomb survivors have shown that environmental exposures, such as ionizing radiation, are a risk factor for breast cancer [13]. Exposure to radiation at a young age (Fig. 1.1) has been identified as a causative agent of breast cancer in selected populations [14–17], but there is no definitive proof of what causes breast cancer in the population at large. The increased risk associated with exposure to environmental chemicals, such as alcohol [18] and cigarette smoke [19–25], makes these agents suspects for causing cancer in the human population (Fig. 1.1).
Because of the distinctive geographic pattern of breast cancer, which generally increases with increasing latitude and consequently decreasing ultraviolet B light, it was proposed that vitamin D may alter breast cancer risk [1, 2]. The geographic pattern of breast cancer incidence and mortality [1, 2] was noted to be strikingly similar to that of colon cancer, for which dietary intake of vitamin D has been reported to be protective. A study of serum levels of 25-hydroxyvitamin D concentrations showed an inverse association with colon cancer incidence [3]. Animal studies have supported a possible protective effect of dietary vitamin D in mammary tumor development [4]. Milk is fortified with vitamin D in the United States, although it it has not been fortified in Europe, except in some northern countries. A case-control study in an area with some vitamin D added to milk found that consumption of 3 or more 8-oz. glasses a day of milk was associated with a 23 per cent reduction in risk of breast cancer [5]. These lines of evidence led to this prospective study which examined the association of milk consumption, the primary source of dietary vitamin D in the U. S. diet, and breast cancer incidence. The study was performed in a cohort of elderly women who were followed for 16 years in Rancho Bernardo, California, USA.
Age-adjusted mortality rates of colorectal [1] breast [2, 3] ovarian [4] and prostate cancer [5-7] rise with increasing distance from the equator and tend to be highest in areas with the least winter sunlight. Distinctive changes in mortality rates from colon cancer occur in migrants from low-risk to high-risk areas of the world [8]. Breast cancer rates in the daughters of women who migrate across approximately 10 degrees of more of latitude differ dramatically from rates in the parents’ country of origin, and, in general, from rates in the mother [9]. These and other findings suggest that both diseases have a largely environmental or dietary etiology [8,9]. Mortality rates from both cancers rise in migrants from low to high latitudes and decline with migration from high to low latitudes.
Breast cancer incidence rates in the United States have increased at a rate of 1% per year since 1940 [1]. Despite considerable advances in early detection and in therapeutic modalities, the mortality caused by this disease has remained almost unchanged for the past five decades [2, 3]. This already dismal picture is worsened by the gradual increase in breast cancer incidence in most Western countries and in societies that recently became westernized or that are in the process of westernization [2, 3]. Epidemiological observations that daughters of women who migrate from low-incidence to high-incidence countries acquire the breast cancer risk prevailing in the new country [4], suggest that aspects of lifestyle or the environment are major determinants of breast cancer risk. A study of population-attributable risks has estimated that at least 45% to 55% of breast cancer cases in the United States may be explained by the following factors: advanced age at the time of the first full-term pregnancy, nulliparity, family history of breast cancer, higher socioeconomic status, earlier age at menarche, and prior benign breast disease [5].
The activities of vitamin D and synthetic vitamin D analogs (deltanoids) are primarily mediated through binding to vitamin D receptors (VDRs), members of the steroid/thyroid receptor superfamily. Chemopreventive properties of this class of compounds include in vitro and in vivo antiproliferative, pro-apoptotic, pro-differentiating, and anti-angiogenic activities. Natural vitamin D and a number of deltanoids have shown chemopreventive efficacy in preclinical studies. Although also supported by substantial epidemiologic data, the development of natural vitamin D as a cancer chemopreventive has been hindered by dose-limiting hypercalcemic effects. Unfortunately, these same safety concerns also apply to many deltanoids, including those approved for treatment of secondary hyperparathyroidism in patients with end-stage renal disease. However, several new synthetic deltanoids have recently shown promise in preclinical safety and chemopreventive efficacy studies.
Breast cancer is a devastating disease. New approach in therapy are needed. In this chapter, we describe our efforts to identify novel vitamin D3 analogs which may have a potent antiproliferative effect on breast cancer without causing hypercalcemia.
The ecologic approach is applied to determining for which cancers solar UV-B radiation reduces the risk. Cancer mortality rates from 16 western European countries for 1989–91 are used along with dietary supply factors for 1979–81, and latitude is used as an index of solar UV-B radiation. This study is a follow on to a recent study using cancer mortality rates in 500 state economic areas in the U.S.A. along with DNA-weighted UV-B radiation for July 1992 from the Total Ozone Mapping Spectrometer (TOMS) in which a protective role for UV-B was found for 12 types of cancer (Grant, submitted). Increasing latitude is found to be a risk factor for 7 types of cancer identified in Grant (submitted), cancers of the breast, colon, esophagus, kidney, ovary and prostate, and non-Hodgkin’s lymphoma (NHL), as well as 2 additional cancers, cancer of the pancreas and multiple myeloma. Those cancers for which the U.S.A. results could not be confirmed tend to be the minor cancers. These results should form the basis for further studies on the protective role of solar UV-B radiation and/or vitamin D against cancer.
