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Is the purported increase in melanoma a fraud?
In the last post, I made a case that sunlight does not cause melanoma, and that if Melanoma is increasing, as stated by the Melanoma International Foundation (MIF), it is doing so while sunlight exposure is decreasing. But suppose that the increase in melanoma is not an increase at all? Some believe that there is no proliferation of melanoma, but only a proliferation of dermatologists, and a proliferation of diagnoses of skin spots as being melanoma by some dermatologists in an attempt to make more money. An article by Harmon Leon,[1] writing for the Huffington Post, served as a reminder of the potential for fraud among (unscrupulous) dermatologists. I strongly suggest you read that article. I am indebted to Mr. Leon for a few of the points made in this post.
I do not mean to suggest that all dermatologists are dishonest. Many of the facts that I gather are derived from research performed by dermatologists who are trying to awaken the public to the fraudulent actions of some members of their profession.
Those who profit from scare tactics regarding melanoma I call The Powers of Darkness. They have frightened us away from the sunlight, or as Dr. Michael Holick (an honest dermatologist) says, “scared the daylights out of us to scare us out of the daylight.” The consequence is widespread vitamin D deficiency that has led to millions of cases of death and disability.
Dr. Arthur Rhodes, a dermatologist, wrote in a 2003 editorial for an independent dermatology newspaper[2] that melanoma’s public message—that sunlight was the sole cause of melanoma—was causing death among patients and medical professionals alike. In it he suggested that many people were not taking care of melanomas that occurred in areas of little or no sunlight exposure; this was because they assumed that only sunlight could cause melanoma. The following are some of the examples that he gathered from his experience with this most deadly of skin cancers:
1. A dermatology trainee died of melanoma at age 28. He watched a mole change in his armpit for years, but because that area never received UV light, he assumed it was not melanoma and delayed seeking help.
2. A 40-year-old woman had a sore on the bottom of her heel and believing only sunlight caused melanoma, she had no idea that it was melanoma. She died three years later.
3. A Harvard-trained lung specialist ignored a sore on his upper back. He and his fiancée, a Harvard-trained pediatric resident, observed the change for several years without having it examined. They didn’t know that melanoma could occur in an area that never received sunlight. He died six months after diagnosis at age 29.
Here is a quote from this enlightened dermatologist:
“If a medical resident can misinterpret public health messages about sun exposure and melanoma, and two Harvard-trained physicians were ignorant about the most important risk factors for developing melanoma, then the general public will tend to make the same potentially fatal mistakes. Those mistakes lead to delayed diagnosis of this potentially lethal cancer—particularly when we pound out the message that the culprit in melanoma is sun, sun, sun, and we are not sufficiently emphasizing the most important risk factors for developing melanoma.”
Dr. Rhodes states that “melanoma is a heterogeneous disease with multiple causes, arising from potential precursor moles that have little or nothing to do with sun exposure [emphasis mine], including dysplastic nevi, congenital nevi, and abnormal moles on acral surfaces and mucous membranes.”
Another celebrated dermatologist, Dr. Bernard Ackerman, wrote a meticulously documented 440 page monograph called The Sun and the “Epidemic” of Melanoma: Myth on Myth.[3] In it he presents nearly every piece of research regarding sunlight and melanoma up until 2008, and concludes that the purported "epidemic" of sunlight-caused melanoma is a myth.
I agree with these dermatologists. The “epidemic” of melanoma is a myth, and dermatologists themselves are paying a price. Their own sunlight avoidance is causing widespread vitamin D deficiency among members of their profession. Australian dermatologists, while living in one of the sunniest areas of the world, have an average blood-vitamin D level of only 13 ng/ml—a level considered to be severely deficient.[4] At least this group is following their own advice to avoid the sun. As you will see, not all dermatologists are following their own advice—especially those in the USA.
