Sunlight, Vitamin D and Skin Cancer

CONTENTS 1. Sunlight, UV-Radiation, Vitamin D and Skin Cancer: How Much Sunlight Do We Need?....................................................... 1 Michael F. Holick Abstract................................................................................................................................. 1 Prehistorical and Historic Perspectives.............................................................................. 1 Photoproduction of Vitamin D3............................................................................................ 2 Factors Controlling Cutaneous Vitamin D Synthesis........................................................ 2 Sources and Metabolism of Vitamin D................................................................................ 4 Role of Vitamin D in the Prevention of Chronic Diseases................................................. 5 Vitamin D Deficiency Pandemic.......................................................................................... 7 Sunlight, Vitamin D and the Skin Cancer Conundrum.................................................... 7 Conclusion.......................................................................................................................... 10 2. Solar Ultrav iolet Irradiance and Cancer Incidence and Mortality...................................................................... 16 William B. Grant Introduction........................................................................................................................ 16 Cancer................................................................................................................................. 16 Other Diseases for Which Solar UVB and Vitamin D Are Beneficial/Protective.......... 25 Summary and Conclusion.................................................................................................. 25 3. Vitamin D Status and Cancer Incidence and Mortality............................................................................................. 31 Edward Giovannucci Introduction........................................................................................................................ 31 Ecologic Studies of Sun Exposure..................................................................................... 32 Case-Control and Cohort Studies of Sun Exposure........................................................ 32 Prospective Studies of Circulating 25(OH)vitamin D and Cancer Risk........................ 33 Studies of Vitamin D Intake............................................................................................... 35 Randomized Trial of Vitamin D Intake and Colorectal Cancer..................................... 36 Solar Radiation, Vitamin D and Survival Rate of Colon Cancer................................... 36 Vitamin D and Cancer Rates in United States Black Men.............................................. 37 Synthesis of Evidence Regarding Sun Exposure, Vitamin D and Cancer Incidence and Mortality........................................................................ 38 Implications for Future Research...................................................................................... 39 4. Sun Exposure and Cancer Surviva l in Norway: Changes in the Risk of Death with Season of Diagnosis and Latitude.................................................................... 43 Alina Carmen Porojnicu, Arne Dahlback and Johan Moan Abstract............................................................................................................................... 43 Introduction.............................................