Objective:
The aim of this review was to determine the link between night/shift work and breast cancer.
Methods:
The analysed articles were taken from the PUBMED database between 1996 and 2015. The keywords used were "breast cancer risk", "night work" and "shift work". In total, 25 articles were selected.
Results:
Night/shift workers are more at risk to develop a breast cancer (relative risk (RR) between 1.09; 95 % CI: 1.02-1.20 and 1.48; 95 % CI: 1.36-1.61 in the meta-analyses). However, this risk is not found by some cohort and case-control studies. The circadian rhythm disruption, responsible of disorderliness of melatonin secretion, could be one of the mechanisms involved in the increase of that risk. Hormonal status of night/shift workers, their geographic origin, their lifestyle and their vitamin D deficiency appear as other mechanisms potentially responsible for increased risk of cancer in this professional population. Moreover, a dose-effect connection may exist, with an increase of the risk with the number of years of night/shift work.
Conclusion:
Night/shift work is associated with a moderate increased risk of breast cancer, especially among women who worked over 20 years. Recommendations concerning the breast monitoring in this population could be diffused. The benefit of melatonin supplementation remains to be assessed.
The book is the first one published exclusively on the field of nutritional epidemiology of breast cancer. It summarizes the currently existing knowledge, with an updated and comprehensive international bibliography (1.000 references). The authors also performed a review on the epidemiological studies on nutrition and breast cancer carried out in Uruguay between 1994 and 2011, which allowed exploring and identifying the main risk and protective factors for the disease in this high-risk country. Epidemiologists, Nutritionists, Public Health managers and breast specialists from the prevention to the treatment fields will find in this book a unique source of technical information, which will contribute in expanding their knowledge and view of the disease. © Springer Science+Business Media B.V. 2012. All rights reserved.
The fetal-origin hypothesis has reshaped the way of scientific thinking by identifying that the in utero and postnatal metabolic environment can be memorized by the developing organism through fetal and neonatal imprinting. In light of this hypothesis, prenatal and postnatal events can be thought of as the foundation for structural and functional development of an organism. An example of such a prenatal event includes a nutritional inadequacy that may have long-term consequences for health. For example, vitamin D inadequacy during prenatal and early neonatal life has been associated with an increased risk for nutritional rickets, failure to thrive, osteomalacia and osteoporosis. Emerging evidence also suggests that long-term vitamin D inadequacy is implicated in many chronic diseases including cancer. This chapter discusses the role of vitamin D in nutritional imprinting and, specifically, the potential effect of vitamin D in modulating risk of prostate cancer.
The clinical and societal impact of malignancy continues to be highly significant in the developed world and is becoming increasingly so in the developing world, despite significant progress in understanding disease etiology and generating novel therapies. The reasons for the sustained burden are numerous; they include the demographic transition occurring in many countries and the intrinsic complexity of the disease. The increased understanding of cancers has led to the development of a number of high-profile “targeted” therapies that are aimed at specific molecular lesions. Although many of these have generated significant clinical results, the development lead on these drugs also has significant associated financial costs that may prohibit their worldwide usage. This may change in the future as development lead times are reduced and targeting strategies improve. In the short-to-medium term, there is a need to understand the etiology of high-profile malignancies and develop preventative and therapeutic options that perhaps focus on shifting cancer from an acute to chronic disease.
