Using newly available data on worldwide cancer incidence,
researchers at the Moores Cancer Center at University
of California, San Diego (UCSD) have shown a clear association
between deficiency in exposure to sunlight, specifically
ultraviolet B (UVB), and endometrial cancer.
UVB exposure triggers photosynthesis of vitamin D3 in
the body. This form of vitamin D is also available through
diet and supplements. Previous studies from this research
team have shown associations between higher levels of
vitamin D3 and lower risk of cancers of the breast, colon,
kidney and ovary.
Approximately 200,000 cases and 50,000 deaths from endometrial
cancer occur annually worldwide, including 41,000 new
cases and 7,400 deaths in the United States.
"This is the first study, to our knowledge, to show
that higher serum levels of vitamin D are associated with
reduced risk of endometrial cancer," said Cedric
F. Garland, Dr. P.H., professor of Family and Preventive
Medicine in the UCSD School of Medicine, and member of
the Moores UCSD Cancer Center.
He continued, "Previous epidemiological studies
have focused on estrogen levels -- either natural or through
hormone replacement therapy -- which play the major role
in development of the disease, and on fat intake, which
plays a smaller role. Since most women cannot control
their natural levels of estrogen, and very low levels
of fat intake are not acceptable to most American women,
this article provides evidence that vitamin D adequacy
should be considered as part of a comprehensive program
for prevention of this cancer."
This paper used worldwide data only recently available
through a new tool called GLOBOCAN, developed by the World
Health Organization's International Agency for Research
on Cancer. GLOBOCAN is a database of cancer incidence,
mortality and prevalence for 175 countries.
The researchers created a graph with a vertical axis
for endometrial cancer incidence rates, and a horizontal
axis for latitude. The latitudes range from -50 for the
southern hemisphere, to zero for the equator, to +70 for
the northern hemisphere. They then plotted incidence rates
for 175 countries according to latitude. The resulting
chart was a parabolic curve that looks like a smile.
"In general, endometrial cancer incidence was highest
at the highest latitudes in both hemispheres," said
Garland. "Even after controlling for known variables
such as cloud cover, meat intake, weight, skin pigmentation
and others, the association remained strong."
In the paper, the authors caution that this was a study
of aggregates, or countries, rather than individuals;
findings that apply to aggregates may not apply to individuals.
They recommend further research to study individuals for
the effect of vitamin D from sunlight, diet and supplements
on the risk of endometrial cancer.
The study will be published November 16, 2007, in the
journal Preventive Medicine.
This is the third environmental paper from this research
team to show a strong association between vitamin D and
cancer using global incidence data (GLOBOCAN). The first
paper, which illuminated a similar pattern for kidney
cancer, was published Sept. 15, 2006, in the International
Journal of Cancer. The second, on ovarian cancer, was
published Oct. 31, 2006, in the American Journal of Preventive
Medicine.