Iodine prophylaxis—the protective factor against stomach cancer in iodine deficient areas
- 175 Downloads
Poland has one of the highest death rates for stomach cancer in Europe. Moderate iodine deficiency and in consequence high goitre prevalence led to the implementation in 1996 of a very efficient mandatory model of iodine prophylaxis, based on household salt iodisation (30 ± 10mg KI/1 kg of salt).
Aim of the study
The aim of the study was evaluation of incidence rate of stomach cancer and its possible relation to increased iodine consumption in the years 1992–2004.
Iodine supply and effectiveness of iodine prophylaxis were evaluated on the basis of comparative analysis of goitre prevalence and ioduria in schoolchildren. To allow comparison between time periods with varying population age structures, the incidence rates of stomach cancer were standardized for age, using the “world standard population”. The direct standardization method has been applied. For each sex, the time-trend of incidence rates was shown in graphs over the years 1991–2004.
Evident increase in iodine consumption in this period of time was proved by rise in percentage of schoolchildren (6–8 years old) with ioduria above 100 µg/l from 11.4% in 1992–1993 to 52.9.1% in 2003. It was correlated with the decrease in goitre prevalence from 18.8% to 3.2% respectively. The 24-h thyroid uptake of 131I in investigated population fell from 45.5% in 1986 to 26.8% in 1998. In Krakow the standardized incidence ratio of stomach cancer for men decreased from 19.1 per 100,000 to 15.7 per 100,000, and for women from 8.3 per 100,000 to 5.9 per 100,000 in the years 1992–2004. A significant decline of average rate of decrease was observed in men and women (2.3% and 4.0% per year respectively).
Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas—further studies are necessary.
Keywordsgastric cancer iodine deficiency iodine prophylaxis
- 1.Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J (1992) Cancer incidence in five continents. Vol. VI. Lyon, France: International Agency for Research on Cancer. IARC Scientific PublicationsGoogle Scholar
- 2.Jedrychowski W, Popiela T (1986) Gastric cancer in Poland—a decreased malignancy due to changing nutritional habits of the population. Neoplasma 33:97–106Google Scholar
- 3.Jedrychowski W, Popiela T, Steindorf K, Tobiasz-Adamczyk B, Kulig J, Penar A, Wahrendorf J (2001) Nutrient intake patterns in gastric and colorectal cancers. Int J Occup Med Environ Health 14:391–395Google Scholar
- 5.Venturi S, Donati FM, Venturi A, Venturi M, Grossi L, Guidi A (2000) Role of iodine in evolution and carcinogenesis of thyroid, breast and stomach. Adv Clin Path 4:11–17Google Scholar
- 6.Venturi S, Grossi L, Marra GA, Venturi A, Venturi M (2003) Iodine, Helicobacter pylori, stomach cancer and evolution. Eur Epimarker 7:1–7Google Scholar
- 9.Behrouzian R, Aghdami N (2004) Urinary iodine/creatinine ratio in patients with stomach cancer in Urmia, Islamic Republic of Iran. East Mediterr Health J 10:921–924Google Scholar
- 10.Szybinski Z, Delange F, Lewiński A, Podoba J, Rybakowa M, Wasik R, Szewczyk L, Huszno B, Golkowski F, Przybylik-Mazurek E, Karbownik M, Zak T, Pantoflinski J, Trofimiuk M, Kinalska I (2001) A programme of iodine supplementation using only iodised household salt is efficient—the case of Poland. Eur J Endocrinol 144:331–333CrossRefGoogle Scholar
