{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:49:29Z","timestamp":1777301369009,"version":"3.51.4"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vitamin D has been identified as a potential protective factor in the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition) model postulates various stages of cancer development due to vitamin D deficiency and the associated latency period. The purpose of this study is to examine this age-dependent inverse relationship globally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this ecological study, a series of linear and polynomial regression tests were performed between country-specific UVB estimates adjusted for cloud cover and crude incidence rates of CRC for different age groups. Multiple linear regression was used to investigate the association between crude incidence rates of colorectal cancer and UVB estimate adjusting for urbanization, skin pigmentation, smoking, animal consumption, per capita GDP, and life expectancy. Statistical analysis was followed by geospatial visualization by producing choropleth maps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The inverse relationship between UVB exposure and CRC crude rates was stronger in older age groups at the country level. Quadratic curve fitting was preferred, and these models were statistically significant for all age groups. The inverse association between crude incidence rates of CRC and UVB exposure was statistically significant for age groups above 45\u2009years, after controlling for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The age-dependent inverse association between UVB exposure and incidence of colorectal cancer exhibits a greater effect size among older age groups in global analyses. Studying the effect of chronic vitamin D deficiency on colorectal cancer etiology will help in understanding the necessity for population-wide screening programs for vitamin D deficiency, especially in regions with inadequate UVB exposure. Further studies are required to assess the need for adequate public health programs such as selective supplementation and food fortification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-021-11089-w","type":"journal-article","created":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T19:03:24Z","timestamp":1625425404000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?"],"prefix":"10.1186","volume":"21","author":[{"given":"Vidya Lakshmi","family":"Purushothaman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael E.","family":"Cuomo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cedric F.","family":"Garland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2191-7833","authenticated-orcid":false,"given":"Timothy K.","family":"Mackey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"11089_CR1","unstructured":"Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Pi\u00f1eros M, Znaor A, Soerjomataram I, Bray F. Global Cancer observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2018. Available from:\u00a0https:\/\/gco.iarc.fr\/today. Accessed 3 May 2019."},{"issue":"5","key":"11089_CR2","doi-asserted-by":"publisher","first-page":"E359","DOI":"10.1002\/ijc.29210","volume":"136","author":"J Ferlay","year":"2015","unstructured":"Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359\u201386 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25220842. [cited 2019 May 2].","journal-title":"Int J Cancer"},{"issue":"20","key":"11089_CR3","doi-asserted-by":"publisher","first-page":"6055","DOI":"10.3748\/wjg.v20.i20.6055","volume":"20","author":"F Bishehsari","year":"2014","unstructured":"Bishehsari F, Mahdavinia M, Vacca M, Malekzadeh R, Mariani-Costantini R. Epidemiological transition of colorectal cancer in developing countries: Environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol. 2014;20(20):6055 Available from: http:\/\/www.wjgnet.com\/1007-9327\/full\/v20\/i20\/6055.htm. [cited 2019 May 2].","journal-title":"World J Gastroenterol"},{"issue":"1\u20132","key":"11089_CR4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.jsbmb.2005.06.018","volume":"97","author":"ED Gorham","year":"2005","unstructured":"Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, et al. