Vitamin D status in adult patients with nonmelanoma skin cancer in Cape Town, South Africa: a cross‐sectional study

Deventer, Linda van; Kannenberg, Susanna M H; Eken, Maaike M.

doi:10.1111/ijd.14068

Cited by 7 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, after the diagnosis, half of the patients still did not use SPF. The results are similar to that of a study in South Africa where 83% of the participants who presented themselves for a first non-melanoma skin cancer and 50% of the cases with previous non-melanoma skin cancer did not use sunscreen (44).…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results

et al. 2020

View full text Add to dashboard Cite

Ultraviolet radiation (UV), mainly from sunlight, is the main risk factor of the most common human skin cancer, basal cell carcinoma (BCC). A positive effect of UV on the skin is its contribution to the synthesis of vitamin D, which is important in sustaining general health, but having high levels of vitamin D is considered a risk factor for BCC. However, vitamin D receptor has antagonistic effects to UV radiation in regulating Sonic Hedgehog pathway. This is a pilot study aimed at characterizing the sun-related behavior and vitamin D status of 52 BCC patients and 59 controls from our geographical area. Patients were included in 4 subgroups: Single, multiple, recurrent, and both multiple and recurrent BCCs. Patients, more than controls, had at least one sunburn in childhood and lentigines (P<0.001). Also, they spent daily, on average, more time in the sun than controls (P<0.001) (3.00-8.00 and 1.50-4.00 h respectively). Outdoor work was similar in both groups. Participants had lower vitamin D serum levels than expected. Due to the small number of cases, no statistically significant differences were found between the subgroups but some tendencies were noted. Patients with only one recurrent BCC had less sunburns than the ones who also developed tumors at multiple sites (P=0.2). Patients with multiple and recurrent tumors had slightly lower vitamin D levels compared with single BCC patients (P=0.1) although they used more vitamin D supplements after the BCC diagnosis (P=0.2). Having a diagnosis of BCC, made patients more compliant to the use of sunscreen cream, but even so, half of them still did not use it. In conclusion, more effort should be invested in sun-related education and public health actions should focus on vitamin D deficiencies.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Season also has an influence even closer to the Equator, at 33˚S, in South Africa, ~50% of the patients with BCC and/or squamous cell carcinoma had levels below 20 ng/ml, and over 90% were below 30 ng/ml, also having a considerable seasonal variation (44).…”

Section: Discussionmentioning

confidence: 99%

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results

et al. 2020

View full text Add to dashboard Cite

show abstract

“…As stated in the previous sections that there are few published works linking vitamin D levels and NMSC, with inconsistent results (Asgari et al, 2010;Caini et al, 2014;Eide et al, 2011;Liang et al, 2012;Soares et al, 2018;Tang et al, 2011;Tang et al, 2010;van Dam et al, 2000;van der Pols et al, 2013;van Deventer, Kannenberg & du Toit, 2018;Vojdeman et al, 2019). We consider this to be a limitation for our study since we cannot design it from a more generalized hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory studies suggest that vitamin D and its metabolites may reduce the risk of skin cancer. However, only a few epidemiological studies have assessed the association between vitamin D serum levels and NMSC risk, and these have shown controversial results: some report an association between higher vitamin D levels and an increased risk of developing skin cancer (Asgari et al, 2010;Eide et al, 2011;Liang et al, 2012;Soares et al, 2018;van der Pols et al, 2013;Vojdeman et al, 2019), while others report a decreased risk (Tang et al, 2011;Tang et al, 2010), and others found no association (van Dam et al, 2000;van Deventer, Kannenberg & du Toit, 2018). In 2014, Caini et al (2014 found a statistically significant positive association with an increased risk of NMSC for high values of 25(OH)D 3 in their review and meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D serum levels and non-melanoma skin cancer risk

Morgado-Águila¹,

Gil-Fernández

Dávila-Villalobos³

et al. 2021

PeerJ

View full text Add to dashboard Cite

Background Skin cancer is one of the common malignancies. There is sufficient evidence that sunlight (ultraviolet radiation) contributes to the development of skin cancer, but there is also evidence that relates adequate serum levels of vitamin D produced on the skin by the action of ultraviolet radiation with the decreased risk of various types of cancers, including skin cancer. The aim of this study was to investigate the association of vitamin D serum levels among patients with non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) and controls. Methods A prospective observational case-control study was conducted in a sample of 84 subjects in Extremadura (Spain). Forty-one patients with histologically diagnosed basal cell carcinomas and squamous cell carcinomas and 43 healthy controls were randomly chosen to assess whether vitamin D (25(OH)D3) serum level, age and sex were related to non-melanoma skin cancer and to determine the possible risk of this type of skin cancer for these variables. Results When analysing serum vitamin D levels, we ensured that all our subjects, both cases and controls, had normal or low serum vitamin D levels, even though the samples were taken during months with the highest solar irradiance in our region. It is striking in our results that there was a higher percentage of subjects with deficits of vitamin D who did not have skin cancer (66%) than patients with deficits with these types of skin cancers (34%). When adjusting the model for age and sex, vitamin D values above 18 ng/ml increased the risk of suffering from non-melanoma skin cancer by nearly 7-fold (aOR: 6.94, 95% CI [1.55–31.11], p = 0.01). Conclusions Despite the controversial data obtained in the literature, our results suggest that lower levels of vitamin D may be related to a reduced incidence of non-melanoma skin cancer.