- 11.Golkowski F, Huszno B, Trofimiuk M, Sowinski J, Bandurska-Stankiewicz E, Dorant B, Szybinski Z (2003) Prevalence of goiter in schoolchildren—a study on the influence of adequate iodine prophylaxis. J Endocrinol Invest 26(Suppl. to No. 2):11–15Google Scholar
- 12.Szybinski Z, Lewinski A (1998) National Programme for Elimination of Iodine Deficiency Disorders in Poland (1999–2003). Endokrynol Pol 49:203–213Google Scholar
- 14.Rachtan J, Geleta M, Sokolowski A, et al. (2003) Epidemiology of gastric cancer. In: Epidemiology of the malignant neoplasms in Kraków’s region (1985–1999). Oncologic Center in KrakówGoogle Scholar
- 15.Delange F, Benker G, Caron PH, Eber O, Ott W, Peter F, Podoba J, Simescu M, Szybinski Z, Vertongen F, Vitti P, Wiersinga W, Zamrazil V (1997) Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol 136:180–187Google Scholar
- 16.Szybinski Z (1998) Results of the programme on iodine deficiency in Poland and monitoring system of mandatory model of iodine prophylaxis. Endokrynol Pol 49:9–20Google Scholar
- 17.Szybinski Z, Zarnecki A (1993) Prevalence of goitre, iodine deficiency and iodine prophylaxis in Poland. The results of nation-wide study. Endokrynol Pol 44:373–388Google Scholar
- 18.Huszno B, Hubalewska-Hola A, Baldys-Waligorska A, Sowa-Staszczak A, Szybinski Z (2003) The impact of iodine prophylaxis on thyroid 131-iodine uptake in the region of Kraków, Poland. J Endocrinol Invest 26(Suppl. to No. 2):7–10Google Scholar
- 19.ICCIDD (2003) Iodine deficiency in Europe. J Endocrinol Invest 26(Suppl. to No. 9):60–62Google Scholar
- 20.Spitzweg C, Joba W, Eisenmenger W, Heufelder AE (1998) Analysis of human sodium iodide gene symporter expression in extrathyroid tissue and cloning of its complementary deoxyribonucleic acid from salivary gland, mammary gland and gastric mucosa. J Clin Endocrinol Metab 83:1746–1751CrossRefGoogle Scholar
- 22.Wojtyniak B, Gorynski P, Kuszewski K (2003). Malignant neoplasms. In: Health status of the polish population. National Institute of Hygiene, Warsaw, pp 103–109Google Scholar
- 23.Jedrychowski W, Maugeri U (2004) Contribution of epidemiology in Poland to better understanding of the natural history of gastrointestinal tract diseases. Eur Epimarker 8:1–7Google Scholar
- 24.Sekula W, Figurska K, Jutrowska I, Barysz A (2004) Dlugookresowe zmiany w spozyciu zywnosci w Polsce i ich skutki zywieniowe i zdrowotne. Zyw Czlow Metab Supl 2:55–72Google Scholar
- 25.Bielanski W (1999) Epidemiological study on Helicobacter pylori infection and extragastroduodenal disorders in Polish population. J Physiol Pharmacol 50:723–733Google Scholar
- 26.Celinski K, Kurzeja-Miroslaw A, Slomka M, Cichoz-Lach H, Madro A, Kasztelan-Szczerbinska B (2006) Ann Agric Environ Med 13:185–191Google Scholar
- 27.Abnet CC, Fan JH, Kamangar F, Sun XD, Taylor PR, Ren JS, Mark SD, Zhao P, Fraumeni JF Jr, Qiao YL, Dawsey SM (2006) Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort. Int J Cancer 119:1508–1510CrossRefGoogle Scholar
- 28.Kandemir EG, Yonem A, Narin Y (2005) Gastric carcinoma and thyroid status. J Inter Med Res 33:222–227Google Scholar
- 29.Kamangar F, Dawsey SM, Blaser MJ, Perez-Perez GI, Pietinen P, Newschaffer CJ, Abnet CC, Albanes D, Virtamo J, Taylor PR (2006) Opposing risks of gastric cardia and noncardia gastric adenocarcinomas associated with Helicobacter pylori seropositivity. J Nat Cancer Inst 98:1445–1452CrossRefGoogle Scholar
- 30.Comment of Nyren O, Blot WJ (2006). J Nat Cancer Inst. 98:1432–1434Google Scholar
- 31.WHO, UNICEF, ICCIDD (2001) Assessment of the iodine deficiency disorders and monitoring their elimination. WHO, GenevaGoogle Scholar