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005;97(1\u20132):179\u201394 Available from: https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0960076005002451?via%3Dihub. [cited 2019 May 3].","journal-title":"J Steroid Biochem Mol Biol"},{"key":"11089_CR5","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.jsbmb.2014.12.010","volume":"148","author":"SB Mohr","year":"2015","unstructured":"Mohr SB, Gorham ED, Kim J, Hofflich H, Cuomo RE. Garland CF. Could vitamin D sufficiency improve the survival of colorectal cancer patients? J Steroid Biochem Mol Biol. 2015;148:239\u201344 Available from: https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0960076014003161?via%3Dihub. [cited 2019 May 3].","journal-title":"J Steroid Biochem Mol Biol"},{"key":"11089_CR6","unstructured":"Vitamin D - Fact sheet for Health Professionals (NIH)."},{"issue":"2","key":"11089_CR7","first-page":"607","volume":"31","author":"CF Garland","year":"2011","unstructured":"Garland CF, French CB, Baggerly LL, Heaney RP. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011;31(2):607\u201311 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21378345. [cited 2019 May 3].","journal-title":"Anticancer Res"},{"issue":"2","key":"11089_CR8","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1038\/jid.2009.323","volume":"130","author":"MKB Bogh","year":"2010","unstructured":"Bogh MKB, Schmedes AV, Philipsen PA, Thieden E, Wulf HC. Vitamin D Production after UVB Exposure Depends on Baseline Vitamin D and Total Cholesterol but Not on Skin Pigmentation. J Invest Dermatol. 2010;130(2):546\u201353 Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0022202X15347035. [cited 2019 May 3].","journal-title":"J Invest Dermatol"},{"issue":"11","key":"11089_CR9","doi-asserted-by":"publisher","first-page":"e111265","DOI":"10.1371\/journal.pone.0111265","volume":"9","author":"JP Ekwaru","year":"2014","unstructured":"Ekwaru JP, Zwicker JD, Holick MF, Giovannucci E, Veugelers PJ. The Importance of Body Weight for the Dose Response Relationship of Oral Vitamin D Supplementation and Serum 25-Hydroxyvitamin D in Healthy Volunteers. PLoS One. 2014;9(11):e111265 Available from: http:\/\/dx.plos.org\/10.1371\/journal.pone.0111265. [cited 2019 May 3].","journal-title":"PLoS One"},{"issue":"9","key":"11089_CR10","doi-asserted-by":"publisher","first-page":"3262","DOI":"10.1096\/fj.11-180935","volume":"25","author":"P Huebbe","year":"2011","unstructured":"Huebbe P, Nebel A, Siegert S, Moehring J, Boesch-Saadatmandi C, Most E, et al. APOE \u03b5 4 is associated with higher vitamin D levels in targeted replacement mice and humans. FASEB J. 2011;25(9):3262\u201370 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21659554. [cited 2020 Apr 1].","journal-title":"FASEB J"},{"key":"11089_CR11","doi-asserted-by":"crossref","unstructured":"Savoie MB, Paciorek A, Zhang L, Van Blarigan EL, Sommovilla N, Abrams D, et al. Vitamin D Levels in Patients with Colorectal Cancer Before and After Treatment Initiation. J Gastrointest Cancer. 2018; Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30058032. [cited 2019 May 3].","DOI":"10.1007\/s12029-018-0147-7"},{"issue":"7","key":"11089_CR12","doi-asserted-by":"publisher","first-page":"896","DOI":"10.3390\/nu10070896","volume":"10","author":"H Maalmi","year":"2018","unstructured":"Maalmi H, Walter V, Jansen L, Boakye D, Sch\u00f6ttker B, Hoffmeister M, et al. Association between Blood 25-Hydroxyvitamin D Levels and Survival in Colorectal Cancer Patients: An Updated Systematic Review and Meta-Analysis. Nutrients. 2018;10(7):896 Available from: http:\/\/www.mdpi.com\/2072-6643\/10\/7\/896. [cited 2019 May 3].","journal-title":"Nutrients"},{"issue":"1","key":"11089_CR13","first-page":"223","volume":"32","author":"WB Grant","year":"2012","unstructured":"Grant WB. Ecological studies of the UVB-vitamin D-cancer hypothesis. Anticancer Res. 2012;32(1):223\u201336 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22213311. [cited 2019 May 3].","journal-title":"Anticancer Res"},{"issue":"7","key":"11089_CR14","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1093\/jnci\/djj101","volume":"98","author":"E Giovannucci","year":"2006","unstructured":"Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective Study of Predictors of Vitamin D Status and Cancer Incidence and Mortality in Men. JNCI J Natl Cancer Inst. 2006;98(7):451\u20139 Available from: http:\/\/academic.oup.com\/jnci\/article\/98\/7\/451\/2522019\/Prospective-Study-of-Predictors-of-Vitamin-D. [cited 2019 May 3].","journal-title":"JNCI J Natl Cancer Inst"},{"key":"11089_CR15","doi-asserted-by":"publisher","first-page":"j4761","DOI":"10.1136\/bmj.j4761","volume":"359","author":"VI Dimitrakopoulou","year":"2017","unstructured":"Dimitrakopoulou VI, Tsilidis KK, Haycock PC, Dimou NL, Al-Dabhani K, Martin RM, et al. Circulating vitamin D concentration and risk of seven cancers: Mendelian randomisation study. BMJ. 2017;359:j4761 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29089348. [cited 2019 May 3].","journal-title":"BMJ"},{"issue":"7","key":"11089_CR16","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1016\/j.annepidem.2009.03.021","volume":"19","author":"CF Garland","year":"2009","unstructured":"Garland CF, Gorham ED, Mohr SB, Garland FC. Vitamin D for Cancer Prevention: Global Perspective. Ann Epidemiol. 