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. 2021 Mar 23:11:558040.
doi: 10.3389/fonc.2021.558040. eCollection 2021.

Periodic Fluctuations in the Incidence of Gastrointestinal Cancer

Mun-Gan Rhyu  1 , Jung-Hwan Oh  2 , Tae Ho Kim  2 , Joon-Sung Kim  2 , Young A Rhyu  3 , Seung-Jin Hong  1
Affiliations

Periodic Fluctuations in the Incidence of Gastrointestinal Cancer

Mun-Gan Rhyu et al. Front Oncol. .

Abstract

Purpose: Native stem cells can be periodically replaced during short and long epigenetic intervals. Cancer-prone new stem cells might bring about periodic (non-stochastic) carcinogenic events rather than stochastic events. We investigated the epigenetic non-stochastic carcinogenesis by analyzing regular fluctuations in lifelong cancer incidence.

Materials and methods: Korean National Cancer Screening Program data were collected between 2009 and 2016. Non-linear and log-linear regression models were applied to comparatively evaluate non-stochastic and stochastic increases in cancer incidence. Prediction performances of regression models were measured by calculating the coefficient of determination, R2.

Results: The incidence of gastric and colorectal cancers fluctuated regularly during both short (8 years) and long (20 years) intervals in the non-linear regression model and increased stochastically in the log-linear regression model. In comparison between the 20-year interval fluctuation model and the stochastic model, R2 values were higher in the 20-year interval fluctuation model of men with gastric cancer (0.975 vs. 0.956), and in the stochastic model of men with colorectal cancer (0.862 vs. 0.877) and women with gastric cancer (0.837 vs. 0.890) and colorectal cancer (0.773 vs. 0.809). Men with gastric cancer showed a high R2 value (0.973) in the 8-year interval fluctuation model as well.

Conclusion: Lifelong incidence of gastrointestinal cancer tended to fluctuate during short and long intervals, especially in men with gastric cancer, suggesting the influence of an epigenetic schedule.

Keywords: Helicobacter pylori; adult stem cells; colon cancer; gastric cancer; mass screening.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Age-specific incidences of gastric and colorectal cancers in the Korean National Cancer Screening Program between 2009 and 2016. (A, B) The incidences of gastric cancer and those of colorectal cancer are depicted at 2-year intervals. (C) Male-to-female ratios of gastric and colorectal cancer incidences are plotted. The vertical dashed lines indicate 8-year intervals after 40 years of age.
Figure 2
Figure 2
Non-linear regression models for 20-year fluctuation intervals in gastric and colorectal cancers. (A) Comparison of non-linear periodic model (solid lines) and log-linear stochastic model (dashed lines). Dots represent observed incidence rates of gastric and colorectal cancers in the Korean National Cancer Screening Program between 2009 and 2016. (B) Fluctuation magnitudes of periodic fluctuation function in models 20-year-interval regression equation. Vertical dashed lines indicate 8-year intervals after 40 years of age.
Figure 3
Figure 3
Non-linear regression models for 8-year fluctuation intervals in gastric and colorectal cancers. Non-linear periodic model (solid lines) and log-linear stochastic model (dashed lines) are compared. Dots represent observed incidence rates of gastric and colorectal cancers in the Korean National Cancer Screening Program between 2009 and 2016.
Figure 4
Figure 4
Comparison of the growth rates of gastric and colorectal cancer incidences in men and women in the Korean National Cancer Screening Program between 2009 and 2016. (A) Growth rates of gastric and colorectal cancer incidences are plotted at 2-year intervals. (B) Growth rate curves are plotted according to the Korean National Cancer Screening Program year subgroups 2009–2011, 2012–2013, and 2014–2016. (C) Growth rates of the 2 cancer incidences are plotted at 4-year intervals. Vertical dashed lines indicate 8-year intervals after 40 years of age.
Figure 5
Figure 5
Age-specific incidence of synchronous gastric and colorectal cancer in the Korean National Cancer Screening Program between 2009 and 2016.
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