Plasma 25-Hydroxyvitamin D and Risk of Non-Melanoma and Melanoma Skin Cancer: A Prospective Cohort Study

TY - JOUR

T1 - Plasma 25-Hydroxyvitamin D and Risk of Non-Melanoma and Melanoma Skin Cancer

T2 - A Prospective Cohort Study

AU - Afzal, Shoaib

AU - Nordestgaard, Børge G

AU - Bojesen, Stig E

PY - 2013/3

Y1 - 2013/3

N2 - Sun exposure is a major risk factor for skin cancer and is also an important source of vitamin D. We tested the hypothesis that elevated plasma 25-hydroxyvitamin D (25-OH-vitD) associates with increased risk of non-melanoma and melanoma skin cancer in the general population. We measured plasma 25-OH-vitD in 10,060 white individuals from the Danish general population. During 28 years of follow-up, 590 individuals developed non-melanoma skin cancer and 78 developed melanoma skin cancer. Increasing 25-OH-vitD levels, by clinical categories or by seasonally adjusted tertiles, were associated with increasing cumulative incidence of non-melanoma skin cancer (trend P=2 × 10-15 and P=3 × 10-17) and melanoma skin cancer (P=0.003 and P=0.001). Multivariable adjusted hazard ratios of non-melanoma skin cancer were 5.04 (95% confidence interval (CI): 2.78-9.16) for 25-OH-vitD ≥50 vs. <25 nmol l-1, and 4.02 (2.45-6.60) for top versus bottom tertile. Multivariable adjusted hazard ratios of melanoma skin cancer were 4.7 (0.96-23.3) for 25-OH-vitD ≥50 vs. <25 nmol l-1, and 6.3 (1.38-28.8) for top versus bottom tertile. The absolute 20-year risk was 11% for non-melanoma skin cancer and 1.5% for melanoma skin cancer, in participants with age >60 years, 25-OH-vitD winter levels ≥50 nmol l-1, and performing outdoor exercise. In conclusion, we show that increasing levels of 25-OH-vitD are associated with increased risk of non-melanoma and melanoma skin cancer.

AB - Sun exposure is a major risk factor for skin cancer and is also an important source of vitamin D. We tested the hypothesis that elevated plasma 25-hydroxyvitamin D (25-OH-vitD) associates with increased risk of non-melanoma and melanoma skin cancer in the general population. We measured plasma 25-OH-vitD in 10,060 white individuals from the Danish general population. During 28 years of follow-up, 590 individuals developed non-melanoma skin cancer and 78 developed melanoma skin cancer. Increasing 25-OH-vitD levels, by clinical categories or by seasonally adjusted tertiles, were associated with increasing cumulative incidence of non-melanoma skin cancer (trend P=2 × 10-15 and P=3 × 10-17) and melanoma skin cancer (P=0.003 and P=0.001). Multivariable adjusted hazard ratios of non-melanoma skin cancer were 5.04 (95% confidence interval (CI): 2.78-9.16) for 25-OH-vitD ≥50 vs. <25 nmol l-1, and 4.02 (2.45-6.60) for top versus bottom tertile. Multivariable adjusted hazard ratios of melanoma skin cancer were 4.7 (0.96-23.3) for 25-OH-vitD ≥50 vs. <25 nmol l-1, and 6.3 (1.38-28.8) for top versus bottom tertile. The absolute 20-year risk was 11% for non-melanoma skin cancer and 1.5% for melanoma skin cancer, in participants with age >60 years, 25-OH-vitD winter levels ≥50 nmol l-1, and performing outdoor exercise. In conclusion, we show that increasing levels of 25-OH-vitD are associated with increased risk of non-melanoma and melanoma skin cancer.

U2 - 10.1038/jid.2012.395

DO - 10.1038/jid.2012.395

M3 - Journal article

C2 - 23190899

SN - 0022-202X

VL - 133

SP - 629

EP - 636

JO - Journal of Investigative Dermatology

JF - Journal of Investigative Dermatology

ER -