2009;19(7):468\u201383 Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1047279709001057. [cited 2019 May 2].","journal-title":"Ann Epidemiol"},{"key":"11089_CR17","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.envint.2018.11.052","volume":"122","author":"SE Mousavi","year":"2019","unstructured":"Mousavi SE, Amini H, Heydarpour P, Amini Chermahini F, Godderis L. Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms. Environ Int. 2019;122:67\u201390 Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/30509511\/. [cited 2021 Apr 8].","journal-title":"Environ Int"},{"issue":"4","key":"11089_CR18","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1111\/2041-210X.12168","volume":"5","author":"M Beckmann","year":"2014","unstructured":"Beckmann M, V\u00e1clav\u00edk T, Manceur AM, \u0160prtov\u00e1 L, von Wehrden H, Welk E, et al. glUV: a global UV-B radiation data set for macroecological studies. Methods Ecol Evol. 2014;5(4):372\u201383 Available from: http:\/\/doi.wiley.com\/10.1111\/2041-210X.12168. [cited 2020 Apr 1].","journal-title":"Methods Ecol Evol"},{"key":"11089_CR19","unstructured":"Earthdata [Internet]. Available from:\u00a0https:\/\/earthdata.nasa.gov\/. Accessed 3 May 2019."},{"key":"11089_CR20","unstructured":"World Bank Open Data; https:\/\/data.worldbank.org\/.\u00a0Accessed 3 May 2019."},{"key":"11089_CR21","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1006\/jhev.2000.0403","volume":"39","author":"NG Jablonski","year":"2000","unstructured":"Jablonski NG, Chaplin G. The evolution of human skin coloration. J Hum Evol. 2000;39:57\u2013106; PMID:10896812. https:\/\/doi.org\/10.1006\/jhev.2000.0403.","journal-title":"J Hum Evol"},{"issue":"2","key":"11089_CR22","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.3390\/ijerph110202169","volume":"11","author":"E Christenson","year":"2014","unstructured":"Christenson E, Elliott M, Banerjee O, Hamrick L, Bartram J. Climate-related hazards: a method for global assessment of urban and rural population exposure to cyclones, droughts, and floods. Int J Environ Res Public Health. 2014;11(2):2169\u201392. https:\/\/doi.org\/10.3390\/ijerph110202169.","journal-title":"Int J Environ Res Public Health"},{"key":"11089_CR23","volume-title":"Global Smoking Prevalence and Cigarette Consumption 1980-2012","author":"Institute for Health Metrics and Evaluation (IHME)","year":"2014","unstructured":"Institute for Health Metrics and Evaluation (IHME). Global Smoking Prevalence and Cigarette Consumption 1980-2012. Seattle, United States: Institute for Health Metrics and Evaluation (IHME); 2014."},{"key":"11089_CR24","unstructured":"The Food and Agricultural Organization of the United Nations. http:\/\/www.fao.org\/faostat\/en\/#data\/FBS.\u00a0Accessed 3 May 2019."},{"issue":"4","key":"11089_CR25","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1159\/000314350","volume":"35","author":"SB Mohr","year":"2010","unstructured":"Mohr SB, Gorham ED, Garland CF, Grant WB, Garland FC. Low Ultraviolet B and Increased Risk of Brain Cancer: An Ecological Study of 175 Countries. Neuroepidemiology. 2010;35(4):281\u201390 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20948235. [cited 2019 Aug 6].","journal-title":"Neuroepidemiology"},{"issue":"1","key":"11089_CR26","doi-asserted-by":"publisher","first-page":"181","DOI":"10.4161\/derm.23773","volume":"5","author":"RE Cuomo","year":"2013","unstructured":"Cuomo RE, Mohr SB, Gorham ED, Garland CF. What is the relationship between ultraviolet B and global incidence rates of colorectal cancer? Dermatoendocrinol. 2013;5(1):181\u20135 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24494052. [Internet]. [cited 2019 Apr 23].","journal-title":"Dermatoendocrinol"},{"issue":"5","key":"11089_CR27","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1177\/1403494819831905","volume":"47","author":"K Voskarides","year":"2019","unstructured":"Voskarides K. The \u201ccancer\u2013cold\u201d hypothesis and possible extensions for the Nordic populations. Scand J Public Health. 