Abstract
BackgroundRecent reports have shown that vitamin D status was inversely associated with the risk of various cancers. However, few studies examined the association between vitamin D levels and risk of skin cancer.MethodsWe prospectively evaluated the association between baseline plasma 25(OH)D levels and the risk of incident squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) among 4,641 women from the Nurses’ Health Study (NHS) and the NHS II with 510 incident BCC cases and 75 incident SCC cases. We used multivariate logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsPlasma 25(OH)D levels were positively associated with risk of BCC after adjusting for age at blood draw, season of blood draw, lab batch, hair color, burning tendency, the number of sunburns, and ultra-violet B flux of residence at blood collection. Women in the highest quartile of 25(OH)D had more than 2-fold increased risk of BCC compared with women in the lowest quartile (OR = 2.07, 95% CI = 1.52–2.80, P for trend <0.0001). We also found a significantly positive association between plasma 25(OH)D levels and SCC risk after adjusting for the same covariates (OR, highest vs. lowest quartile = 3.77, 95% CI = 1.70–8.36, P for trend = 0.0002).ConclusionIn this prospective study of women, plasma vitamin D levels were positively associated with non-melanoma skin cancer risk. Considering that most circulating vitamin D is due to sun exposure, the positive association between plasma vitamin D and non-melanoma skin cancer is confounded by sun exposure. Our data suggest that one-time measurement of plasma vitamin D levels may reasonably reflect long-term sun exposure and predict the risk of non-melanoma skin cancer.
Highlights
Skin cancer, the most common malignancy, has been increasing rapidly over the past decades in the United States, especially in women [1,2,3]
Experimental studies have shown that vitamin D treatment can inhibit proliferation of melanoma and basal cell carcinomas in vitro [15,16], recent evidence in a large cohort of postmenopausal women suggests that daily supplementation of vitamin D did not reduce incidence of skin cancer [17]
Similar significantly positive findings were obtained between plasma 25(OH)D and risk of basal cell carcinoma (BCC) in both cohorts in multivariate models (P for trend,0.0001 and = 0.01)
Summary
The most common malignancy, has been increasing rapidly over the past decades in the United States, especially in women [1,2,3]. In an analysis of the Osteoporotic Fractures in Men Study, inverse association between plasma vitamin D levels and risk of non-melanoma skin cancer in elderly men was found [9]. In two other recent analyses of health maintenance organization populations, higher plasma vitamin D levels were significantly associated with increased risk of non-melanoma skin cancer [10,11]. Experimental studies have shown that vitamin D treatment can inhibit proliferation of melanoma and basal cell carcinomas in vitro [15,16], recent evidence in a large cohort of postmenopausal women suggests that daily supplementation of vitamin D did not reduce incidence of skin cancer [17]. Few studies examined the association between vitamin D levels and risk of skin cancer
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