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诊断季节是否可预测癌症患者的生存?来自苏黎世癌症登记处的结果。

Is Season of Diagnosis a Predictor of Cancer Survival? Results from the Zurich Cancer Registry.

机构信息

Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland.

Cancer Registry Zurich, Zug, Schaffhausen, and Schwyz, Institute of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

出版信息

Nutrients. 2022 Oct 14;14(20):4291. doi: 10.3390/nu14204291.

Abstract

In Switzerland, there is a large seasonal variation in sunlight, and vitamin D deficiency is relatively common during winter. The season of diagnosis may be linked to cancer survival via vitamin D status. Using data from the Cancer Registry of Zurich, Zug, Schaffhausen, and Schwyz with more than 171,000 cancer cases registered since 1980, we examined the association of the season of diagnosis with survival for cancers including prostate (ICD10 code C61; International Categorization of Diseases, version 10), breast (C50), colorectal (C18-21), lung (C34), melanoma (C43), and all sites combined. Cox proportional hazards regression models were used to assess the differences in the all-cause mortality by the season of the diagnosis. Winter was used as the reference season. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for all the cancers combined (excluding nonmelanoma skin cancer) and for prostate (in men), breast (in women), colorectal, lung cancer, and melanomas, separately. A diagnosis in summer and/or autumn was associated with improved survival in all the sites combined for both sexes (men: HR 0.97 [95% CI 0.96-0.99]; women: HR 0.97 [95% CI 0.94-0.99]) and in colorectal (HR 0.91 [95% CI 0.84-0.99]), melanoma (HR 0.81 [95% CI 0.65-1.00]), and breast cancer (HR 0.91 [95% CI 0.94-0.99]) in women. Our study results suggest that a cancer diagnosis in summer and/or autumn is associated with a better prognosis. The improved seasonal survival coincides with the seasonal variation of sun-induced vitamin D, and vitamin D may play a protective and beneficial role in cancer survival.

摘要

在瑞士,阳光的季节性变化很大,冬季维生素 D 缺乏症较为常见。诊断季节可能通过维生素 D 状态与癌症生存率相关。我们利用 1980 年以来苏黎世、楚格、沙夫豪森和施维茨癌症登记处的超过 171000 例癌症病例的数据,检查了诊断季节与包括前列腺癌(ICD10 代码 C61;国际疾病分类,第 10 版)、乳腺癌(C50)、结直肠癌(C18-21)、肺癌(C34)、黑色素瘤(C43)和所有部位癌症的生存关联。使用 Cox 比例风险回归模型评估了诊断季节对全因死亡率的差异。冬季被用作参考季节。计算了所有癌症(不包括非黑色素瘤皮肤癌)以及前列腺癌(男性)、乳腺癌(女性)、结直肠癌、肺癌和黑色素瘤的季节诊断的危险比(HR)和 95%置信区间(CI)。夏季和/或秋季诊断与两性所有部位(男性:HR 0.97[95%CI 0.96-0.99];女性:HR 0.97[95%CI 0.94-0.99])以及结直肠癌(HR 0.91[95%CI 0.84-0.99])、黑色素瘤(HR 0.81[95%CI 0.65-1.00])和乳腺癌(HR 0.91[95%CI 0.94-0.99])的生存改善相关。我们的研究结果表明,夏季和/或秋季的癌症诊断与更好的预后相关。季节性生存的改善与阳光诱导的维生素 D 的季节性变化一致,维生素 D 可能在癌症生存中发挥保护和有益的作用。

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