2019;47(5):477\u201381. https:\/\/doi.org\/10.1177\/1403494819831905.","journal-title":"Scand J Public Health"},{"issue":"1","key":"11089_CR28","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1017\/S0007114513001840","volume":"111","author":"J Hilger","year":"2014","unstructured":"Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl D, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111(1):23\u201345. https:\/\/doi.org\/10.1017\/S0007114513001840.","journal-title":"Br J Nutr"},{"key":"11089_CR29","doi-asserted-by":"publisher","first-page":"589587","DOI":"10.1155\/2014\/589587","volume":"2014","author":"P Pludowski","year":"2014","unstructured":"Pludowski P, Grant WB, Bhattoa HP, Bayer M, Povoroznyuk V, Rudenka E, et al. Vitamin d status in central europe. Int J Endocrinol. 2014;2014:589587\u201312. https:\/\/doi.org\/10.1155\/2014\/589587.","journal-title":"Int J Endocrinol"},{"key":"11089_CR30","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.jsbmb.2013.11.003","volume":"144 Pt A","author":"C Palacios","year":"2014","unstructured":"Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014;144 Pt A:138\u201345. https:\/\/doi.org\/10.1016\/j.jsbmb.2013.11.003.","journal-title":"J Steroid Biochem Mol Biol"},{"key":"11089_CR31","unstructured":"Garland CF, Gorham ED. Dose-response of serum 25-hydroxyvitamin D in association with risk of colorectal cancer: A meta-analysis."},{"issue":"1","key":"11089_CR32","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1093\/ajcn\/77.1.204","volume":"77","author":"RP Heaney","year":"2003","unstructured":"Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003;77(1):204\u201310 Available from: https:\/\/academic.oup.com\/ajcn\/article\/77\/1\/204\/4689654. [cited 2019 Aug 6].","journal-title":"Am J Clin Nutr"},{"issue":"1","key":"11089_CR33","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/1471-2407-6-264","volume":"6","author":"FP Boscoe","year":"2006","unstructured":"Boscoe FP, Schymura MJ. Solar ultraviolet-B exposure and cancer incidence and mortality in the United States, 1993\u20132002. BMC Cancer. 2006;6(1):264 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17096841. [cited 2019 May 3].","journal-title":"BMC Cancer"},{"key":"11089_CR34","unstructured":"Grant WB, Garland CF. The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res. 26(4A):2687\u201399 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16886679. [cited 2019 May 3]."},{"issue":"3","key":"11089_CR35","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1097\/CEJ.0b013e3282b6fd0f","volume":"17","author":"P Waltz","year":"2008","unstructured":"Waltz P, Chodick G. Assessment of ecological regression in the study of colon, breast, ovary, non-Hodgkin\u02bcs lymphoma, or prostate cancer and residential UV. Eur J Cancer Prev. 2008;17(3):279\u201386 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18414201. [cited 2019 May 3].","journal-title":"Eur J Cancer Prev"},{"key":"11089_CR36","unstructured":"Takachi R, Tsubono Y, Baba K, Inoue Phd M, Sasazuki S, Iwasaki M, et al. Japan Public Health Center-Based Prospective Study Group. Red meat intake may increase the risk of colon cancer in Japanese, a population with relatively low red meat consumption.\u00a0Asia Pac J Clin Nutr. 2011;20."},{"key":"11089_CR37","unstructured":"Aune D, De Stefani E, Ronco A, Boffetta P, Deneo-Pellegrini H, Acosta G, Mendilaharsu M. Fruits, vegetables and the risk of cancer: a multisite case-control study in Uruguay.\u00a0Asian Pac J Cancer Prev. 2009;10(3): 419\u201328."},{"key":"11089_CR38","doi-asserted-by":"crossref","unstructured":"Zhang J, Dhakal IB, Zhao Z, Li L. Trends in mortality from cancers of the breast, colon, prostate, esophagus, and stomach in East Asia: role of nutrition transition.\u00a0Eur J Cancer Prev. 2012;21(5):480\u20139. Available from:\u00a0https:\/\/journals.lww.com\/eurjcancerprev\/Fulltext\/2012\/09000\/Trends_in_mortality_from_cancers_of_the_breast,.12.aspx. [cited 2021 Jun 1].","DOI":"10.1097\/CEJ.0b013e328351c732"},{"issue":"2","key":"11089_CR39","doi-asserted-by":"publisher","first-page":"pkz034","DOI":"10.1093\/jncics\/pkz034","volume":"3","author":"FF Zhang","year":"2019","unstructured":"Zhang FF, Cudhea F, Shan Z, Michaud DS, Imamura F, Eom H, et al. Preventable Cancer Burden Associated With Poor Diet in the United States. JNCI Cancer Spectr. 