Sun-protective behaviors, vitamin D, and skin cancer: A systematic review.

Abstract

e19712 Background: Sun-protective behavior (SPB) is promoted for the primary and secondary prevention of skin cancer. Vitamin D (Vit D) can be obtained from oral intake or via cutaneous synthesis. We hypothesize that SPB is associated with an increased risk of Vit D deficiency. Methods: We conducted a systematic review of the published literature on SPB and Vit D in skin cancer survivors or high risk patients for skin cancer. We searched original articles from PubMed and examined reference lists thru December, 2010. Results: Six articles were included. Two studies in xeroderma pigmentosum (XP) patients concluded the lack of association between SPB and Vit D level. Studies in renal transplant and basal cell nevus syndrome (BCNS) showed a high risk of Vit D deficiency in patients with SPB compared to the general population. There was one study among a cohort of skin cancer survivors which did not show a difference in the prevalence of Vit D deficiency between the survivors with and without SPB. Only two studies (DeLong, Kraemer) assessed Vit D intake. Conclusions: Results of published studies on SPB and Vit D remain inconclusive. Prospective cohort studies with adequate sample size and adjustment for Vit D intake is warranted to evaluate this potential association. Author Year Population Type Results Conclusion DeLong 2010 Skin cancer survivor; sun protected (n=76) vs. not (n=78) Cross-sectional 25(OH)D ≤ 20ng/mL 18% vs. 16% No relationship between Vit D level and SPB Tang 2010 BCNS (n=41) vs. general population (n=360) Retrospective cohort 25(OH)D ≤ 20ng/mL 56% vs. 18% BCNS patients may be at increased risk of Vit D deficiency Hoesl 2010 XP (n= 15) Cross-sectional 25(OH)D ≤ 25ng/mL 67% No association between duration of SPB and Vit D level Ulrich 2009 Organ transplant recipients; sun screen (n=60) vs. control (n=60) Prospective, case control Mean 25(OH)D 53ng/mL vs. 60ng/mL Not reported Querings 2006 Renal transplant recipients with sun protection (n=31) vs. general population (n=31) Case control Mean 25(OH)D 10.9ng/mL vs. 20ng/mL High risk of Vit D deficiency in renal transplant recipients Kraemer 1997 XP (n=9) Cohort Mean 25(OH)D 17.8ng/mL Despite SPB normal Vit D can be maintained 25(OH)D: 25-hydroxyvitamin D