engleski

Cancer and multiple sclerosis in Croatia

Background. Multiple sclerosis (MS) is an autoimmune disease, triggered by a combination of genetic and environmental risk factors, individually insufficient to provoke the disease before adolescence. Only few investigations studied the relation between cancer and MS. Some papers analyzed the coexistence of cancer in MS patients. Cancers associated with MS were found in 4 (1, 8%) out of 219 MS patients in Croatia and in 8, 5% of MS deaths in the USA (1990.2001). Few studies demonstrated a resemblance between geographic distribution of MS and cancer of the colon or prostate. Aim. To investigate possible risk factors shared between cancer and MS. Method. Incidence rates of MS in Croatia were collected from seven population-based epidemic studies published between 1990-2000. Only studies, which used Poser&#8217; s diagnostic criteria and reported the number of cases and the population studied, were taken into account. We compared and correlated incidence of MS in Croatia with the incidence of cancers in the same studied areas. The survey included the most frequent cancer sites for females and males together in Croatia drawn from the Croatian Cancer Register: stomach cancer, cancer of the colon and rectum, pancreatic cancer, lung caner, cancer of the kidneys and brain cancer. A seven-year (1988-1994) mean annual cancer incidence was calculated using population data from the Republic of Croatia Census for 1991. Results. The mean annual incidence of MS was nearly double higher than in the continental area (2.1/100, 000, 95% CI 1.9-2.4 vs. 1.3, 95% CI 1.0-1.7 ; chi-square=11.34, df=1, p=0.0007). Among the cancers significantly higher incidence rates in the continental area were found for stomach (34.3/100.000, 95% CI 32.6-36.1 Vs. 20.6, 95% CI 18.4-22.9 ; chi-square=71.4, df=1, p<0.00001) and lung cancer (58.2, 95% CI 55.9-60.5 vs. 46.0, 95% CI 42.7-49.5 ; chi-square=31.28, df=1, p<0.00001) whilst colon cancer was more frequent in the coastal area (20.2, 95%CI 18.1-22.5 vs. 16.3, 95%CI 15.2-17.6 ; chi-square=9.88, df=1, p=0.0017). The geographic distribution of MS was significantly correlated with pancreatic (r=0.634, df=23, p=0.0007) as well as lung cancer (r=0.478, df=23, p=0.015). Conclusion. This research adds further cancers, possibly exposure-related, to the list of diseases with geographic distribution like MS. Stomach cancer and lung cancer have a higher incidence in the continental Croatia, whilst colon cancer in the coastal Croatia. Significant correlations were found between MS and pancreatic, as well as lung cancer. The similarity of MS distribution with the named cancers is unlikely to be incidental. Some authors have documented a possible protective role of the &#8220; Mediterranean diet&#8221; for the lung and the stomach cancer. A diet rich in fat and meat is a risk factor for pancreatic, colorectal, as well as stomach cancers. MS has a higher incidence in the continental area. In Gorski Kotar and Slavonia seems to be associated with a diet rich in meat and fat. Perhaps the &#8220; Mediterranean diet&#8221; have a protective role for the MS too.

Cancer; Multiple Sclerosis; Epidemiology

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