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Vitamin D ultraviolet radiation and disparities
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Abruzzi, Amy E.. Vitamin D ultraviolet radiation and disparities. Retrieved from https://doi.org/doi:10.7282/T3HH6H29

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TitleVitamin D ultraviolet radiation and disparities
NameAbruzzi, Amy E. (author); DEMISSIE, KITAW (chair); RHOADS, GEORGE (internal member); Ohman-Strickland, Pamela (internal member); August, David (outside member); Rutgers University; Graduate School - New Brunswick
Date Created2013
Other Date2013-10 (degree)
SubjectPublic Health, Vitamin D deficiency, Vitamin D in the body, Cancer--Longitudinal studies, Prostate--Cancer--Etiology, Colon--Cancer--Etiology, Rectal--Cancer--Etiology, Mortality and race
Extentxii, 181 p. : ill.
DescriptionVitamin D, a steroid hormone with documented anti-cancer properties, is largely obtained through environmental exposure. It has been suggested that vitamin D deficiency, which is higher among U.S. Blacks than Whites, may contribute to survival differences from prostate and colorectal cancers. In addition, Blacks may be at higher risk for Multiple Primary Cancers (MPCs) involving these tumor pairings. It is currently unknown what factors other than prior radiotherapy may contribute to MPC development. The aims of this thesis were to: (1) conduct a systematic review of vitamin D radiation (VDR) and its relationship to prostate and colorectal cancers, including the role of the environment, sun-reactive Skin Types and their correlation with race/ethnicity; (2) examine whether Black/White differences in survival are related to VDR, and if higher levels of VDR are associated with increased survival from prostate and colorectal cancers; and (3) examine if Black/White disparities exit in MPC development for these cancers and if lower levels of VDR are associated with these disparities. Using a retrospective, population-based cohort design, male patients aged 50 years and older who were diagnosed from 1978 to 2003 with a non-metastatic first primary prostate, colon or rectal cancer were followed for 10 year survival and MPC development. VDR levels were estimated based on the patient’s county of residency at diagnosis. In addition to tumor factors, socio-demographic covariates such as county-level socio-economic deprivation and a proxy for smoking were included. The analysis utilized a multivariate Cox Proportional Hazards model, adjusted for various factors, and an evaluation of competing risks. The results indicate that VDR may contribute to Black-White differences in survival from prostate and colon cancer, which is strongly modified by urbanicity. While a moderate protective association was observed with increasing VDR among patients residing in all-urban areas, a modest increase in risk was observed among patients in least-urban areas. To a lesser extent, VDR may also contribute to an increased risk of some MPCs. More generally, Blacks are at higher risk for MPCs and several factors including prior radiotherapy, smoking and socio-economic deprivation may increase the risk of their development.
NotePh.D.
NoteIncludes bibliographical references
NoteIncludes vita
Noteby Amy E. Abruzzi
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/T3HH6H29
Languageeng
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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