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Ultraviolet, Vitamin D and Health

Clinicians and researchers gathered at the first North American scientific conference on UV, Vitamin D and Health on March 8th 2006 in Toronto. Attendees from the United States, Canada and Australia presented the most current research on the health effects of vitamin D, methods for obtaining vitamin D and the health risks of UV radiation exposure.

At the conclusion of the conference, national health organizations met to develop consistent and accurate messages about skin cancer prevention and vitamin D for the public. Among others, the messages have been endorsed by the American Cancer Society and the World Health Organization Collaborative Centre for Promotion of Sun Protection, and were developed with technical support and consultation with staff from the US Centers for Disease Control and Prevention.

Key Messages:

1. There is strong evidence of the harms of exposure to UV radiation from the sun and other sources, including skin cancer, melanoma and some cataracts. Based on expert consensus, sun protection is required when the UV index is 3 (moderate) or higher.

2. There is strong evidence of the benefits of adequate vitamin D status on musculoskeletal health and prevention of fractures in the elderly. There is also a growing body of evidence that vitamin D may have beneficial effects on some types of cancer, in particular colorectal cancer. Experts are concerned the vitamin D status may be too low in the general population to achieve these health benefits.

3. Vitamin D is obtained through skin exposure to UVB radiation, and also through diet (particularly fortified foods) and supplementation. To minimize the health risks associated with UVB radiation exposure while maximizing the potential benefits of optimum Vitamin D status, supplementation and small amounts of sun exposure are the preferred methods of obtaining vitamin D.

4. Groups at risk of not obtaining adequate amounts of vitamin D include: 

  • the elderly
  • exclusively breast-fed babies
  • individuals with dark skin pigmentation
  • individuals with limited skin exposure to the sun (e.g. housebound, or those who wear clothing covering most of the skin for cultural/religious reasons
  • those who during winter are living above 37 degrees latitude (Canada and Northern US).

The full statement and list of  of messages can be accessed here.

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Late Stage Melanoma More Common in Blacks and Hispanics

While whites are more likely to be diagnosed with melanoma, researchers from the University of Miami have found that Hispanics and blacks are more likely than whites to be diagnosed with late-stage melanoma. Late-stage diagnosis carries a higher mortality rate than diagnosis at earlier stages. The 5-year relative survival rate for localized melanoma (98%) decreases to 64% and 16% respectively for regional and distant stage melanoma.

The study analyzed the records of melanoma cases reported to the Florida Cancer Data system during the years of 1997 to 2002. Only records with both stage and race/ethnicity information were used. Of the melanoma cases reported for each racial/ethnic group, 26% of Hispanic patients, 52% of non-Hispanic black patients and only 16% of non-Hispanic white patients were diagnosed with late-stage melanoma.

The authors suggest that suboptimal secondary prevention efforts in minority populations may be the reason for this disparity.

Article Published: Hu S, Soza-Vento RM, Parker DF, et al. Comparison of Stage at Diganosis of Melanoma Among Hispanic, Black, and White Patients in Miami-Dade County, Florida. Arch Dermatol. 2006;142:704-708

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New Statistics about Youth Sun Safety Behaviors

The U. S. Centers for Disease Control and Prevention monitor health-risk behaviors among young people in the United State with the Youth Risk Behavior Surveillance System. The most recent statistics come from the 2005 the Youth Risk Behavior Survey which was given to a sampling of students in public and private schools across the country in grades 9-12.

Students who took the survey answered two questions about routine sun safety behaviors. The first was about routine sunscreen use, the second about routine practice of sun safety behaviors.

Concerning routine sunscreen use nationwide, 9% of students reported that they wore sunscreen with an SPF of 15 or higher when outside for more than one hour on a sunny day most of the time or always. The prevalence of routine sunscreen use was higher among female (11.7%) than male (6.3%) students. Sunscreen use was also higher, overall, among white (10.2%) students compared with Hispanic (7.6%) and black (3.4%) students.

Concerning routine sun safety behaviors, nationwide, 18.2% of students most of the time or always stayed in the shade, wore long-sleeved shirt, or wore a hat that shaded their face, ears, and neck when outside for more than one hour on a sunny day. The overall prevalence of these sun safety behaviors was higher among male (20.5%) than female (15.9%) students. In white students, routine sun safety behaviors were reported by 20.4% of male students, while only 11.7% of female students reported similar behavior. However, among black students, 23% of female students reported routine sun safety behavior compared to 17.5% of male students. Overall, the prevalence of routine practice of sun safety behaviors was higher among black (20.3%) and Hispanic (22.4%) students than white (16.1) students.

The Full Text of the Youth Risk Behavior Surveillance Survey is available here.

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