The Skin Cancer Foundation (SCF) misstates the facts about Sunlight and vitamin D. Could it be an effort to promote sunscreens?

The Skin Cancer Foundation (SCF) misstates the facts about Sunlight and vitamin D. Could it be an effort to promote sunscreens?

By: Marc Sorenson, Sunlight Institute–

 

The Skin Cancer Foundation recently posted a press release on their website stating that they have busted the “myths surrounding vitamin D and sun exposure.” In it they quote Perry Robins, president of the foundation, as saying, “The misconception that exposure to UVB radiation is the optimal source of vitamin D puts people at risk for potentially life-threatening skin cancer. Furthermore, in most cases the body stops producing vitamin D after just a few minutes of sun exposure.”[1]

The idea, that sunlight exposure is the optimal source of vitamin D, is not a misconception–as will be explained below. We will also discuss the fact, that while the skin may cease producing vitamin D after 20 minutes of full-body exposure, it is because it has produced all the vitamin D the body needs—up to an impressive 20,000 international units  (IU). Since many multi-vitamin supplements contain only 400-600 IU, it is obviously best to make sunlight the primary source of vitamin D.

In addition, the SCF press release states that “About 86 percent of melanomas (the most dangerous form of skin cancer) and 90 percent of nonmelanoma skin cancers are associated with exposure to UV radiation.”[2] The citation, of course, comes from a dermatological journal, Archives of Dermatology. Here are a few facts the SCF should have considered: (a) Whereas common skin cancers such as squamous-cell carcinoma is more common among those who are regularly in the sunlight, the risk of the deadly melanoma is considerably reduced by regular sunlight exposure.[3] (b) In addition, it should be known that most melanoma occurs on areas of the body that are seldom or never exposed to sunlight.[4] [5] [6]

Other facts that belie the aforementioned statements made by the SCF in their press release are these: (a) Outdoor workers, while receiving 3-9-times the sunlight exposure as indoor workers, have had no increase in melanoma since 1940, (b)whereas melanoma in indoor workers has increased steadily and exponentially.[7] Quite obviously, if sunlight exposure led to melanoma, outdoor workers would have the greatest incidence of the disease and indoor workers would have a lesser incidence. That the opposite is the case is also manifested by numerous scientific papers showing that those with more regular exposure to sunlight have a lesser risk of melanoma.[8]

It should also be noted that sunlight exposure has profoundly decreased in the last hundred and ten years due to a population that has moved indoors. For example, indoor occupations such as “professional, managerial, clerical, sales, and service workers (except private household service workers) grew from one-quarter to three-quarters of total employment between 1910 and 2000.” The outdoor occupation of farming decreased by 96%.[9] Yet, the Melanoma International Foundation (MIF) has stated that ultraviolet radiation from sunlight causes melanoma and should be avoided as a detriment to human health. They also state that melanoma incidence has increased by 3,000% since 1935.[10] Try to figure out that reasoning! Considering that the population has moved indoors, it becomes obvious that there is a terrible disconnect between the facts and the statements of both the SCF and the MIF. The SCF is closely allied with sunscreen manufacturers. Could this press release be nothing more than a ploy to increase sunscreen sales?

And speaking of sunscreens, the increase in sunscreen sales is dramatic,[11] [12] and the incidence of melanoma continues to skyrocket in spite of its use.[13] The blockage of sunlight by sunscreens correlates to an increased risk of melanoma, and yet the MIF and SCF state that we need to avoid the sunlight? Give me a break! Still, the SCF has stated that “for adequate protection against melanoma, non-melanoma skin cancers and photo-aging, everyone over the age of six months should use sunscreen daily year-round, in any weather.”  Yes, they are suggesting that we use sunscreen even in cloudy weather in the winter! How convenient for an organization, which works closely with sunscreen manufacturers, to make such a statement. Could there be a conflict of interest here?

The SCF press release discusses three statements that they label as “myths.” Let’s look at these statements by the Skin Cancer Foundation to determine which are really myths, and which are really facts.

 

The Foundation lists the following statements as myths:

1.       UVB radiation is a good source of vitamin D.

2.       Sun exposure is the only source of vitamin D

3.       Tanning beds are a healthy option for boosting vitamin D levels.

 

Let’s take a look at each statement and then look at the facts:

#1 UVB radiation is a good source of vitamin D. This is not a myth! UVB radiation from 10-15 minutes of full-body exposure to peak summer sunshine can stimulate the production of up to 20,000 IU of vitamin D.[14] Indeed, UVB radiation is an incredibly effective source of vitamin D, and that is no myth. Any statement to the contrary is false.

#2 Sun exposure is the only source of vitamin D. No such myth, to my knowledge, has been propagated. A myth is an unproved or false collective belief. There is no false collective belief that sun exposure is the only source of vitamin D. However, sunlight is certainly by far the best source of vitamin D.  For example, cod liver oil has about 400 IU per teaspoon; salmon, 400 IU per 3.5 oz. serving; fortified milk, 100 IU per 8 oz. glass; and fortified orange juice 100 IU per 8 oz. glass. Compare this to 20,000 IU from sun exposure; it’s no contest.[15]

#3 Tanning beds are a healthy option for boosting vitamin D levels. This is not a myth!