This chapter explores the literature on ultraviolet (UV) irradiance in urban ecosystems with respect to the likely effects on human health. The focus was the question of whether the health effects of UV radiation should be included in the planning of landscape elements such as trees and shading structures, especially for high use pedestrian areas and school play grounds. Ultraviolet radiation can have a strong effect on humans, primarily as a cause or contributing factor for skin cancer and eye cataracts. It is also a probable factor in the development of immune deficiencies. However, UV can also positively affect human health, primarily because it is essential for photosynthesis of vitamin D in human skin. Vitamin D has long been recognized as a requirement for bone health. Recent epidemiological findings attribute vitamin D for the reduction of many types of non-skin cancers. Moreover, there is evidence that it may reduce mortality for those diagnosed with melanoma skin cancer. Alternatively, some public health authorities, particularly those from countries with a large population of northern European descent, strongly recommend that exposure to UV radiation should be minimized to prevent skin cancer. Other agencies, including the World Health Organization, that take a broader world view, differentiate their recommendations according to skin color. They recommend that humans with darker skin, who are likely deficient in vitamin D and also have little access to vitamin D fortified foods, should have moderate UV exposure. Judging from current knowledge of typical spectra of solar radiation in tree shade and the difference between the action spectra (effectiveness versus radiation wavelength) for vitamin D synthesis and that for sunburn in human skin, tree shade has advantages for moderate exposure to solar radiation. Where trees are separated, as is typical in heavily populated urban areas, the shortest wavelengths of UV radiation are scattered from the sky into shady locations with some sky view, and to a small extent, vitamin-D-promoting wavelengths are increased over the radiation spectrum that causes sunburn. The sunburn action spectrum includes longer wavelengths that are less readily scattered into direct beam shade. Global climate change, which is expected to increase temperatures, especially at higher latitudes, may have a variety of effects on UV exposure for human populations. For example, warming could lead to greater exposure as people adapt to increased temperatures by wearing less clothing. However, empirical evidence for a temperature influence on human exposure independent of radiation climate does not seem to exist.
Breast cancer and type II diabetes are two of the main chronic diseases in women and are suspected to share common risk factors. But their etiologies are still partially unknown, in particular concerning some dietary factors and some parameters of the metabolic syndrome. If evidence is convincing that themetabolic syndrome is associated with an increased type II diabetes risk, questions remain unanswered regarding cholesterol level, anthropometric factors and breast cancer risk. The French E3N cohort database was thus used to evaluate the associations between alcohol, coffee, meat consumption and serum concentration and dietary intake of vitamin D on the risks of breast cancer and type II diabetes. We showed that a high coffee consumption was associated with a decreased risk of type II diabetes, and that a high vitamin D blood level was associated with a decreased risk of breast cancer. Whereas null or moderated alcohol consumption was not related to type II diabetes risk, an increase in alcohol consumption was associated with an increased breast cancer risk. Our results suggested limiting processed meat consumption. They also favoured recommendation towards low body mass index ora low hip circumference by a healthy diet and a regular physical activity so as to decrease breast cancer and type II diabetes risks.
The well known associations of breast cancer with fertility patterns and diet are interdependent and it is difficult to estimate the extent to which breast cancer is related to diet. This was attempted by analysing breast cancer rates in populations of single (never married) women for which the contribution of childbearing would be small. Age specific breast cancer rates for single women showed the same variation by country, social class, urban-rural area and with time, as did the corresponding rates for married women, suggesting that common or related factors determined breast cancer rates in single and married women. Also, dietary correlations of breast cancer rates at 55-64 years, around 1960, were not sifnificantly different for single women and the general female population. This supported the view that the dietary associations with breast cancer, observed in larger studies of general female populations, did not arise indirectly from an association with childbearing rates. It was pointed our that the positive association of breast cancer with sugar, observed for single and for all women, was accopanied by a negative association with starch. These opposite associations with two forms of varbohydrate seemed inconsistent on general nutritional grounds and could be explained as arising indirectly to the association of breast cancer with affluence. Otherwise, it would seem necessary to establish a nutritional difference between starch and sugar, which could reasonably influence breast cancer rates, before the association was accepted as indicating cause.
A previous publication has shown that there has been a great increase in the incidence of breast cancer in Iceland. The present study was undertaken to evaluate the importance of known risk factors connected with the reproductive history of the women. In a prospective investigation of a cohort of 31,453 women we confirmed previous findings of the increased risk following higher age at first pregnancy and for nulliparous women. The age at first pregnancy and the proportion of nulliparous women have decreased with time in the Icelandic population so that these factors should have tended to decrease the risk, making the found increase still more important. The effect of parity is that the risk decreases with larger number of children and this effect is independent of the effect of age at first pregnancy. Lower age at menarche increases the breast cancer risk, but the contribution of that factor to the overall risk is negligible.
Malignant and benign human breast tumours as well as rabbit breast tissue were examined for specific receptors for 1,25-dihydroxyvitamin D3 using competitive binding studies and sucrose density gradient analysis. Classical high affinity, low capacity receptors for 1,25-dihydroxyvitamin D3 were found in breast and node tissue in seven of ten patients with breast cancer and in all three patients with benign neoplasms. An inflammatory breast mass showed no binding. Similar receptors were found in breast tissue from pregnant and lactating rabbits. Taken with other recent data, these results suggest that 1,25-dihydroxyvitamin D3 may activate calcium transport in the malignant as well as in the normal lactating breast.
