Advertisement

Does sunlight prevent cancer? A systematic review

      Abstract

      Accumulating evidence for beneficial effects of sunlight on several types of cancer with a high mortality rate makes it necessary to reconsider the health recommendations on sun exposure, which are now mainly based on the increased risks for skin cancer. We reviewed all published studies concerning sun exposure and cancer, excluding skin cancer.
      All selected studies on prostate (3 ecologic, 3 case-control and 2 cohort), breast (4 ecologic, 1 case-control and 2 cohort) and ovary cancer (2 ecologic and 1 case-control) showed a significantly inverse correlation between sunlight and mortality or incidence. Two ecologic, 1 case-control and 2 prospective studies showed an inverse relation between sunlight and colon cancer mortality; 1 case-control study found no such association. Ecologic studies on non-Hodgkin lymphoma (NHL) mortality and sunlight gave conflicting results: early studies showing mostly positive and later studies showing mostly negative correlations. Three case-control studies and 1 cohort study found a significant inverse association between the incidence of NHL and sunlight.
      The question of how to apply these findings to (public) health recommendations is discussed.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Armstrong B.K.
        • Kricker A.
        The epidemiology of UV induced skin cancer.
        J Photochem Photobiol B. 2001; 63: 8-18
        • White E.
        • Kirkpatrick C.S.
        • Lee J.A.
        Case-control study of malignant melanoma in Washington State. I. Constitutional factors and sun exposure.
        Am J Epidemiol. 1994; 139: 857-868
        • Kaskel P.
        • Sander S.
        • Kron M.
        • et al.
        Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs.
        Br J Dermatol. 2001; 145: 602-609
        • Heenan P.J.
        • English D.R.
        • Holman C.D.
        • Armstrong B.K.
        Survival among patients with clinical stage I cutaneous malignant melanoma diagnosed in Western Australia in 1975/1976 and 1980/1981.
        Cancer. 1991; 68: 2079-2087
        • Barnhill R.L.
        • Fine J.A.
        • Roush G.C.
        • Berwick M.
        Predicting five-year outcome for patients with cutaneous melanoma in a population-based study.
        Cancer. 1996; 78: 427-432
        • Berwick M.
        • Armstrong B.K.
        • Ben-Porat L.
        • et al.
        Sun exposure and mortality from melanoma.
        J Natl Cancer Inst. 2005; 97: 195-199
        • van der Mei I.A.
        • Ponsonby A.L.
        • Dwyer T.
        • et al.
        Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study.
        Br Med J. 2003; 327: 316
        • VanAmerongen B.M.
        • Dijkstra C.D.
        • Lips P.
        • Polman C.H.
        Multiple sclerosis and vitamin D: an update.
        Eur J Clin Nutr. 2004; 58: 1095-1109
        • Ponsonby A.L.
        • McMichael A.
        • van der Mei I.
        Ultraviolet radiation and autoimmune disease: insights from epidemiological research.
        Toxicology. 2002; 181–182: 71-78
        • Studzinski G.P.
        • Moore D.C.
        Sunlight – can it prevent as well as cause cancer?.
        Cancer Res. 1995; 55: 4014-4022
        • Moon S.J.
        • Fryer A.A.
        • Strange R.C.
        Ultraviolet radiation: effects on risks of prostate cancer and other internal cancers.
        Mutat Res. 2005; 571: 207-219
      1. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No. 5, Version 1.0. Lyon: IARC Press; 2001.

