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Environ Int. 2018 Dec;121(Pt 1):428-434. doi: 10.1016/j.envint.2018.09.030. Epub 2018 Sep 25.

Colorectal cancer, sun exposure and dietary vitamin D and calcium intake in the MCC-Spain study.

Author information

1
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.
2
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.
3
Instituto de Biomedicina (IBIOMED), Universidad de León, Spain; Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain.
4
Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
5
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain.
6
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
7
Área de Cáncer y Salud Pública, FISABIO-Salud Pública, Valencia, Spain.
8
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
9
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain.
10
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Oncology Institute IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Universidad de Oviedo, Asturias, Spain.
11
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Salud Pública Navarra - IdiSNA, Pamplona, Navarra, Spain.
12
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastián, Spain.
13
Centro de Investigación en Recursos Naturales, Salud, y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain.
14
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
15
Instituto de Biomedicina (IBIOMED), Universidad de León, Spain.
16
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain.
17
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Biomedicina (IBIOMED), Universidad de León, Spain.
18
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. Electronic address: v.moreno@iconcologia.net.

Abstract

OBJECTIVES:

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.

STUDY DESIGN:

Multicenter population-based frequency matched case-control study in Spain (MCC-Spain), with 2140 CRC cases and 3950 controls.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

KEYWORDS:

Calcium; Colorectal cancer; Skin phenotype; Sunlight; Vitamin D

PMID:
30266013
DOI:
10.1016/j.envint.2018.09.030
[Indexed for MEDLINE]
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