There are still other dermatologists who refuse to sing in the official choir of the Powers of Darkness. Writing in the British Medical Journal in 2008, Dr. Sam Shuster argued that the purported increase in melanoma is not really an increase at all, but an artifact due to non-melanoma lesions being diagnosed as melanoma.[5] In 2009, another study by dermatologists— Dr. Nick Levell and his colleagues, including Shuster—this time published by the British Journal of Dermatology, came to a similar conclusion and called the “increase” in melanoma a “midsummer night’s dream.”[6] They concluded, after tracking the reported increase in Melanoma in the Eastern region of the UK between 1991 and 2004, that benign lesions were being classified in increasing numbers as stage-one melanoma. No other stages of the disease increased, and the increase in mortality due to melanoma was either miniscule or non-existent. This was true even though all grades of tumors were diagnosed at first presentation. They also noted that “the distribution of the lesions reported did not correspond to the sites of lesions caused by solar exposure,”—in other words, the “cancers” were occurring on areas of the body seldom exposed to sunlight. Levell and his group also say that “the large increase in reported incidence is likely to be due to diagnostic drift which classifies benign lesions as stage 1 melanoma.”
They further stated that “These findings inevitably challenge the validity of epidemiology studies linking increasing melanoma incidence with UV radiation, and suggest the need for a search for other ways in which the disease may be caused.”
Dr. Ackerman agreed. In his meticulously documented monograph, he notes that “researchers have created an epidemic of melanoma when, in fact, the only change has been an “epidemic” in diagnoses of melanoma.”
Notwithstanding the research presented by these dermatologists, the American Academy of Dermatology (AADA) and other melanoma organizations continue to spread misinformation regarding the disease. Dr. William James, president of the AAD has said that melanoma has become the most common form of cancer for young adults 25-29 years old, testifying to that statement before the FDA.[7] Yet, he did not mention data from the National Cancer Institute indicating that death due to melanoma has decreased by 50% among women of ages 20-49 since 1975.[8] That means young women have less than one chance in 100,000 of dying from melanoma, which does not even place it in the top 15 causes of cancer death.[9] And, the American Cancer Society states that “since 2000 melanoma has been decreasing rapidly in whites younger than 50, by 3% per year in men since 1991 and by 2.3% per year since 1995 in women.” We might ask why these figures are not included in the statements by dermatologists regarding the “epidemic” of melanoma. Could it be because of a cozy financial relationship with pharmaceutical companies that produce sunscreen?[10]
Harmon Leon gave another reason to question the “epidemic” of melanoma: The USA has 4.5% of the world’s population, yet has 52% of the world’s melanoma. The American Cancer Society estimates 68,720 new melanomas in the US during 2009,[11] whereas the World Health Organization estimates 132,000 new cases yearly worldwide.[12] Something is very strange here. It certainly seems that the exceptionally high melanoma figures in the USA might be doctored to produce sunscreen sales, dermatology visits and the removal of benign leisions. If you want to read about how this is done, click on this link. http://www.cnbc.com/id/27087326
In addition, Dr. Ackerman points out the following in his monograph:
1. The American Academy of Dermatology (AAD), the Skin Cancer Foundation and the American Cancer Society sold their seals of recognition to manufacturers of sunscreens, based on research conducted solely by the sunscreen industry. The price, he says, was “substantial in terms of dollars but incalculable in terms of honor.” For instance, for an application of $10,000 and an annual fee of 5,000, sunscreen manufacturers may boast approval of their products in the form of the “Seal of Recognition” of the American Academy of Dermatology. They then display this seal on the front of their tubes. The American Cancer Society allows its logo to be placed on tubes of Neutrogena sunscreens in exchange for $300,000 annually.
2. In 2007, the year in which the Seal of Recognition program for the AAD was implemented, the past president of the board, who chaired the Seal program, and half the members of the board had financial ties to companies that manufacture sunscreen. And in 2008, all four new members of the board had those ties.
