The role of vitamin D in cancer prevention: does UV protection conflict with the need to raise low levels of vitamin D?

Abstract

BACKGROUND: Vitamin D is essential for life. Part of the body's supply of vitamin D is ingested in food, but UV induced vitamin D synthesis in the body plays an even more important role. UV irradiation is a cause for the currently rising incidence of skin cancer in many countries; on the other hand, Vitamin D might be protective against some cancers. In this paper we summarize the current data on vitamin D and cancer and on the vitamin D status of populations in Europe and discuss whether current recommendations on UV protection require changes. METHODS: In 2008, the International Agency for Research on Cancer (IARC) published a systematic review on vitamin D and cancer. We describe its main findings and review additional publications retrieved by a selective literature search on vitamin D, UV light, and skin cancer. In addition, we systematically review the current recommendations on vitamin D supplementation. RESULTS: Higher vitamin D levels are associated with a lower risk of colon cancer. For breast cancer, the situation is less clear. In general, higher vitamin D levels are associated with lower overall mortality. Concerning optimal Vitamin D levels, serum values ≥ 50 nmol/L (ie.. ≥ 20 ng/mL) are frequently discussed, and a few authors favor markedly higher values. Brief UV exposures are usually adequate for endogenous vitamin D synthesis. CONCLUSION: More research is needed into the possible protective effects of vitamin D against cancer. Brief, daily UV exposure stimulates vitamin D production and causes negligible skin damage. Raising the vitamin D level even further by extended solar UV exposure or irradiation in a solarium is inadvisable because of the risk of skin cancer. Oral vitamin D supplementation can be considered as an alternative, particularly for persons at high risk, such as the elderly and members of certain ethnic groups.