title: Sunlight and mortality from breast, ovarian, colon, prostate, and non-melanoma skin cancer: a composite death certificate based case-control study.
abstract: OBJECTIVE
  To explore whether mortality from female breast, ovarian, colon, and prostate cancer were negatively associated with exposure to sunlight.
  
  
  METHODS
  A death certificate based case-control study of mortality was conducted into five cancers: female breast, ovarian, colon, prostate, and non-melanoma skin cancer (as a positive control) to examine associations with residential and occupational exposure to sunlight. Cases were all deaths from these cancers between 1984 and 1995 in 24 states of the United States. Controls, which were age frequency matched to a series of cases, excluded deaths from cancer and certain neurological diseases. Multiple logistic regression was used in a model that included age, sex, race, residential exposure to sunlight (based on region), and socioeconomic status, occupational exposure to sunlight, and physical activity (the last three based on usual occupation).
  
  
  RESULTS
  Residential exposure to sunlight was negatively and significantly associated with mortality from female breast, ovarian, prostate, and colon cancer. Only female breast and colon cancer, however, also showed significant negative associations with jobs with the highest occupational exposure to sunlight (odds ratio (OR) 0.82 (95% confidence interval (95% CI) 0.70 to 0.97) for female breast cancer; OR 0.90 (95% CI 0.86 to 0.94) for colon cancer). For both cancers, the negative association with occupational sunlight was greatest in the geographical region of highest exposure to sunlight and was independent of physical activity on the job. Non-melanoma skin cancer, as expected, was positively associated with both residential and occupational sunlight.
  
  
  CONCLUSIONS
  In this exploratory study, unlike mortality from non-melanoma skin cancer, mortality from female breast cancer and colon cancer were negatively associated with both residential and occupational sunlight.
authors.affiliation: Radiation Epidemiology Branch, National Cancer Institute, 6120 Executive Boulevard, Bethesda, Maryland 20892, USA. mf101e@nih.gov
authors.forename: D M
authors.initials: DM
authors.lastname: Freedman
authors.forename: M
authors.initials: M
authors.lastname: Dosemeci
authors.forename: K
authors.initials: K
authors.lastname: McGlynn
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000401:mortality; D003644:Death Certificates; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D010051:Ovarian Neoplasms / Q000401:mortality; D011471:Prostatic Neoplasms / Q000401:mortality; D012044:Regression Analysis; D012111:Residence Characteristics; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality; D013472:Sunlight / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology