Vitamin D Status and Cancer Incidence and Mortality

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Abstract

The role of excessive sun exposure in increasing risk of skin cancers is well established. Less known, less established and more controversial is the potential role of sun exposure in reducing risk of several types of internal cancers. The hypothesis that sunlight may be beneficial against several types of cancer extends back almost seven decades. Initially, Peller and Stephenson observed higher rates of skin cancer, but lower rates of other malignancies in United States Navy personnel in the 1930s.1 Based on this observation, Peller and Stephenson hypothesized that acquiring skin cancer conferred immunity against other cancers. Several years later, Apperly observed an association between latitude and cancer mortality rate, which led him to state that “The presence of skin cancer is really an occasional accompaniment of a relative cancer immunity in some way related to the exposure to solar radiation”.2 However, no plausible mechanism was proffered and these observations were essentially ignored for about four decades. In 1980, Garland and colleagues hypothesized that the potential benefit of sun exposure was attributed to vitamin D.3 Initially, the hypothesis was centered on colon cancer,3 but later it was extended to breast cancer,4 ovarian cancer,5 prostate cancer,6,7 and to multiple cancer types.8