show abstract

“…Indeed, in a case–control study, vitamin D and SCC risk were directly associated in the unadjusted model but after correcting for the effect of undesired variables (including age, sex and sunlight exposure) there was no significant association [ 56 ]. Perhaps, the association between high vitamin D levels and SCC suggests that UV exposure may have a predominant adverse influence that exceeds any putative benefit from the higher levels of vitamin D. What is clear is that sun protection should always be advised, especially for patients with skin cancer, while ensuring adequate levels of vitamin D [ 57 ]. Hormone receptors are also important in both AK and SCC.…”

Section: Influential Role Of Exposome Factorsmentioning

confidence: 99%

Exposome and Skin. Part 2. The Influential Role of the Exposome, Beyond UVR, in Actinic Keratosis, Bowen’s Disease and Squamous Cell Carcinoma: A Proposal

Molina-García

Malvehy

Granger

et al. 2022

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Actinic keratosis (AK) is the main risk factor for the development of cutaneous invasive squamous cell carcinoma (SCC). It represents the first sign of severe chronic ultraviolet radiation exposure, which has a clear significant effect. Nevertheless, the skin is exposed to many other exposome factors which should be thoroughly considered. Our aim was to assess the impact of exposome factors other than ultraviolet radiation (UVR) on the etiopathology of AK and Bowen's disease (BD) and progression of AK to SCC and to design tailored prevention strategies. We performed an exhaustive literature search in September 2021 through PubMed on the impact of exposome factors other than UVR on AK, BD and SCC. We conducted several parallel searches combining terms of the following topics: AK, BD, SCC and microbiome, hormones, nutrition, alcohol, tobacco, viral infections, chemical contaminants and air pollution. Notably, skin microbiome studies have shown how Staphylococcus aureus infections are associated with AK and AK-to-SCC progression by the production of chronic inflammation. Nutritional studies have demonstrated how a caloric restriction in fat intake, oral nicotinamide and moderate consumption of wine significantly reduce the number of premalignant keratoses and SCC. Regarding lifestyle factors, both alcohol and smoking are associated with the development of SCC in a dosedependent manner. Relevant environmental factors are viral infections and chemical contaminants. Human papillomavirus infections induce deregulation of cellular proliferation and are associated with AK, BD and SCC. In addition to outdoor jobs, occupations such as industrial processing and farming also increase the risk of developing keratoses and SCC. The exposome of AK will undoubtedly help the understanding of its etiopathology and possible progression to

show abstract

Vitamin D status in adult patients with nonmelanoma skin cancer in Cape Town, South Africa: a cross‐sectional study

Abstract: The findings highlight the need for the development of recommendations and guidelines on sun protection in patients with NMSC, while still ensuring an adequate vitamin D status. High risk factors included winter and female gender.

Cited by 7 publications

References 19 publications

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results

Vitamin D serum levels and non-melanoma skin cancer risk

Exposome and Skin. Part 2. The Influential Role of the Exposome, Beyond UVR, in Actinic Keratosis, Bowen’s Disease and Squamous Cell Carcinoma: A Proposal

Contact Info

Product

Resources

About

Vitamin D status in adult patients with nonmelanoma skin cancer in Cape Town, South Africa: a cross‐sectional study

Abstract: The findings highlight the need for the development of recommendations and guidelines on sun protection in patients with NMSC, while still ensuring an adequate vitamin D status. High risk factors included winter and female gender.

Cited by 7 publications

References 19 publications

Assessment of sun‑related behavior and serum vitamin&nbsp;D in basal cell carcinoma: Preliminary results

Assessment of sun‑related behavior and serum vitamin&nbsp;D in basal cell carcinoma: Preliminary results

Vitamin D serum levels and non-melanoma skin cancer risk

Exposome and Skin. Part 2. The Influential Role of the Exposome, Beyond UVR, in Actinic Keratosis, Bowen’s Disease and Squamous Cell Carcinoma: A Proposal

Contact Info

Product

Resources

About

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results

Assessment of sun‑related behavior and serum vitamin D in basal cell carcinoma: Preliminary results