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Global breast cancer seasonality

  • Epidemiology
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Abstract

Human breast cancer incidence has seasonal patterns that seem to vary among global populations. The aggregate monthly frequency of breast cancer diagnosis was collected and examined for 2,921,714 breast cancer cases diagnosed across 64 global regions over spans from 2 to 53 years. Breast cancer is consistently diagnosed more often in spring and fall, both in the Northern and Southern Hemispheres, regardless of presumable menopausal status (≤50, >50). This seasonality is increasingly more prominent as population distance from the equator increases and this latitude dependence is most pronounced among women living in rural areas. Moreover, the overall annual incidence (2005–2006), per 100,000 population, of breast cancer increased as the latitude of population residence increased. These data make it clear that human breast cancer discovery occurs non-randomly throughout each year with peaks near both equinoxes and valleys near both solstices. This stable global breast cancer seasonality has implications for better prevention, more accurate screening, earlier diagnosis, and more effective treatment. This complex latitude-dependent breast cancer seasonality is clearly related to predictable local day/night length changes which occur seasonally. Its mechanism may depend upon seasonal sunlight mediation of vitamin D and seasonal mediation of nocturnal melatonin peak level and duration.

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References

  1. Ross JA et al (1997) Seasonal trends in the self-detection of breast cancer: induction from the cancer and steroid hormone (CASH) study. Breast Can Res Treat 42:187–192

    Article  CAS  Google Scholar 

  2. Moan J et al (2005) Solar radiation, vitamin D and survival rate of colon cancer in Norway. J Photochem Photobiol B 78:189–193

    Article  CAS  PubMed  Google Scholar 

  3. Lambe M, Blomqvist P, Bellocco R (2003) Seasonal variation in the diagnosis of cancer: a study based on national cancer registration in Sweden. Br J Cancer 88(9):1358–1360

    Article  CAS  PubMed  Google Scholar 

  4. Lee JAH (1967) Seasonal alterations and the natural history of malignant neoplasms. Prog Clin Cancer 3:96–106

    CAS  PubMed  Google Scholar 

  5. Mason BH et al (1985) Seasonal variation in breast cancer detection: correlation with tumour progesterone receptor status. Breast Cancer Res Treat 5:171–176

    Article  CAS  PubMed  Google Scholar 

  6. Hostmark J, Laerum O, Farsund T (1984) Seasonal variations of symptoms and occurrence of human bladder carcinomas. Scand J Urol Nephrol 18(2):107–111

    Article  CAS  PubMed  Google Scholar 

  7. Swerdlow AJ (1985) Seasonality of presentation of cutaneous melanoma, squamous cell cancer and basal cell cancer in the Oxford Region. Br J Cancer 52(6):893–900

    CAS  PubMed  Google Scholar 

  8. Chleboun JO, Gray BN (1987) The profile of breast cancer in Western Australia. Med J Aust 147:331–334

    CAS  PubMed  Google Scholar 

  9. Harris R et al (1987) The seasonal risk of pediatric/juvenile acute lymphocytic leukemia in the United States. J Chron Dis 40:915–923

    Article  CAS  PubMed  Google Scholar 

  10. Akslen L, Sothern RB (1998) Seasonal variations in the presentation and growth of thyroid cancer. Br J Cancer 77:1174–1179

    CAS  PubMed  Google Scholar 

  11. Cohen P, Wax Y, Modan B (1983) Seasonality in the occurrence of breast cancer. Cancer Res 43:892–896

    CAS  PubMed  Google Scholar 

  12. Robsahm TE et al (2004) Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control 15:149–158

    Article  PubMed  Google Scholar 

  13. Gao F et al (2001) Seasonal variation in breast cancer diagnosis in Singapore. Br J Cancer 84(9):1185–1187

    Article  CAS  PubMed  Google Scholar 

  14. Kirkham N et al (1985) Seasonality and breast cancer. Eur J Surg Oncol 11:143–146

    CAS  PubMed  Google Scholar 

  15. Holdaway I et al (1990) Seasonal change in the concentration of progesterone receptor in breast cancer. Cancer Res 50:5883