        • Hanchette C.L.
        • Schwartz G.G.
        Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation.
        Cancer. 1992; 70: 2861-2869
        • Grant W.B.
        An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation.
        Cancer. 2002; 94: 1867-1875
        • Garland F.C.
        • Garland C.F.
        • Gorham E.D.
        • Young J.F.
        Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation.
        Prev Med. 1990; 19: 614-622
        • Bentham G.
        Association between incidence of non-Hodgkin’s lymphoma and solar ultraviolet radiation in England and Wales.
        Br Med J. 1996; 312: 1128-1131
        • Hartge P.
        • Devesa S.S.
        • Grauman D.
        • Fears T.R.
        • Fraumeni Jr., J.F.
        Non-Hodgkin’s lymphoma and sunlight.
        J Natl Cancer Inst. 1996; 88: 298-300
        • Grant W.B.
        A multicountry ecologic study of risk and risk reduction factors for prostate cancer mortality.
        Eur Urol. 2004; 45: 271-279
        • Gorham E.D.
        • Garland F.C.
        • Garland C.F.
        Sunlight and breast cancer incidence in the USSR.
        Int J Epidemiol. 1990; 19: 820-824
        • Grant W.B.
        An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates.
        Cancer. 2002; 94: 272-281
        • Garland C.F.
        • Garland F.C.
        Do sunlight and vitamin D reduce the likelihood of colon cancer?.
        Int J Epidemiol. 1980; 9: 227-231
        • Lefkowitz E.S.
        • Garland C.F.
        Sunlight, vitamin D, and ovarian cancer mortality rates in US women.
        Int J Epidemiol. 1994; 23: 1133-1136
        • Hu S.
        • Ma F.
        • Collado-Mesa F.
        • Kirsner R.S.
        Ultraviolet radiation and incidence of non-Hodgkin’s lymphoma among Hispanics in the United States.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 59-64
        • Langford I.H.
        • Bentham G.
        • McDonald A.L.
        Mortality from non-Hodgkin lymphoma and UV exposure in the European Community.
        Health Place. 1998; 4: 355-364
        • McMichael A.J.
        • Giles G.G.
        Have increases in solar ultraviolet exposure contributed to the rise in incidence of non-Hodgkin’s lymphoma?.
        Br J Cancer. 1996; 73: 945-950
        • Uehara M.
        • Takahashi K.
        • Hoshuyama T.
        • Pan G.
        • Feng Y.
        Geographical correlation between ambient UVB level and mortality risk of leukemia in Japan.
        Environ Res. 2003; 92: 78-84
        • Freedman D.M.
        • Dosemeci M.
        • McGlynn K.
        Sunlight and mortality from breast, ovarian, colon, prostate, and non-melanoma skin cancer: a composite death certificate based case-control study.
        Occup Environ Med. 2002; 59: 257-262
        • Bodiwala D.
        • Luscombe C.J.
        • French M.E.
        • et al.
        Associations between prostate cancer susceptibility and parameters of exposure to ultraviolet radiation.
        Cancer Lett. 2003; 200: 141-148
        • John E.M.
        • Schwartz G.G.
        • Koo J.
        • Van Den Berg D.
        • Ingles S.A.
        Sun exposure, vitamin D receptor gene polymorphisms, and risk of advanced prostate cancer.
        Cancer Res. 2005; 65: 5470-5479
        • Kampman E.
        • Slattery M.L.
        • Caan B.
        • Potter J.D.
        Calcium, vitamin D, sunshine exposure, dairy products and colon cancer risk (United States).
        Cancer Causes Control. 2000; 11: 459-466
        • Hughes A.M.
        • Armstrong B.K.
        • Vajdic C.M.
        • et al.
        Sun exposure may protect against non-Hodgkin lymphoma: a case-control study.
        Int J Cancer. 2004; 112: 865-871
        • Freedman D.M.
        • Zahm S.H.
        • Dosemeci M.
        Residential and occupational exposure to sunlight and mortality from non-Hodgkin’s lymphoma: composite (threefold) case-control study.
        Br Med J. 1997; 314: 1451-1455
        • Smedby K.E.
        • Hjalgrim H.
        • Melbye M.
        • et al.
        Ultraviolet radiation exposure and risk of malignant lymphomas.
        J Natl Cancer Inst. 2005; 97: 199-209
        • Robsahm T.E.
        • Tretli S.
        • Dahlback A.
        • Moan J.
        Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway).
        Cancer Causes Control. 2004; 15: 149-158
        • John E.M.
        • Dreon D.M.
        • Koo J.
        • Schwartz G.G.
        Residential sunlight exposure is associated with a decreased risk of prostate cancer.
        J Steroid Biochem Mol Biol. 2004; 89–90: 549-552
        • John E.M.
        • Schwartz G.G.
        • Dreon D.M.
        • Koo J.
        Vitamin D and breast cancer risk: the NHANES I Epidemiologic follow-up study, 1971–1975 to 1992. National Health and Nutrition Examination Survey.
        Cancer Epidemiol Biomarkers Prev. 1999; 8: 399-406
        • Adami J.
        • Gridley G.
        • Nyren O.
        • et al.
        Sunlight and non-Hodgkin’s lymphoma: a population-based cohort study in Sweden.
        Int J Cancer. 1999; 80: 641-645
        • Moan J.
        • Porojnicu A.C.
        • Robsahm T.E.
        • et al.
        Solar radiation, vitamin D and survival rate of colon cancer in Norway.
        J Photochem Photobiol B. 2005; 78: 189-193
        • Porojnicu A.C.
        • Robsahm T.E.
        • Ree A.H.
        • Moan J.
        Season of diagnosis is a prognostic factor in Hodgkin’s lymphoma: a possible role of sun-induced vitamin D.
        Br J Cancer. 2005; 93: 571-574
        • Bodiwala D.
        • Luscombe C.J.
        • French M.E.
        • et al.
        Polymorphisms in the vitamin D receptor gene, ultraviolet radiation, and susceptibility to prostate cancer.
        Environ Mol Mutagen. 2004; 43: 121-127
        • Giovannucci E.
        The epidemiology of vitamin D and cancer incidence and mortality: a review (United States).
        Cancer Causes Control. 2005; 16: 83-95
        • Schwartz G.G.
        Vitamin D and the epidemiology of prostate cancer.
        Semin Dial. 2005; 18: 276-289
        • Harris D.M.
        • Go V.L.
        Vitamin D and colon carcinogenesis.
        J Nutr. 2004; 134: 3463S-3471S
        • Welsh J.
        Vitamin D and breast cancer: insights from animal models.
        Am J Clin Nutr. 2004; 80: 1721S-1724S
        • Chen T.C.
        • Holick M.F.
        Vitamin D and prostate cancer prevention and treatment.
        Trends Endocrinol Metab. 2003; 14: 423-430
        • DeLeo V.A.
        The vitamin D and sunlight controversy – we will wait and see.
        Cutis. 2005; 76: 229
        • Tuohimaa P.
        • Tenkanen L.
        • Ahonen M.
        • et al.
        Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries.
        Int J Cancer. 2004; 108: 104-108
        • Schernhammer E.S.
        • Hankinson S.E.
        Urinary melatonin levels and breast cancer risk.
        J Natl Cancer Inst. 2005; 97: 1084-1087
      2. Comprehensive Cancer Centres. Age specific mortality rates per 100,000 person-years according to site among (fe)males in 2003. Source: Statistics Netherlands. Available from: http://www.ikcnet.nl/uploaded/FILES/Landelijk/cijfers/Incidentie%202003/B3%202003.xls. In: Comprehensive Cancer Centres, 2006.