3. Darrell Rigel, a former president of the AAD, affirmed how important it was to avoid the sun while he, himself, was on vacation in Hawaii.
4. The AAD ran announcements for and updates on their scientific meetings, stating that they took place in “Sunny San Diego” and “Sunny San Antonio.” [Aren’t they supposed to avoid the sunlight?]
We now have two possibilities (see parts 1 and 2 of this post). (1.) Either melanoma has increased exponentially while sunlight exposure dramatically decreased or (2.) There has been no increase in melanoma; the purported increase is nothing more than an increase in the number of harmless skin spots that are being diagnosed as melanoma by an increasing number of dermatologists. In either case, the idea that regular, non-burning sunlight exposure is the cause of melanoma is a fraud—an idea promulgated by dermatological academies, sunscreen manufacturers and melanoma foundations driven by the desire for profit.
[1] http://www.huffingtonpost.com/harmon-leon/is-profit-behind-dermatol_b_640929.html
[2] Rhodes, A. Melanoma’s Public Message. Skin & Allergy News 2003;34 (4):1-4
[3] Ackerman, B. The Sun and the “Epidemic” of Melanoma: Myth on Myth. Ardor Scribendi, New York 2008.
[4] D. Czarnecki, C. J. Meehan and F. Bruce. The vitamin D status of Australian dermatologists. Clinical and Experimental Dermatology 2009;34, 624–25.
[5] Shuster, S. Is sun exposure a major cause of melanoma? No. BMJ 2008;337:a764
[6] N.J. Levell, C.C. Beattie, S. Shuster and D.C. Greenberg. Melanoma epidemic: a midsummer night’s dream? British J Dermatol 2009;161:630–34
[7] http://www.prnewswire.com/news-releases/american-academy-of-dermatology-association-testifies-at-fda-hearing-on-indoor-tanning-devices-89119047.html
[8] Age-adjusted mortality rates by Cancer site, Ages 20-49, White, Female 1975-2007. National Center for Health Statistics, Center for Disease Control, April 10, 2010. National Cancer institute.
[9] http://caonline.amcancersoc.org/cgi/content/full/59/4/225/TBL6
[10] http://findarticles.com/p/articles/mi_hb4393/is_3_39/ai_n29418761/
[11] American Cancer Society Cancer reference Information 2009. http://nccu.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_melanoma_50.asp?sitearea=
[12] http://www.who.int/uv/faq/skincancer/en/index1.html
Saturday, July 31, 2010
Friday, July 30, 2010
Exposing the Sunlight/Melanoma Fraud: Part 1
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For the purposes of this article, we discuss regular, non-burning exposure to sunlight--the type of sunlight that slowly produces a tan--and the type of sunlight exposure that can save your life. Never, ever burn yourself in the sunlight. See your medical professional before making any changes in your sunlight habits.
Is melanoma caused by regular sunlight exposure, or are we being defrauded?
The Melanoma International Foundation (MIF), is one the Powers of Darkness--organizations that would have us all become vitamin D deficient and ill by avoiding the healing sun.[i] They, like many other sun phobes, believe that sunlight should be shunned as a detriment to human healthand that “90% or more of melanoma is caused by ultraviolet radiation either from the sun or tanning salons."[ii] The MIF states that “Melanoma is epidemic: rising faster than any other cancer and projected to affect one person in 50 by 2010, currently it affects 1 in 75. In 1935, only one in 1,500 was struck by the disease.” In other words, they say there has been a 3,000% increase in melanoma since 1935. If true, then their statement that sunlight is the cause of melanoma flies in the face of reason. Consider the following:
1. If melanoma has indeed increased exponentially since 1935, and that increase is due to sunlight exposure, then sunlight exposure must also have shown a parallel or at least significant increase in that time. To determine whether that has happened, I analyzed data from the Bureau of Labor Statistics, (BLS) to determine if there was an increase or decrease in human sunlight exposure during the years from 1910 to 2,000.[iii] I paid special attention to the changes since 1935, the year the MIF used as a baseline for measuring increases in melanoma incidence. The data showed that indoor occupations grew from one-quarter to three-quarters of total employment between 1910 and 2000, and that during the same period, the outdoor occupation of farming declined from 33% to 1.2% of total employment, a 96% reduction. The data also show that approximately 66% of the decline in the occupation of farmers and 50% of the decline in the occupation of farm laborers occurred after 1935.