    CAS  PubMed  Google Scholar 

  16. Aaltomaa S, Lipponen P, Eskelinen M (1992) Demographic prognostic factors in breast cancer. Acta Oncol 31:635–640

    Article  CAS  PubMed  Google Scholar 

  17. Galea M, Blamey R (1991) Season of initial detection in breast cancer (letter). Br J Cancer 63:157

    CAS  PubMed  Google Scholar 

  18. Porojnicu AC et al (2007) Changes in risk of death from breast cancer with season and latitude. Breast Cancer Res Treat 102(3):323–328

    Article  PubMed  Google Scholar 

  19. Lim HS et al (2006) Cancer survival is dependent on season of diagnosis and sunlight exposure. Int J Can 119:1530–1536

    Article  CAS  Google Scholar 

  20. Grant WB (2002) An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates. Cancer 94(1):272–281

    Article  PubMed  Google Scholar 

  21. Hartveit F (1996) Micrometastases to the axilla in breast cancer: their size and season of presentation. Invasion Metastasis 16:144–149

    CAS  PubMed  Google Scholar 

  22. Mason B et al (1990) Season of initial discovery of tumour as an independent variable predicting survival in breast cancer. Br J Cancer 61:137–141

    CAS  PubMed  Google Scholar 

  23. Mason B et al (1990) Season of tumour detection influences factors predicting survival of patients with breast cancer. Breast Cancer Res Treat 15:27–37

    Article  CAS  PubMed  Google Scholar 

  24. Paradiso ASG, Fanelli M, Mangia A, Cellamare G, Schittulli F (2001) Predictability of monthly and yearly rhythms of breast cancer features. Breast Cancer Res Treat 67:41–49

    Article  CAS  PubMed  Google Scholar 

  25. Hartveit F (2000) Annual rhythm in the growth of human breast carcinomas as reflected in the histology of their growing edge. J Surg Pathol 8(1):39–47

    Article  Google Scholar 

  26. Vyzula R et al (2001) Seasonal variation in estrogen and progesterone receptor levels in breast cancer—a factor in data interpretation. Neoplasia 48:19–25

    CAS  Google Scholar 

  27. Hughes A et al (1976) Ovarian independent fluctuations of estradiol receptor levels in mammalian tissues. Mol Cell Endocrinol 5:379–388

    Article  CAS  PubMed  Google Scholar 

  28. Martin P et al (1979) Multiple steroid receptors in human breast cancer. III. Relationships between steroid receptors and the state of differentiation and the activity of carcinomas throughout the pathologic features. Cancer Chemother Pharmacol 2(2):115–120

    Article  CAS  PubMed  Google Scholar 

  29. Cohen P (1990) Host heterogeneity in female breast cancer: possible significance for pathophysiology, therapy, and prevention. Breast Cancer Res Treat 15:205–212

    Article  CAS  PubMed  Google Scholar 

  30. Goodman JW, Hodgson GS (1962) Evidence for stem cells in the peripheral blood of mice. Blood 19:702–714

    CAS  PubMed  Google Scholar 

  31. Roger JH (1977) A significance test for cyclic trends in incidence data. Biometrika 64(1):152–155

    Article  Google Scholar 

  32. Edwards JH (1961) The recognition and estimation of cyclic trends. Ann Hum Genet 25:83–87

    Article  CAS  PubMed  Google Scholar 

  33. Mojon A, Fernandez J, Hermida R (1992) Chronolab: an interactive software package for chronobiologic time series analysis written for the Macintosh computer. Chronobiol Int 9:403–412

    Article  CAS  PubMed  Google Scholar 

  34. You WC et al (2005) Etiology and prevention of gastric cancer: a population study in a high risk area of China. Chin J Dig Dis 6(4):149–154

