Skin cancer prevention and UV-protection: how to avoid vitamin D-deficiency?
Because solar UV-radiation represents the most important environmental risk factor for the development of non-melanoma skin cancer, UV protection is important to prevent these malignancies. Consequently, public health campaigns were developed to improve the knowledge of the general population regarding the role of UV-radiation for the development of skin cancer. However, it has to be noted that vitamin D-mediated positive effects of UV light were not adequately considered in most of these campaigns, that often propose a strict 'no sun policy' without giving recommendations how to prevent vitamin D-deficiency. Under our living conditions, approximately 90% of all vitamin D needed by the human body has to be formed in the skin through the action of UV-B-radiation and it has been shown that strict sun protection causes vitamin D-deficiency. This dilemma represents a serious problem, for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer, bone diseases, autoimmune diseases, infectious diseases, cardiovascular diseases and hypertension has now been reported in a large number of laboratory and epidemiologic investigations. Although further work is necessary to define an adequate vitamin D-status and adequate guidelines for UV-exposure, it is at present mandatory that guidelines for UV-exposure (e.g. in skin cancer prevention campaigns) consider these facts and give recommendations how to prevent vitamin D-deficiency. At present, most experts in the field agree that the evidence to date suggests that daily intake of 1000-2000 IU vitamin D could reduce the incidence of vitamin D-deficiency-related diseases with minimal risk in Europe, the US, and other countries. In this review, we analyze the present literature to help developing well-balanced guidelines on UV-protection that ensure an adequate vitamin D-status. These recommendations will hopefully protect us against vitamin D-deficiency without increasing the risk to develop UV-induced skin cancer.
Klinik für Dermatologie, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, Germany. hajrei@uniklinik-saarland.de
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D002112:Calcifediol / Q000097:blood; D019587:Dietary Supplements; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000517:prevention & control*; D012307:Risk Factors; D013472:Sunlight; D013473:Sunscreening Agents / Q000009:adverse effects*; D014466:Ultraviolet Rays; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000517:prevention & control* / Q000628:therapy
D013473:Sunscreening Agents; D014807:Vitamin D; D002112:Calcifediol