Further information from the EPA determined that as of 1986, about 5 percent of adult men worked mostly outdoors, and that about 10 percent worked outside part of the time. The proportion of women who worked outside was thought to be lower. [iv]
This material demonstrates a dramatic shift from outdoor, sunlight-exposed activity to indoor, non-sunlight-exposed activity during the 20th Century, including 1935, the MIF-baseline year. According to these facts, if there is a relationship between sunlight exposure and melanoma, the relationship is inverse—the greater the exposure to sunlight, the less is the risk of melanoma.
It has been theorized that the answer to the statement above, is that a decreasing thickness of the ozone layer (allowing more intense sunlight exposure) is responsible for the increasing incidence of melanoma. However, research by Moan and Dahlback in Norway reported that yearly melanoma incidence increased 350% in men and 440% in women between 1957 and 1984—a period when there was absolutely no thinning of the ozone layer.[v]
2. If melanoma is increasing due to increased exposure to sunlight, it is clear that outdoor workers, being exposed to far more sunlight, would also have far more melanoma. Nevertheless, Godar, et al.[vi] present evidence that outdoor workers, while receiving 3-9 times the UVR exposure as indoor workers,[vii] [viii] have had no increase in melanoma since before 1940, whereas melanoma incidence in indoor workers has increased steadily and exponentially. Many other studies corroborate the Godar findings that outdoor workers have fewer melanomas than indoor workers.[ix] [x] [xi] [xii] [xiii] [xiv] [xv] [xvi] [xvii] [xviii] [xix] [xx] [xxi] [xxii] [xxiii] [xxiv]
I repeat: the greater the exposure to sunlight, the less is the risk of melanoma.
3. If sunlight exposure is the reason for the increase in melanoma, we would expect that areas of the body that receive the most exposure would also be the areas of greatest occurrence of the disease. This is not the case. Research by Garland, et al.,[xxv] assessing the incidence of melanoma occurring at various body sites, found higher rates on the trunk (seldom exposed to sunlight) than on the head and arms (commonly exposed to sunlight). Others have shown that melanoma in women occur primarily on the upper legs, and in men more frequently on the back—areas of little sunlight exposure.[xxvi] In African Americans, melanoma is more common on the soles of the feet and on the lower legs, where exposure to sunlight is almost non-existent.[xxvii]
Again: the greater the exposure to sunlight, the less is the risk of melanoma. How, then can sunlight cause melanoma? Keep in mind that sunscreen use has increased dramatically in the last four decades, paralleling the increase in melanoma. Sunscreens are meant to block sunlight, no? This is one more indication that melanoma risk is increased by sunlight deficiency.
4. A question: If melanoma is caused by sunlight exposure, why do melanomas occur on areas that seldom or never receive sunlight exposure—areas such as inside the mouth,[xxviii] on sexual organs[xxix] and armpits?[xxx]
Mull over this information and you will see that the promoting of sunlight as the cause of melanoma is the promoting of a fraud—a fraud that is creating death and destruction due to vitamin D deficiency, which correlates to more than 100 serious diseases and disorders (see my book for documentation). The Powers of Darkness will continue spreading falsehoods about sunlight and melanoma until the truth is brought forth. Join the sunshine movement and help to spread truth and light. And remember: when you enjoy the sunlight, be sure never to burn.