    Article  PubMed  Google Scholar 

  35. Wood PA, Hrushesky WJM (2005) Sex cycle modulates cancer growth. Breast Cancer Res Treat 91(1):95–102

    Article  PubMed  Google Scholar 

  36. Oh EY et al (2008) Seasonal modulation of post-resection breast cancer metastasis. Breast Cancer Res Treat 111(2):219–228

    Article  PubMed  Google Scholar 

  37. Welsh J (2007) Targets of vitamin D receptor signaling in the mammary gland. J Bone Miner Res 22:V86–V90

    Article  CAS  PubMed  Google Scholar 

  38. Byrne B, Welsh J (2007) Identification of novel mediators of Vitamin D signaling and 1, 25(OH)2D3 resistance in mammary cells. J Steroid Biochem Mol Biol 103(3–5):703–707

    Article  CAS  PubMed  Google Scholar 

  39. Sundaram S et al (2003) The combination of a potent vitamin D3 analog, EB 1089, with ionizing radiation reduces tumor growth and induces apoptosis of MCF-7 breast tumor xenografts in nude mice. Clin Cancer Res 9(6):2350–2356

    CAS  PubMed  Google Scholar 

  40. Blask DE, Sauer LA, Dauchy RT (2002) Melatonin as a chronobiotic/anticancer agent: cellular, biochemical, and molecular mechanisms of action and their implications for circadian-based cancer therapy. Curr Top Med Chem 2(2):113–132

    Article  CAS  PubMed  Google Scholar 

  41. Vijayalaxmi et al (2004) Melatonin as a radioprotective agent: a review. Int J Radiat Oncol Biol Phys 59(3):639–653

    CAS  PubMed  Google Scholar 

  42. Blask DE, Dauchy RT, Sauer LA (2005) Putting cancer to sleep at night: the neuroendocrine/circadian melatonin signal. Endocrine 27(2):179–188

    Article  CAS  PubMed  Google Scholar 

  43. Cos S et al (2006) Estrogen-signaling pathway: a link between breast cancer and melatonin oncostatic actions. Cancer Detect Prev 30(2):118–128

    Article  CAS  PubMed  Google Scholar 

  44. Mohr SB et al (2008) Relationship between low ultraviolet B irradiance and higher breast cancer risk in 107 countries. Breast J 14(3):255–260

    Article  PubMed  Google Scholar 

  45. Porojnicu AC, Dahlback A, Moan J (2008) Sun exposure and cancer survival in Norway: changes in the risk of death with season of diagnosis and latitude. Adv Exp Med Biol 624:43–54

    Article  PubMed  Google Scholar 

  46. Mason B et al (1990) Season of initial discovery of tumour as an independent variable predicting survival in breast cancer. Br J Cancer 61:137–141

    CAS  PubMed  Google Scholar 

  47. Zhou W et al (2005) Vitamin D is associated with improved survival in early-stage non-small cell lung cancer patients. Cancer Epidemiol Biomarkers Prev 14(10):2303–2309

    Article  CAS  PubMed  Google Scholar 

  48. Grant WB (2002) An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer 94(6):1867–1875

    Article  PubMed  Google Scholar 

  49. Lefkowitz ES, Garland CF (1994) Sunlight, vitamin D, and ovarian cancer mortality rates in US women. Int J Epidemiol 23(6):1133–1136

    Article  CAS  PubMed  Google Scholar 

  50. Hanchette CL, Schwartz GG (1992) Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation. Cancer 70(12):2861–2869

    Article  CAS  PubMed  Google Scholar 

  51. Garland CF, Garland FC (1980) Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol 9(3):227–231

    Article  CAS  PubMed  Google Scholar 

  52. Barger-Lux MJ, Heaney RP (2002) Effects of above average summer sun exposure on serum 25-hydroxyvitamin D and calcium absorption. J Clin Endocrinol Metab 87(11):4952–4956

