Grant William B, Peiris Alan N
Dermatoendocrinol. 2012 Apr 1;4(2):85-94. doi: 10.4161/derm.19667.
Considerable disparities in cancer survival rates exist between African Americans (AAs) and white Americans (WAs). Various factors such as differences in socioeconomic status (SES), cancer stage at time of diagnosis, and treatment-which this analysis considers primary explanatory factors-have accounted for many of these differences. An additional factor not usually considered is vitamin D. Previous studies have inversely correlated higher solar ultraviolet-B (UVB) doses and serum 25-hydroxyvitamin D (25(OH)D) concentrations with incidence and/or mortality rates for about 20 types of cancer and improved survival rates for eight types of cancer. Because of darker skin pigmentation, AAs have 40% lower serum 25(OH)D concentrations than WAs. This study reviews the literature on disparities in cancer survival between AAs and WAs. The journal literature indicates that there are disparities for 13 types of cancer after consideration of SES, stage at diagnosis and treatment: bladder, breast, colon, endometrial, lung, ovarian, pancreatic, prostate, rectal, testicular, and vaginal cancer; Hodgkin lymphoma and melanoma. Solar UVB doses and/or serum 25(OH)D concentrations have been reported inversely correlated with incidence and/or mortality rates for all of these cancers. This finding suggests that future studies should consider serum 25(OH)D concentrations in addressing cancer survival disparities through both measurements of serum 25(OH)D concentrations and increasing serum 25(OH)D concentrations of those diagnosed with cancer, leading to improved survival rates and reduced disparities.
非裔美国人(AAs)和美国白人(WAs)在癌症生存率方面存在显著差异。社会经济地位(SES)差异、诊断时的癌症分期以及治疗等各种因素——本分析将这些因素视为主要解释因素——解释了其中的许多差异。另一个通常未被考虑的因素是维生素D。先前的研究表明,较高的太阳紫外线B(UVB)剂量和血清25-羟基维生素D(25(OH)D)浓度与约20种癌症的发病率和/或死亡率呈负相关,与8种癌症的生存率提高相关。由于皮肤色素沉着较深,非裔美国人的血清25(OH)D浓度比美国白人低40%。本研究回顾了关于非裔美国人和美国白人在癌症生存率方面差异的文献。期刊文献表明,在考虑SES、诊断分期和治疗后,有13种癌症存在差异:膀胱癌、乳腺癌、结肠癌、子宫内膜癌、肺癌、卵巢癌、胰腺癌、前列腺癌、直肠癌、睾丸癌和阴道癌;霍奇金淋巴瘤和黑色素瘤。据报道,太阳UVB剂量和/或血清25(OH)D浓度与所有这些癌症的发病率和/或死亡率呈负相关。这一发现表明,未来的研究在通过测量血清25(OH)D浓度以及提高癌症患者的血清25(OH)D浓度来解决癌症生存差异问题时,应考虑血清25(OH)D浓度,从而提高生存率并减少差异。