2019;3(2):pkz034. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31360907. [cited 2019 Aug 6].","journal-title":"JNCI Cancer Spectr"},{"key":"11089_CR40","doi-asserted-by":"crossref","unstructured":"Cheng J, Chen Y, Wang X, Wang J, Yan Z, Gong G, et al. Meta-analysis of prospective cohort studies of cigarette smoking and the incidence of colon and rectal cancers. Eur J Cancer Prev. 2015;24(1). Available from: https:\/\/journals.lww.com\/eurjcancerprev\/Fulltext\/2015\/01000\/Meta_analysis_of_prospective_cohort_studies_of.2.aspx.\u00a0[cited 2021 Jun 1].","DOI":"10.1097\/CEJ.0000000000000011"},{"key":"11089_CR41","doi-asserted-by":"crossref","unstructured":"Tsoi KKF, Pau CYY, Wu WKK, Chan FKL, Griffiths S, Sung JJY. Cigaette Smoking and the Risk of Colorectal Cancer: A Meta-analysis of Prospective Cohort Studies. Clin Gastroenterol Hepatol. 2009;7(6):682\u20138.e5. https:\/\/pubmed.ncbi.nlm.nih.gov\/19245853\/.\u00a0[cited 2021 Jun 1].","DOI":"10.1016\/j.cgh.2009.02.016"},{"key":"11089_CR42","doi-asserted-by":"crossref","unstructured":"Liang PS, Chen TY, Giovannucci E. Cigarette smoking and colorectal cancer incidence and mortality: systematic review and meta-analysis.\u00a0Int J Cancer. 2009;124:2406\u201315. Available from: www.interscience. [cited 2021 Jun 1].","DOI":"10.1002\/ijc.24191"},{"issue":"8","key":"11089_CR43","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1158\/1940-6207.CAPR-14-0470","volume":"8","author":"PD Chandler","year":"2015","unstructured":"Chandler PD, Buring JE, Manson JE, Giovannucci EL, Moorthy MV, Zhang S, et al. Circulating Vitamin D Levels and Risk of Colorectal Cancer in Women. Cancer Prev Res (Phila). 2015;8(8):675\u201382 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25813525. [cited 2019 May 3].","journal-title":"Cancer Prev Res (Phila)"},{"key":"11089_CR44","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.ebiom.2018.03.032","volume":"30","author":"Y Zhu","year":"2018","unstructured":"Zhu Y, Chen P, Gao Y, Ta N, Zhang Y, Cai J, et al. MEG3 Activated by Vitamin D Inhibits Colorectal Cancer Cells Proliferation and Migration via Regulating Clusterin. EBioMedicine. 2018;30:148\u201357 Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29628342. [cited 2019 May 3].","journal-title":"EBioMedicine"},{"issue":"6","key":"11089_CR45","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1002\/cncr.10427","volume":"94","author":"WB Grant","year":"2002","unstructured":"Grant WB. An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer. 2002;94(6):1867\u201375 Available from: http:\/\/doi.wiley.com\/10.1002\/cncr.10427. [cited 2019 May 3].","journal-title":"Cancer"},{"key":"11089_CR46","unstructured":"Gausman V, Dornblaser D, Anand S, Hayes RB, O\u2019Connell K, Du M, et al. Risk Factors Associated With Early-Onset Colorectal Cancer. Clin Gastroenterol Hepatol. 2019; Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31622737. [cited 2020 Apr 1]."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-11089-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-021-11089-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-11089-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T19:03:43Z","timestamp":1625425423000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-021-11089-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,5]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["11089"],"URL":"https:\/\/doi.org\/10.1186\/s12889-021-11089-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-115162\/v1","asserted-by":"object"}]},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,5]]},"assertion":[{"value":"21 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. Data were not collected for individuals, but rather as aggregated statistics from publicly available data sources.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"TM is a senior editorial board member of BMC Public Health. TM is an employee of the startup company S-3 Research LLC. S-3 Research is a startup funded and currently supported by the National Institutes of Health \u2013 National Institute on Drug Abuse through a Small Business Innovation and Research contract for opioid-related social media research and technology commercialization. Author reports no other conflict of interest associated with this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1238"}}