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Cancer Causes & Control
Published in: Cancer Causes & Control 7/2013

01-07-2013 | Original paper

Relationship between cancer survival and ambient ultraviolet B irradiance in China

Authors: Wanqing Chen, Bruce K. Armstrong, Bayzidur Rahman, Rongshou Zheng, Siwei Zhang, Mark Clements

Published in: Cancer Causes & Control | Issue 7/2013

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Abstract

Background

Ecological studies in predominantly European populations have reported higher cancer survival in areas of higher solar ultraviolet (UV) B irradiation, perhaps due to a cancer protective effect of vitamin D synthesized photochemically in the skin. Such studies have not been done in developing countries, perhaps because of lack of cancer registries that can do outcome follow-up. One minus the mortality-to-incidence ratio (1−MIR), however, can be used as a measure of survival, and MIR as a measure of fatality, in developing country cancer registries. We analyzed the association between ambient solar UVB and MIR in China.

Methods

National cancer registration data in 32 counties of China in 2004–2005 were used to estimate MIR by age, sex, and area. The accuracy of 1−MIR as a measure of survival was assessed in the Cixian County cancer registry. Contemporary satellite measurements of cloud-adjusted ambient UVB intensity at 305 nm were taken from an NASA database and spatial Kriging methods used to estimate the average daily irradiance in each county. We estimated mortality hazard ratios (HRs) per 10 mW/m2 of UVB for all cancers together, and the ten commonest cancer types by fitting a generalized linear model assuming mortality had a binomial distribution conditional on the sum of mortality and incidence, adjusted for sex, age, and location.

Results

The 5-year survival proportions for the main cancer types were in good agreement with 1−MIR in Cixian County. MIR ratios for all cancers combined were inversely associated with ambient UVB in men (HR = 0.96, 95 % CI 0.93–0.99) and women (HR = 0.91, 95 % CI 0.88–0.94) and in urban (HR = 0.95, 95 % CI 0.94–0.96) and rural areas (HR = 0.90, 95 % CI 0.87–0.93). Similar inverse associations were present for cancers of esophagus, stomach, and bladder in both sexes together and breast cancer in women. They were present in urban residents for all major cancers except liver cancer, bladder cancer, and breast cancer in women. For rural residents, most HRs were <1.0 but, with the exception of breast cancer, their upper 95 % confidence bounds were >1.0.

Conclusion

Ambient UVB was significantly inversely associated with MIR for all cancers together and four of ten cancer types. Solar UVB may increase survival from some cancers in China.
Appendix
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Metadata
Title
Relationship between cancer survival and ambient ultraviolet B irradiance in China
Authors
Wanqing Chen
Bruce K. Armstrong
Bayzidur Rahman
Rongshou Zheng
Siwei Zhang
Mark Clements
Publication date
01-07-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 7/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0210-4

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