A hospital-based case-control study of breast cancer was undertaken in Rangoon. The age-standardized incidence rate, 25.1 per 100,000 woman-years and the shape of the age-incidence curve show that Rangoon women have an intermediate level of breast cancer risk compared to women of other countries in the world. The analysis is based on 193 cases and 400 controls. Breast cancer risk was found to be directly related to educational attainment. There was an increased risk associated with early menarche and late menopause. The most striking finding was the strong inverse relationship between risk and parity; women who had six or more children have only one-third the breast cancer risk of married women who had less than four children. This association is not confounded by case-control differences in age at birth of first child. The association of breast cancer risk with age at first birth was not striking; only women with a first birth after age 30 were at increased risk. Breast cancer risk was unrelated to lactation. Overall, the epidemiology of breast cancer in Burma is similar to that in most other countries. However, the possibility of an unusual relationship of risk to parity and age at first parturition warrants further exploration.
The risk of breast cancer in Finland is low (40·1/100,000) compared with the other Nordic countries. A case-control study
was carried out on 122 cases of breast cancer and 534 controls between the ages of 41 and 60. It was found that age at first
marriage and birth of the first child as well as the number of abortions and parity adjusted for age at first birth were associated
with the breast cancer risk, whereas lactation was not The results did not confirm the hypothesis (de Waard) that overweight
and/or the size of the woman influence the risk of breast cancer.
In 1980, 89,538 U.S. women 34 to 59 years of age, with no history of cancer, completed an independently validated dietary questionnaire that included the use of beer, wine, and liquor. During the ensuring four years, 601 cases of breast cancer were diagnosed among cohort members. Among the women consuming 5 to 14 g of alcohol daily (about three to nine drinks per week), the age-adjusted relative risk of breast cancer was 1.3 (95 percent confidence limits, 1.1 and 1.7). Consumption of 15 g of alcohol or more per day was associated with a relative risk of 1.6 (95 percent confidence limits, 1.3 and 2.0; Mantel extension chi for linear trend = +4.2; P less than 0.0001). Adjustment for known breast cancer risk factors and a variety of nutritional variables did not materially alter this relation. Significant associations were observed for beer and liquor when considered separately. Among women without risk factors for breast cancer who were under 55 years of age, the relative risk associated with consumption of 15 g of alcohol or more per day was 2.5 (95 percent confidence limits, 1.5 and 4.2). These prospective data derived from measurements of alcohol intake recorded before the diagnosis of breast cancer confirm the findings of several previous case-control studies. Viewed collectively, they suggest that alcohol intake may contribute to the risk of breast cancer.
The distribution of death certification rates from various cancers or groups of cancers in broad Italian geographical areas (north/centre/south) was analysed. In both sexes, total cancer mortality was considerably elevated in the north of the country compared to southern regions (around 70% for males and 30% for females in the truncated 35-64 rate), and generally intermediate in central areas. Northern mortality rates were higher for respiratory cancers and other tobacco related neoplasms (excluding bladder), with a north/south ratio ranging from 1.5 for lung and most respiratory sites to about 4.0 for oesophageal cancer in males. There was little tendency towards a leveling of these differences in younger (40-49 year old) males. Northern areas showed higher death certification rates for cancers of the stomach, large bowel, liver and most other digestive sites. The lower gastric cancer mortality registered in southern Italy is curious, since this is the poorest part of the country. Death certification rates from all other common neoplasms (uterus apart) were also elevated in the north. The geographical variation, however, appeared more limited for non-epithelial neoplasms. The substantial differences in cancer mortality between various Italian geographical areas can hardly be dismissed as due to lower death certification accuracy in the south. Some of the differences can be explained in terms of available knowledge of the causes of cancer (eg reproductive factors for breast and ovarian neoplasms, alcohol plus tobacco for oesophageal cancer). However, the lower mortality from respiratory cancers in southern areas can only with some difficulty be totally explained in terms of tobacco consumption. Likewise, the north/south variation cannot be related to non-specific consequences of industrialization, since cancer mortality was similarly elevated in highly industrialized and chiefly rural northern areas. It is conceivable that dietary factors may also explain some of the differences. However, at present, there is no obvious general explanation for this quite peculiar geographical distribution of cancer mortality within a single country.
PIP
The authors examine variations in mortality due to cancer among the northern, central, and southern regions of Italy. Using data from official death records for the years 1969-1978, the authors calculate age-standardized mortality rates for all ages and for ages 35-64, and age-specific mortality rates for men and women aged 40-49. The results are presented by sex and region for 29 categories of cancer. The analysis shows a clear north-south gradient with consistently higher mortality rates in the north, lower rates in the south, and intermediate values in the central region. More detailed findings according to sex, age, and type of cancer are discussed, and possible reasons for the geographical variations, including regional patterns concerning diet, alcohol consumption, and smoking, are considered.