Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Environ Int. 2018 Dec;121(Pt 1):428-434. doi: 10.1016/j.envint.2018.09.030. Epub 2018 Sep 25.
To explore the association of colorectal cancer with environmental solar radiation and sun exposure behavior, considering phenotypic variables (eye color, hair color and skin phenotype), dietary intake of vitamin D and calcium, and socio-demographic factors.
Multicenter population-based frequency matched case-control study in Spain (MCC-Spain), with 2140 CRC cases and 3950 controls.
Data were obtained through personal interviews using a structured epidemiological questionnaire that included socio-demographic data, residential history, environmental exposures, behavior, phenotypic and dietary information. An environmental-lifetime sun exposure score was constructed combining residential history and average daily solar radiation, direct and diffuse. Logistic regression was used to explore the association between different variables. A structural equation model was used to verify the associations of the conceptual model.
We found a lower risk of CRC in subjects frequently exposed to sunlight during the previous summer and skin burning due to sun exposure. No association was observed in relation to the residential solar radiation scores. Subjects with light eye or light hair colors had a lower risk of CRC that those with darker colors. Dietary calcium and vitamin D were also protective factors, but not in the multivariate model. The structural equation model analysis suggested that higher sun exposure was associated with a decreased risk of CRC, as well as dietary intake of calcium and vitamin D, and these factors are correlated among themselves and with environmental solar radiation and skin phenotypes.
The results agree with previous observations that sun exposure, dietary vitamin D and calcium intake, and serum 25(OH)D concentration reduce the risk of CRC and indicate that these factors may be relevant for cancer prevention.
探讨结直肠癌与环境太阳辐射和阳光暴露行为的关系，同时考虑表型变量（眼睛颜色、头发颜色和皮肤表型）、维生素 D 和钙的饮食摄入以及社会人口因素。
西班牙多中心基于人群的频数匹配病例对照研究（MCC-Spain），纳入 2140 例结直肠癌病例和 3950 例对照。
通过个人访谈使用结构化的流行病学问卷收集数据，问卷包括社会人口统计学数据、居住史、环境暴露、行为、表型和饮食信息。构建了一个环境终生阳光暴露评分，结合居住史和平均每日太阳辐射、直接和漫射辐射。使用逻辑回归探索不同变量之间的关联。使用结构方程模型验证概念模型的关联。
我们发现，与过去夏天经常暴露在阳光下和因阳光暴露而灼伤的受试者相比，结直肠癌的风险较低。与居住的太阳辐射评分无关。眼睛或头发颜色较浅的受试者患结直肠癌的风险低于颜色较深的受试者。饮食中的钙和维生素 D 也是保护因素，但在多变量模型中并非如此。结构方程模型分析表明，较高的阳光暴露与结直肠癌风险降低相关，以及钙和维生素 D 的饮食摄入，这些因素相互之间以及与环境太阳辐射和皮肤表型相关。
研究结果与之前的观察结果一致，即阳光暴露、饮食中的维生素 D 和钙摄入以及血清 25(OH)D 浓度降低了结直肠癌的风险，并表明这些因素可能与癌症预防有关。
