Cutaneous malignant melanoma incidences analyzed worldwide by sex, age, and skin type over personal Ultraviolet-B dose shows no role for sunburn but implies one for Vitamin D₃

Abstract

Because the incidence of cutaneous malignant melanoma (CMM) was reported to increase with increasing terrestrial UVR (290–400 nm) doses in the US back in 1975 and a recent publication showed no association exists with UVR exposure at all, we set out to fully elucidate the role of UVR in CMM. To achieve this goal, we analyzed the CMM incidences over latitude and estimated the average personal UVR dose in the US and numerous countries (> 50) on 5 continents around the world. Using data from the International Agency for Research on Cancer in 2005, we performed worldwide analysis of CMM over UVR dose by sex, age group (0–14, 15–29, 30–49, 50–69, 70–85+) and Fitzpatrick skin types I-VI. Surprisingly, increasing UVR doses, which represent erythemally-weighted doses comprised primarily of UVB (290–315 nm) radiation, did not significantly correlate with increasing CMM incidence for people with any skin type anywhere in the world. Paradoxically, we found significant correlations between increasing CMM and decreasing UVB dose in Europeans with skin types I-IV. Both Europeans and Americans in some age groups have significant increasing CMM incidences with decreasing UVB dose, which shows UVB is not the main driver in CMM and suggests a possible role for lower cutaneous vitamin D3 levels and UVA (315–400 nm) radiation. CMM may be initiated or promoted by UVA radiation because people are exposed to it indoors through windows and outdoors through some sunscreen formulations. Thus, our findings may explain why some broad-spectrum sunscreen formulations do not protect against getting CMM.

Sun Exposure and Melanoma, Certainties and Weaknesses of the Present Knowledge

“…Godar et al have suggested that low cutaneous vitamin D3 levels with high environmental and low ratio of UVB/UVA doses are the two main drivers for CMM development. In fact, both Europeans and Americans, in some age groups, have a significant increase of CMM incidence if this ratio decreases ( 76 ). If this is true, we could explain the curious relationship between melanoma risk and sun exposure, where sunburn is a factor but occupational sun exposure is not (at least in temperate climes).…”

Untangling the most probable role for vitamin D3 in autism

“…For example, along with HPV-16 and −18, HPV-38 has been found in melanomas and are implicated in its etiology. 129–131 Most importantly, note that the cervical Pap smears only detect cancerous cells and not the presence of HPV, so that it would be wise to include a broad-spectrum HPV test along with routine Pap smears in the future, especially for women who intend to get pregnant or who already are pregnant.…”

Association of XPC Polymorphisms with Cutaneous Malignant Melanoma Risk: Evidence from a Meta-Analysis

“…It is firmly established that around 8-12% of CMM cases have a family history of CMM (6). UV-light is the most important cause, and the incidence of CMM in individuals with a susceptible skin type increases with proximity to the equator (7). Despite several decades of research on CMM, both etiology and pathogenesis of this disease is still unknown.…”

“…The etiology of CMM is likely to be multifactorial, involving UV exposure and genetic predisposition (6)(7)(8). The nucleotide excision repair (NER) is a versatile system that repairs a wide variety of DNA damage, including UV photoproducts (9).…”