366 Vitamin D supplementation in skin cancer patients is impacted by gender and education, but independent of sun protective practices

Abstract

Vitamin D has been shown to protect against skin cancer. Ultraviolet B radiation is needed for vitamin D production, but it is also a significant risk factor for non-melanoma skin cancer (NMSC). Thus, vitamin D supplementation is important when sun-protection is practiced in patients with NMSC. However, supplementation patterns among these patients have not been reported. Using the 2013-2014 National Health and Nutrition Examination Survey database, we conducted a population-based cross-sectional analysis with survey data from 9770 participants to investigate vitamin D supplementation and the physician’s role in these patterns. We calculated odds ratios (OR), 95% confidence intervals (95%CI), and p-values using logistic regression and ANOVA weighted to reflect the US Census data, adjusting for gender, race, education, marital status, and age. Vitamin D supplementation was significantly more common in patients with a history of NMSC with 84.6% taking supplements versus 55.5% of participants without NMSC (OR=2.09, 95% CI=1.25-3.47). The mean dose of vitamin D intake was also significantly higher in patients with NMSC (M=60.5±8.86 mcg versus M=36.4 ±1.66 mcg, p<0.05). Moreover, physicians had significantly higher odds of recommending supplementation in patients with NMSC (OR=2.43, 95% CI=1.03-5.71). Among NMSC patients, males (OR=0.17, 95% CI=0.06-0.45) and patients without a college degree (OR=0.32 95% CI=0.11-0.89) had significantly lower odds of supplementing with vitamin D. There was no difference in vitamin D intake across sun protective practices (p=0.58), race (p=0.07), and marital status (p=0.41). While it is reassuring that individuals with a history of NMSC are supplementing with vitamin D, the data identifies a subset of skin cancer patients who do not take vitamin D. Furthermore, vitamin D supplementation is not influenced by sun protection measures. Improvements are needed in counseling patients regarding the importance of vitamin D and in managing the delicate balance between sun protection and vitamin D supplementation in skin cancer patients.