Interaction between Race and Micronutrients on Colorectal Cancer Incidence and Mortality
Principal Investigator
Name
Fahad Mukhtar
Degrees
M.D., M.P.H
Institution
University of South Florida
Position Title
Graduate Student/Research Assistant
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-343
Initial CDAS Request Approval
Feb 22, 2018
Title
Interaction between Race and Micronutrients on Colorectal Cancer Incidence and Mortality
Summary
Colorectal cancer (CRC) is the third most common cancer in men and second most common cancer in women. It is the third most common cause of cancer related-death worldwide and the second in the US.
The role of folate on CRC incidence has been inconsistent with different studies finding protective effect, null effect or even an increased risk of CRC. Fewer studies are available on the association between folate and colorectal cancer mortality. Dietary roles of folate on CRC depends on various enzymes. One of these enzymes is Methyl tetrahydrofolate reductase which catalyzes the reaction that forms 5-Methyl tetrahydrofolate. Polymorphism in the gene that codes for this enzyme result in varying effects of folate on CRC with those who are homozygous having a reduced risk of CRC in the presence of adequate folate. Whites are more likely to have this genetic variant giving them a survival advantage. Secondly, intakes of folate varies by race with blacks having a lower intake compared to Whites. Thirdly, African Americans may have a higher demand for folate due to the higher prevalence of anemia from sickle cell disease which is more prevalent in this group.
Calcium intake is lower in African Americans compared to Whites which may be due to lower consumption of milk secondary to lactose intolerance that is more prevalent among African Americans. On average, African Americans consume 83% of the recommended daily allowance (RDA) for calcium whereas European Americans consume more than the RDA. Additionally, the protective effect of calcium on CRC is more in distal tumors which are more in Whites suggesting that calcium may be interacting with local environmental factors in the intestine. Secondly, calcium level and intake are highly correlated with levels of Vitamin D. Disparities in Vitamin D intake between African Americans and European Americans has shown differences in survival between the two groups with African Americans having significantly worse survival.
Many studies have explored the role of calcium and folate on colorectal cancer incidence but few studies have looked at the effect of these micronutrients on CRC mortality and the interaction between race and these micronutrients has not been explored. The aim of this study is to determine if there is an interaction between race with calcium, and race with folate on colorectal cancer incidence and mortality. A second aim is to explore the interaction between race and medications (e.g. NSAIDs) that have been shown to affect colorectal cancer incidence and mortality. The project will be summarized in a thesis for completion of a doctoral degree in Epidemiology at University of South Florida.
The role of folate on CRC incidence has been inconsistent with different studies finding protective effect, null effect or even an increased risk of CRC. Fewer studies are available on the association between folate and colorectal cancer mortality. Dietary roles of folate on CRC depends on various enzymes. One of these enzymes is Methyl tetrahydrofolate reductase which catalyzes the reaction that forms 5-Methyl tetrahydrofolate. Polymorphism in the gene that codes for this enzyme result in varying effects of folate on CRC with those who are homozygous having a reduced risk of CRC in the presence of adequate folate. Whites are more likely to have this genetic variant giving them a survival advantage. Secondly, intakes of folate varies by race with blacks having a lower intake compared to Whites. Thirdly, African Americans may have a higher demand for folate due to the higher prevalence of anemia from sickle cell disease which is more prevalent in this group.
Calcium intake is lower in African Americans compared to Whites which may be due to lower consumption of milk secondary to lactose intolerance that is more prevalent among African Americans. On average, African Americans consume 83% of the recommended daily allowance (RDA) for calcium whereas European Americans consume more than the RDA. Additionally, the protective effect of calcium on CRC is more in distal tumors which are more in Whites suggesting that calcium may be interacting with local environmental factors in the intestine. Secondly, calcium level and intake are highly correlated with levels of Vitamin D. Disparities in Vitamin D intake between African Americans and European Americans has shown differences in survival between the two groups with African Americans having significantly worse survival.
Many studies have explored the role of calcium and folate on colorectal cancer incidence but few studies have looked at the effect of these micronutrients on CRC mortality and the interaction between race and these micronutrients has not been explored. The aim of this study is to determine if there is an interaction between race with calcium, and race with folate on colorectal cancer incidence and mortality. A second aim is to explore the interaction between race and medications (e.g. NSAIDs) that have been shown to affect colorectal cancer incidence and mortality. The project will be summarized in a thesis for completion of a doctoral degree in Epidemiology at University of South Florida.
Aims
The aim of this study is to determine if there is an interaction between race with calcium, and race with folate on colorectal cancer incidence and mortality. A second aim is to explore the interaction between race and medications (e.g. NSAIDs) that have been shown to affect colorectal cancer incidence and mortality.
Collaborators
Dr Hung Luu
University of Pittsburgh