Be sure to look for Part 2 in my next blog. Perhaps the biggest fraud of all is that some dermatologists are diagnosing harmless skin spots as melanoma--a means to defraud insurance companies and increase profits. We will also show that melanoma incidence may not be increasing at all. Stay tuned. The next blog will provide information from enlightened dermatologists who believe that their own profession is misleading the public!
[i] Melanoma International Foundation, 2007 Facts about melanoma.
[ii] Melanoma International Foundation, 2007 Facts about melanoma.
[iii] Ian D. Wyatt and Daniel E. Hecker. Occupational changes in the 20th century. Monthly Labor Review, March 2006 pp 35-57: Office of Occupational Statistics and Employment Projections, Bureau of Labor Statistics
[iv] U.S. Congress, Office of Technology Assessment, Catching Our Breath: Next Steps for Reducing Urban Ozone, OTA-O-412 (Washington, DC: U.S. Government Printing Office, July 1989).
[v] J. Moan and A. Dahlback. The relationship between skin cancers, solar radiation and ozone depletion. Br J Cancer 1992; 65: 916–21
[vi] Godar DE, Landry RJ, Lucas AD. Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma. Med hypothesis (2009), doi:10.1016/j.mehy.2008.09.056
[vii] Godar D. UV doses worldwide. Photochem Photobiol 2005;81:736–49.
[viii] Thieden E, Philipsen PA, Sandby-Møller J, Wulf HC. UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Arch Dermatol 2004;140:197–203.
[ix] Lee J. Melanoma and exposure to sunlight. Epidemiol Rev 1982;4:110–36.
[x] Vågero D, Ringbäck G, Kiviranta H. Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961–1979 Brit J Cancer 1986;53:507–12.
[xi] Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN; Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. Invest Dermatol 2003;120:1087–93.
[xii] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[xiii] Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs. Br J Dermatol 2001;145:602-09.
[xiv] Garsaud P, Boisseau-Garsaud AM, Ossondo M, Azaloux H, Escanmant P, Le Mab G. Epidemiology of cutaneous melanoma in the French West Indies (Martinique). Am J Epidemiol 1998;147:66-8.
[xv] Le Marchand l, Saltzman S, Hankin JH, Wilkens LR, Franke SJM, Kolonel N. Sun exposure, diet and melanoma in Hawaii Caucasians. Am J Epidemiol 2006;164:232-45.
[xvi] Armstong K, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Biol 2001;63:8-18
[xvii] Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981;43:842-9.
[xviii] Crombie IK. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer 1979;40:774-81.
[xix]Weinstock MA, Colditz,BA, Willett WC, Stampfer MJ. Bronstein, BR, Speizer FE. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989;84:199-204.
[xx] Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 20f03;22:3042-52.
[xxi] Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C. Sun exposure and mortality from melanoma. J Nat Cancer Inst 2005;97:95-199.
[xxii] Veierød MB, Weiderpass E, Thörn M, Hansson J, Lund E, Armstrong B. A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003;95:1530-8.
[xxiii] Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child 2006;91:131-8.
[xxiv] Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the western Canada melanoma study. Int J Cancer 2006;35:427-33
[xxv] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[xxvi] Rivers, J. Is there more than one road to melanoma? Lancet 2004;363:728-30.
[xxvii] Crombie, I. Racial differences in melanoma incidence. Br J Cancer 1979;40:185-93.
[xxviii] Burgess, A. et al. Parotidectomy: preoperative investigations and outcomes in a single surgeon practice. ANZ J Surg 2008 Sep;78(9):791-3.
[xxix] Ribé, A Melanocytic lesions of the genital area with attention given to atypical genital nevi. J Cutan Pathol. 2008 Nov;35 Suppl 2:24-7.
[xxx] Rhodes, A. Melanoma’s Public Message. Guest editorial, Skin and Allergy News 2003;34
For the purposes of this article, we discuss regular, non-burning exposure to sunlight--the type of sunlight that slowly produces a tan--and the type of sunlight exposure that can save your life. Never, ever burn yourself in the sunlight. See your medical professional before making any changes in your sunlight habits.
