Increased risk of non-melanoma skin cancer is associated with reduced risk of internal cancers William B. Grant, Sunlight, Nutrition and Health Research Center 9 August 2007 The results regarding occupation and skin cancer incidence in regions of France, Italy, and Spain [Suarez et al., 2007] support my recent paper in which I found that in Spain, non-melanoma skin cancer (NMSC) mortality rates were inversely correlated with 17 types of cancer including melanoma [Grant, 2007a]. I assumed that since those living in Spain are generally living in the same province where their ancestors lived for many generations that their skin was well suited for the prevailing solar UV conditions, so those involved in outdoor occupations would have a slightly increased risk of NMSC. The present study [Suarez et al., 2007] confirms that those with outdoor occupations do have higher incidence rates for NMSC. There is a large body of literature showing that solar UVB and vitamin D reduce the risk of cancer [e.g., Garland et al., 2006; Van der Rhee et al., 2006; Lappe et al., 2007], and has many additional benefits [Holick, 2007]. I have also shown that NMSC is generally a risk reduction for second primary cancers as long as the effects of smoking are considered [Grant, 2007b]. It would be interesting if those studied in the Helios I study and the related Helios II study [Rosso et al., 1996] could be recontacted to determine whether they had developed secondary primary cancers and then to do a study similar to that in Grant [2007b]. Meanwhile, those living in France, Italy, and Spain would very likely improve their health by seeking more, rather than less, sun exposure and other sources of vitamin D3.ReferencesGarland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin D in cancer prevention. Am J Public Health. 2006 Feb;96(2):252-61. Grant WB. An ecologic study of cancer mortality rates in Spain with respect to indices of solar UV irradiance and smoking. Int J Cancer. 2007a;120:1123-7.Grant WB. A meta-analysis of second cancers after a diagnosis of nonmelanoma skin cancer: additional evidence that solar ultraviolet-B irradiance reduces the risk of internal cancers. J Steroid Biochem Mol 2007b;103(3-5):668-674.Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81.Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91. Rosso S, Zanetti R, Martinez C, et al. The multicentre south European study 'Helios'. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer. 1996 Jun;73(11):1447-54. Suarez B, Lopez-Abente G, Martinez C, et al. Occupation and skin cancer: the results of the HELIOS-I multicenter case-control study. BMC Public Health 2007;7:180.Van der Rhee HJ, de Vries E, Coebergh JW. Does sunlight prevent cancer? A systematic review. Eur J Cancer. 2006 Sep;42(14):2222-32. Competing interests DisclosureI receive funding from the UV Foundation (McLean, VA) and the Vitamin D Society (Canada) and expect funding from the European Sunlight Association.