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Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China

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Abstract

Background

Studies finding an inverse correlation of ambient solar irradiance with cancer mortality were the first to suggest that sun exposure and probably, therefore, vitamin D might protect against some cancers. Such correlation has been shown in Asian populations in some studies. We analyzed the correlation between mortality and incidence from a number of cancers and ambient solar ultraviolet (UV) B irradiance in China.

Methods

Cancer mortality data were obtained from the Second National Death Survey conducted in a sample of 263 counties in China from 1990 to 1992. National cancer registration data 1998–2002 in China were used for estimation of cancer incidence. Satellite measurements of cloud-adjusted ambient UVB intensity at 305 nm were obtained from a NASA database and GIS methods used to estimate the average daily irradiance for the 263 counties in 1990. We estimated cancer mortality rate ratios per 10 mW/(nm m2) change in UVB by fitting a negative binomial regression model with mortality as the response variable and UVB as the independent variable, adjusted for sex, age, and urban or rural area.

Results

Mortality rates for all cancers and cancers of the esophagus, stomach, colon and rectum, liver, lung, breast, and bladder were inversely correlated with ambient UVB. This correlation was present in men and women and rural residents for all these cancers but not urban residents for cancers of the esophagus, colon and rectum and liver. Lung cancer mortality showed the strongest inverse correlation with an estimated 12% fall per 10 mW/(nm m2) increase in UVB irradiance even if adjusted for smoking. Only incidence rates for cancers of the esophagus, stomach, colon and rectum and cervix were inversely correlated with ambient UVB. Mortality and incidence from nasopharyngeal cancer increased with increasing UVB [respectively 27 and 12% per mW/(nm m2)]. Mortality from cancer of the cervix also increased, but to a lesser extent and mortality from leukemia was not consistently correlated with UVB irradiance.

Conclusion

Mortality from all cancers together and most major cancers in China was inversely associated with solar UVB. These associations were similar to those observed in a number of populations of European origin. Incidence of some cancer types had the same correlation with UVB. They suggest the possibility that vitamin D may reduce the incidence or improve the outcome of cancer in Chinese people.

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Acknowledgments

Wanqing’s study is supported by Chinese National 8th 5 years Programs for Science and Technology Development No. 85-914-01-07. Mark Clements was supported by Australian National Health and Medical Research Council Capacity Building Grant in Population Health Research No. 262121 and Career Development Award No. 471491, both of which are funded by the Australian National Health and Medical Research Council. Bruce Armstrong’s research is supported by a University of Sydney Medical Foundation Program Grant.

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Authors and Affiliations

  1. National Office for Cancer Prevention and Control, Cancer Institute, Chinese Academy of Medical Sciences, No.17 Pan-Jia-Yuan South Lane, 100021, Chaoyang District, Beijing, China

    Wanqing Chen & Siwei Zhang

  2. National Centre for Epidemiology and Population Health, Australian National University, East Road, Acton, ACT, 2601, Australia

    Mark Clements

  3. School of Public Health, The University of Sydney, City Road, Camperdown, NSW, 2006, Australia

    Wanqing Chen, Mark Clements, Bayzidur Rahman & Bruce K. Armstrong

  4. Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, No.17 Pan-Jia-Yuan South Lane, 100021, Chaoyang District, Beijing, China

    Youlin Qiao

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Correspondence to Wanqing Chen.

Appendix

Appendix

The association between UVB irradiance and lung cancer mortality is potentially confounded by smoking. Assuming that there is no effect modification between UVB and smoking on lung cancer mortality, we can model the lung cancer mortality rateLC by RRUVB [p smoking RRsmoking + (1−p smoking)] ≅ RRUVB p smoking RRsmoking, where RRUVB is the rate ratio for UVB exposure, p smoking is the prevalence of smoking and RRsmoking is the rate ratio for smoking. If we model the UVB rate ratio by exp(a + b × UVB) and smoking prevalence by exp(c + d × UVB) for constants b and d and intercepts a and c, then rateLC = RRsmoking exp(a + c+(b + d)UVB). We can then estimate an adjusted UVB rate ratio using exp(b + d)/exp(d), which requires modeling the change in smoking prevalence by UVB.

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Chen, W., Clements, M., Rahman, B. et al. Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China. Cancer Causes Control 21, 1701–1709 (2010). https://doi.org/10.1007/s10552-010-9599-1

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