An excellent study compared 50 people who used tanning beds regularly with 106 who did not.  The tanning-bed group had 90% higher vitamin D levels and significantly higher bone density.[16] Other research has shown that (a) Women who use tanning beds have a reduced risk of endometrial cancer of 40-50%.[17] (b) There is a significantly lowered risk of venous thrombotic events among women who use tanning beds when compared with those who do not.[18] (c) Tanning-bed use is inversely correlated to breast-cancer risk.[19]

Fortunately, organizations beyond the SCF are “seeing the light.” Cancer Research UK has joined with other health organizations to make a consensus statement regarding sunlight and vitamin D.[20] Those organizations are British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society. Here is the first part of the statement: “Vitamin D is essential for good bone health, and for most people sunlight is the most important source of vitamin D. The time required to make sufficient vitamin D varies according to a number of environmental, physical and personal factors, but is typically short and less than the amount of time needed for skin to redden and burn. Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without unduly raising the risk of skin cancer.”

The aforementioned dermatological and other health societies of the UK do not consider the health benefits of responsible sun exposure to be a myth. Why, then, does the SCF consider themselves so much more intelligent than these organizations? This may be the clue: There are 69 corporate sponsors of the SCF, each of which pays at least $10,000 per year for the privilege of belonging to the  “Corporate Council.[21] If you look at the SCF Corporate-Council page, you will note that many of the members are involved in producing or selling products for skin protection, i.e. sunscreens. Is it any wonder that the SCF suggests year-round sunscreen use, even in cloudy, wintry weather? It certainly smacks of some quid pro quo, no?

Let’s get some safe sunlight as recommended by Cancer Research UK and other reputable organizations across the pond and forget about the biased and irresponsible SCF.

 


 

[1] http://www.skincancer.org/media-and-press/press-release-2013/vitamin-d

[2] Koh HK, Geller AC, Miller DR, Grossbart TA, Lew RA. Prevention and early detection strategies for melanoma and skin cancer: Current status. Archives of Dermatology 1996; 132: 436-442.

[3] Grant, WB. An ecologic study of cancer mortality rates in Spain with respect to indices of solar UVB irradiance and smoking. Int J Cancer. 2007 Mar 1;120(5):1123-8.

[4] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.

[5] Rivers, J.  Is there more than one road to melanoma? Lancet 2004;363:728-30.

[6] Crombie, I. Racial differences in melanoma incidence.  Br J Cancer 1979;40:185-93.

[7] Godar DE, Landry RJ, Lucas AD. Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma. Med hypothesis (2009), doi:10.1016/j.mehy.2008.09.056

[8] Lee J.  Melanoma and exposure to sunlight. Epidemiol Rev 1982;4:110–36.

Vågero D, Ringbäck G, Kiviranta H.  Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961–1979  Brit J Cancer 1986;53:507–12.

Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN; Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer.  Invest Dermatol 2003;120:1087–93.

Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.

Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs. Br J Dermatol 2001;145:602-09.

Garsaud P, Boisseau-Garsaud AM, Ossondo M, Azaloux H, Escanmant P, Le Mab G. Epidemiology of cutaneous melanoma in the French West Indies (Martinique). Am J Epidemiol 1998;147:66-8.

Le Marchand l, Saltzman S, Hankin JH, Wilkens LR, Franke SJM, Kolonel N. Sun exposure, diet and melanoma in Hawaii Caucasians. Am J Epidemiol 2006;164:232-45.

Armstong K, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Biol 2001;63:8-18

Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981;43:842-9.

Crombie IK. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer 1979;40:774-81.

Weinstock MA, Colditz,BA, Willett WC, Stampfer MJ. Bronstein, BR, Speizer FE. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989;84:199-204.

Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 2003;22:3042-52.

Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C.  Sun exposure and mortality from melanoma. J Nat Cancer Inst 2005;97:95-199.

Veierød MB, Weiderpass E, Thörn M, Hansson J, Lund E, Armstrong B. A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003;95:1530-8.

Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child 2006;91:131-8.

Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the western Canada melanoma study. Int J Cancer 2006;35:427-33

[9] Ian D. Wyatt and Daniel E. Hecker.  Occupational changes in the 20th century.  Monthly Labor Review, March 2006 pp 35-57:  Office of Occupational Statistics and Employment Projections, Bureau of Labor Statistics.

[10] Melanoma International Foundation, 2007 Facts about melanoma. Sources: National Cancer Institute 2007 SEER Database, American Cancer Society’s 2007 Facts and Figures, The Skin Cancer Foundation, The American Academy of Dermatology.

[11] Kline & Company’s Cosmetics & Toiletries USA Annual Service (1972 and 2008 editions).

[12] Fredonia market research group report, 2009.

[13] Melanoma incidence in Connecticut, 1936-1999. Source: Connecticut Tumor Registry.

[14] Hollis, BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 2005 Feb;135(2):317-22.

[15] Holick, MF. High Prevalence of Vitamin D Inadequacy and Implications for Health. MAYO CLIN PROC. 2006;81:353-373

[16] Tangpricha, V. et al.  Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher vitamin D levels. Am J Clin Nutr 2004:80:1645-49.

[17] Epstein E, et al.  A population-based cohort study on sun habits and endometrial cancer.  Br J Cancer. 2009 Aug 4;101(3):537-40.

[18] Lindqvist PG et al., Does an active sun exposure habit lower the risk of venous thrombotic events? A D-lightful hypothesis. J Thromb Haemost 2009;7:605-10.

[19] Yang L, et al.  Prospective study of UV exposure and cancer incidence among Swedish women.  Cancer Epidemiol Biomarkers Prev Published Online May 6, 2011.

[20]http://www.sunsmart.org.uk/prod_consump/groups/cr_common/@nre/@sun/documents/generalcontent/cr_052628.pdf.

[21] Corporate Council page, Skin Cancer Foundation. Accessible at http://www.skincancer.org/about-us/corporate-supporters/corporate-council.

 

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