http://bmj.com/cgi/content/full/324/7339/696/d
BMJ 2002;324:696 ( 23 March )
News roundup
Sunlight prevents cancer, study says
Owen Dyer London
Insufficient exposure to ultraviolet radiation may be an important risk
factor for cancer in western Europe and North America, according to the author
of a new study that directly contradicts official advice about sunlight.
The research, published this week in the journal Cancer
(2002;94:1867-75), examined cancer mortality in the United States. Deaths from a
range of cancers of the reproductive and digestive systems were approximately
twice as high in New England as in the south west, despite a diet that varies
little between regions.
An examination of 506 regions found a close inverse correlation between
cancer mortality and levels of ultraviolet B light. The likeliest mechanism for
a protective effect of sunlight is vitamin D, which is synthesised by the body
in the presence of ultraviolet B.
The studys author, Dr William Grant, says northern parts of the United
States may be dark enough in winter that vitamin D synthesis shuts down
completely. While the study focused on white Americans, the same geographical
trend affects black Americans, whose overall cancer rates are significantly
higher. Darker skinned people require more sunlight to synthesise vitamin D.
"There are 13 malignancies that show this inverse correlation, mostly
reproductive and digestive cancers," said Dr Grant. "The strongest inverse
correlation is with breast, colon, and ovarian cancer."
Other cancers apparently affected by sunlight include tumours of the bladder,
uterus, oesophagus, rectum, and stomach.
The paper estimates that in 2002 insufficient exposure to ultraviolet B among
Americans will lead to about 85 000 additional cancers out of 1 285 000
projected cases and 30 000 additional deaths out of 555 000 projected deaths,
compared with what would occur if the entire country could obtain the same
ultraviolet B levels as the southern states.
The total number of additional deaths that might occur in the United States
from melanoma and other skin cancers with the same increased level of
ultraviolet B would be about 3000. "Current advice about avoiding sunlight is
very parochial," said Dr Grant. "Its a dermatologists viewpoint."
Another study by Dr Grant, published in a previous issue of Cancer
(2002;94:272-81), looked at rates of breast cancer in 35 countries. That study
attributed 25% of cases of breast cancer in Europe to insufficient exposure to
ultraviolet B.
"The correlation between breast cancer and latitude in Europe becomes
clearest when Scandinavia is removed from the analysis, probably because they
get so much vitamin D from fish consumption," he said. "They also put vitamin D
in their milk."
Vitamin D supplements in pill form are cheap and readily available, but it is
not known whether they can act as a direct substitute for vitamin D synthesised
from sunlight.
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