Cutaneous vitamin D synthesis versus skin cancer development: The Janus faces of solar UV-radiation.
In scientific and public communities, there is an ongoing discussion how to balance between positive and negative effects of solar UV-exposure. On the one hand, solar UV-radiation represents the most important environmental risk factor for the development of non-melanoma skin cancer. Consequently, UV protection is an important measure to prevent these malignancies, especially in risk groups. Otherwise, approximately 90% of all vitamin D needed by the human body has to be formed in the skin through the action of UV-radiation. 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 investigative and epidemiologic studies. As a consequence, it has been assumed that for the general population in the US, Europe and other countries, the net effects of solar UV B-radiation on human health are beneficial at or near current levels. We and others have shown that strict sun protection causes vitamin D-deficiency/insufficiency and that detection and treatment of vitamin D-deficiency in sun deprived risk groups is of high importance. Although further work is necessary to define an adequate vitamin D-status and adequate guidelines for solar and artificial UV-exposure, it is at present mandatory that public health campaigns and sun protection recommendations to prevent skin cancer consider these facts. In this review, we analyze the present literature to help developing well-balanced recommendations on sun protection that ensure an adequate vitamin D-status. These recommendations will hopefully protect us against adverse effects of UV protection without significantly increasing the risk to develop UV-induced skin cancer.
Reichrath
Jörg
J
Klinik für Dermatologie; Venerologie und Allergologie; Universitätsklinikum des Saarlandes; Homburg/Saar, Germany.
Nürnberg
Bernd
B
N Engl J Med. 1999 Apr 29;340(17):1341-8
10219070
N Engl J Med. 2007 Jul 19;357(3):266-81
17634462
Melanoma Res. 1995 Feb;5(1):59-65
7734957
Cancer Causes Control. 2004 Feb;15(1):97-8
15049326
J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):163-6
15225766
Anticancer Res. 2009 Sep;29(9):3511-36
19667145
J Clin Endocrinol Metab. 2006 Feb;91(2):526-9
16303843
Am J Prev Med. 2007 Mar;32(3):210-6
17296473
J Photochem Photobiol B. 2005 Mar 1;78(3):189-93
15708515
J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):375-9
15225804
Eur J Cancer. 2005 Jan;41(1):45-60
15617990
Exp Dermatol. 2004;13 Suppl 4:11-5
15507106
Exp Dermatol. 2007 Jul;16(7):618-25
17576242
Carcinogenesis. 2009 Jul;30(7):1170-80
19403841
Lab Invest. 2004 Jun;84(6):693-702
15077124
J Clin Endocrinol Metab. 1992 Oct;75(4):1099-103
1328275
Arch Dermatol. 1995 Feb;131(2):164-9
7857112
Onkologie. 2001 Apr;24(2):128-33
11441291
J Natl Cancer Inst. 2005 Feb 2;97(3):195-9
15687362
Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):562-6
15767329
J Invest Dermatol. 2003 Jun;120(6):1087-93
12787139
Ugeskr Laeger. 2007 Apr 23;169(17):1592; author reply 1593
17489148
Dermatoendocrinol. 2009 Jan;1(1):4-6
20046581
Cancer Causes Control. 2004 Mar;15(2):219
15088627
Int J Cancer. 1997 Oct 9;73(2):198-203
9335442
Med J Aust. 1983 Apr 30;1(9):407-10
6835157
Br J Dermatol. 2009 Sep;161(3):630-4
19519827
Dermatoendocrinol. 2009 Jan;1(1):25-33
20046585
J Natl Cancer Inst. 2006 Apr 5;98(7):451-9
16595781
Am J Clin Nutr. 1999 May;69(5):842-56
10232622
Proc R Soc Med. 1965 May;58:295-300
14283879
Am J Clin Nutr. 1991 Jul;54(1 Suppl):193S-201S
2053561
J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):708-11
17368188
Clin Cancer Res. 2000 Feb;6(2):498-504
10690530
Br J Cancer. 2004 Aug 16;91(4):765-70
15238985
Praxis (Bern 1994). 2005 Aug 24;94(34):1295-300
16170998
Cancer. 2002 Mar 15;94(6):1867-75
11920550
Br J Dermatol. 2002 Aug;147(2):197-213
12174089
Br J Dermatol. 2005 Jan;152(1):43-51
15656799
Int J Cancer. 1990 Sep 15;46(3):356-61
2394501
J Cell Biochem. 2003 May 1;89(1):6-8
12682903
J Invest Dermatol. 2005 May;124(5):1080-2
15854055
Int J Cancer. 1988 Sep 15;42(3):319-24
3417359
Eur J Cancer. 2005 Sep;41(14):2141-9
16125927
N Engl J Med. 2001 Mar 29;344(13):975-83
11274625
Arch Dermatol. 2005 Apr;141(4):477-81
15837865
J Am Acad Dermatol. 2007 Mar;56(3):380-6
17097387
Adv Exp Med Biol. 2008;624:16-30
18348444
Clin Cancer Res. 2005 Aug 1;11(15):5370-80
16061850
Cancer Res. 2016 Jan 15;76(2):185
26773094
Photochem Photobiol Sci. 2007 Mar;6(3):232-51
17344960
J Cutan Pathol. 2004 Mar;31(3):224-31
14984574
N Engl J Med. 1992 Dec 3;327(23):1649-62
1435901
Am J Pathol. 1999 Aug;155(2):583-9
10433950
J Immunol. 2004 Sep 1;173(5):2909-12
15322146
Epidemiol Infect. 2006 Dec;134(6):1129-40
16959053
Lancet. 2001 Jan 6;357(9249):4-6
11197362
J Photochem Photobiol B. 2001 Oct;63(1-3):8-18
11684447
FASEB J. 2005 Jul;19(9):1067-77
15985530
Adv Exp Med Biol. 2008;624:125-36
18348453
Lancet. 1989 Nov 18;2(8673):1176-8
2572900
Int J Cancer. 1985 Apr 15;35(4):427-33
3988369
Int J Epidemiol. 1990 Dec;19(4):820-4
2084008
Cancer. 2008 Nov 1;113(9):2398-407
18816636
Recent Results Cancer Res. 2003;164:3-28
12899511
Br J Dermatol. 1994 Oct;131(4):455-64
7947197
Am J Clin Nutr. 1995 May;61(5):1140-5
7733040
Lung Cancer. 2007 Mar;55(3):263-70
17207891
Prog Biophys Mol Biol. 2006 Sep;92(1):9-16
16603232
Adv Exp Med Biol. 2008;624:55-71
18348447
Cancer Epidemiol Biomarkers Prev. 1998 May;7(5):391-5
9610788
Nat Genet. 2000 Jun;25(2):144-6
10835626
Science. 2006 Mar 24;311(5768):1770-3
16497887
Cancer Causes Control. 1994 Jul;5(4):367-92
8080949
QJM. 1996 Aug;89(8):579-89
8935479