    Article  PubMed  Google Scholar 

  53. Cassone V, Natesan A (1997) Time and time again: the phylogeny of melatonin as a transducer of biological time. J Biol Rhy 12(6):489–497

    Article  CAS  Google Scholar 

  54. Arendt J (1997) The pineal gland, circadian rhythms and photoperiodism. In: Redfern PH, Lemmer B (eds) Physiology and pharmacology of biological rhythms. Springer-Verlag, Berlin, pp 375–414

    Google Scholar 

  55. Stokkan KA, Reiter RJ (1994) Melatonin rhythms in Arctic urban residents. J Pineal Res 16(1):33–36

    Article  CAS  PubMed  Google Scholar 

  56. Koukkari WL, Sothern R (2006) Introducing biological rhythm: a primer on the temporal organization of life, with implications for health, society, reproduction and the natural environment. Springer, New York, pp 456–459

    Google Scholar 

  57. Schernhammer ES, Hankinson SE (2005) Urinary melatonin levels and breast cancer risk. J Nat Can Inst 97(14):1084–1087

    Article  CAS  Google Scholar 

  58. Stevens RG (2005) Circadian disruption and breast cancer: from melatonin to clock genes. Epidemiology 16:254–258

    Article  PubMed  Google Scholar 

  59. Tamarkin L et al (1982) Decreased nocturnal plasma melatonin peak in patients with estrogen receptor positive breast cancer. Science 216(4549):1003–1005

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Person(s) who helped us obtain the data from each cancer registry: Belgium (Jos Droste), Canada (Alain Demers), Chile (Maria Enriqueta Betran Vives), Shanghai-China (Chung-Xiao Wu), Colorado-US (Randi Rycroft), Czech Republic (Vlasta Mazankova), England-Oxford (Neil Kennedy), Estonia (Margit Mägi and Mati Rahu), Finland (Timo Hakulinen), Iceland (Laufey Tryggvadóttir), Idaho-US (Stacey L. Carson), Indiana-US (Steve Nygaard), Iran (Seyed Mohsen Mousavi), Ireland (Harry Comber), Israel (Micha Barchana), Lithuania (Juozas Kurtinatis), Massachusetts-US (Susan Gershman), Michigan-US (Georgia Spivak), Montana-US (Debbi Lemons), New Orleans-US (Patty Andrews), New York-US (Maria J. Schymura), New Zealand (Susan Hanna), Northern Australia (Lindy Garling), Northern Ireland (Anna T. Gavin), Norway (Froydis Langmark), Oregon-US (Donald Shipley), Philipines (Ronald De los Reyes), Poland (Zwierko Maria), Rhode Island-US (John Fulton), Scotland (David Brewster), South Carolina-US (DHEC), Taiwan (CJ Chen and San-Lin You), Tasmania (Alison Venn), Texas-US (Melanie Williams), Lampang-Thailand (Nilubol Patel), Songkhla-Thailand (Hutcha Sriplung), Vermont-US (Ali Johnson), Western Australia (Timothy J. Threlfall), and Wisconsin-US (Laura Stephenson).

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Authors and Affiliations

  1. Medical Chronobiological Laboratory, Dorn Research Institute, WJB Dorn VA Medical Center, School of Medicine and School of Public Health, University of South Carolina, 6439 Garners Ferry Road, Columbia, SC, 29209, USA

    Eun-Young Oh, Christine Ansell, Hamayun Nawaz, Chul-Ho Yang, Patricia A. Wood & William J. M. Hrushesky

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  1. Eun-Young Oh
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  2. Christine Ansell
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  3. Hamayun Nawaz
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  4. Chul-Ho Yang
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  6. William J. M. Hrushesky
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Correspondence to William J. M. Hrushesky.

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Oh, EY., Ansell, C., Nawaz, H. et al. Global breast cancer seasonality. Breast Cancer Res Treat 123, 233–243 (2010). https://doi.org/10.1007/s10549-009-0676-7

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  • DOI: https://doi.org/10.1007/s10549-009-0676-7

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