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Volume 43, Issue 11, Pages 1701-1712 (July 2007)

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Does solar exposure, as indicated by the non-melanoma skin cancers,

protect from solid cancers: Vitamin D as a possible explanation

Pentti Tuohimaaa, Eero Pukkalab, Ghislaine Scéloc, n H. Olsend,

H. Brewstere, Kari Hemminkifg, Traceyh, bete Weiderpassij,

h V. Kliewerkl, Vera Pompe-Kirnm, L. McBriden, Carmen Martoso,Kee-Seng

Chiap, Jon M. Tonitaq, Jon G. Jonassonrs, Paolo Boffettac, Brennanc

Received 27 February 2007; received in revised form 13 April 2007;

accepted 19 April 2007. published online 31 May 2007.

Abstract

Background

Skin cancers are known to be associated with sun exposure, whereas

sunlight through the production of vitaminD may protect against some cancers.

The aim of this study was to assess whether patients with skin cancer have an

altered risk of developing other cancers.

Methods

The study cohort consisted of 416,134 cases of skin cancer and

3,776,501 cases of non-skin cancer as a first cancer extracted from 13 cancer

registries. 10,886 melanoma and 35,620 non-melanoma skin cancer cases had second

cancers. The observed numbers (O) of 46 types of second primary cancer after

skin melanoma, basal cell carcinoma or non-basal cell carcinoma, and of skin

cancers following non-skin cancers were compared to the expected numbers (E)

derived from the age, sex and calendar period specific cancer incidence rates in

each of the cancer registries (O/E=SIR, standardised incidence ratios). Rates

from cancer registries classified to sunny countries (Australia, Singapore and

Spain) and less sunny countries (Canada, Denmark, Finland, Iceland, Norway,

Scotland, Slovenia and Sweden) were compared to each other.

Results

SIR of all second solid primary cancers (except skin and lip) after

skin melanoma were significantly lower for the sunny countries (SIR(S)=1.03; 95%

CI 0.99–1.08) than in the less sunny countries (SIR(L)=1.14; 95%CI 1.11–1.17).

The difference was more obvious after non-melanoma skin cancers: after basal

cell carcinoma SIR(S)/SIR(L)=0.65 (95%CI=0.58–0.72); after non-basal cell

carcinoma SIR(S)/SIR(L)=0.58 (95%CI=0.50–0.67). In sunny countries, the risk of

second primary cancer after non-melanoma skin cancers was lower for most of the

cancers except for lip, mouth and non-Hodgkin lymphoma.

Conclusions

Vitamin D production in the skin seems to decrease the risk of

several solid cancers (especially stomach, colorectal, liver and gallbladder,

pancreas, lung, female breast, prostate, bladder and kidney cancers). The

apparently protective effect of sun exposure against second primary cancer is

more pronounced after non-melanoma skin cancers than melanoma, which is

consistent with earlier reports that non-melanoma skin cancers reflect

cumulative sun exposure, whereas melanoma is more related to sunburn.

Keywords: Skin cancer, Second cancer, Vitamin D, Epidemiology,

Prevention, Solar UV-B

It is clear that we need exposure to the sun, never allowing sunburning,

but seeking full body sun exposure for 15- 20 minutes daily....without sun

screen. The alternative? A high quality Vitamin D3 supplement. JC

A not so sunny quote:

" I sincerely believe... that banking establishments are more dangerous than

standing armies, and that the principle of spending money to be paid by

posterity under the name of funding is but swindling futurity on a large scale. "

-- Jefferson to , 1816. ME 15:23