Is melanoma caused by regular sunlight exposure, or are we being defrauded?
The Melanoma International Foundation (MIF), is one the Powers of Darkness--organizations that would have us all become vitamin D deficient and ill by avoiding the healing sun.[i] They, like many other sun phobes, believe that sunlight should be shunned as a detriment to human healthand that “90% or more of melanoma is caused by ultraviolet radiation either from the sun or tanning salons."[ii] The MIF states that “Melanoma is epidemic: rising faster than any other cancer and projected to affect one person in 50 by 2010, currently it affects 1 in 75. In 1935, only one in 1,500 was struck by the disease.” In other words, they say there has been a 3,000% increase in melanoma since 1935. If true, then their statement that sunlight is the cause of melanoma flies in the face of reason. Consider the following:
1. If melanoma has indeed increased exponentially since 1935, and that increase is due to sunlight exposure, then sunlight exposure must also have shown a parallel or at least significant increase in that time. To determine whether that has happened, I analyzed data from the Bureau of Labor Statistics, (BLS) to determine if there was an increase or decrease in human sunlight exposure during the years from 1910 to 2,000.[iii] I paid special attention to the changes since 1935, the year the MIF used as a baseline for measuring increases in melanoma incidence. The data showed that indoor occupations grew from one-quarter to three-quarters of total employment between 1910 and 2000, and that during the same period, the outdoor occupation of farming declined from 33% to 1.2% of total employment, a 96% reduction. The data also show that approximately 66% of the decline in the occupation of farmers and 50% of the decline in the occupation of farm laborers occurred after 1935.
Further information from the EPA determined that as of 1986, about 5 percent of adult men worked mostly outdoors, and that about 10 percent worked outside part of the time. The proportion of women who worked outside was thought to be lower. [iv]
This material demonstrates a dramatic shift from outdoor, sunlight-exposed activity to indoor, non-sunlight-exposed activity during the 20th Century, including 1935, the MIF-baseline year. According to these facts, if there is a relationship between sunlight exposure and melanoma, the relationship is inverse—the greater the exposure to sunlight, the less is the risk of melanoma.
It has been theorized that the answer to the statement above, is that a decreasing thickness of the ozone layer (allowing more intense sunlight exposure) is responsible for the increasing incidence of melanoma. However, research by Moan and Dahlback in Norway reported that yearly melanoma incidence increased 350% in men and 440% in women between 1957 and 1984—a period when there was absolutely no thinning of the ozone layer.[v]
2. If melanoma is increasing due to increased exposure to sunlight, it is clear that outdoor workers, being exposed to far more sunlight, would also have far more melanoma. Nevertheless, Godar, et al.[vi] present evidence that outdoor workers, while receiving 3-9 times the UVR exposure as indoor workers,[vii] [viii] have had no increase in melanoma since before 1940, whereas melanoma incidence in indoor workers has increased steadily and exponentially. Many other studies corroborate the Godar findings that outdoor workers have fewer melanomas than indoor workers.[ix] [x] [xi] [xii] [xiii] [xiv] [xv] [xvi] [xvii] [xviii] [xix] [xx] [xxi] [xxii] [xxiii] [xxiv]
I repeat: the greater the exposure to sunlight, the less is the risk of melanoma.
3. If sunlight exposure is the reason for the increase in melanoma, we would expect that areas of the body that receive the most exposure would also be the areas of greatest occurrence of the disease. This is not the case. Research by Garland, et al.,[xxv] assessing the incidence of melanoma occurring at various body sites, found higher rates on the trunk (seldom exposed to sunlight) than on the head and arms (commonly exposed to sunlight). Others have shown that melanoma in women occur primarily on the upper legs, and in men more frequently on the back—areas of little sunlight exposure.[xxvi] In African Americans, melanoma is more common on the soles of the feet and on the lower legs, where exposure to sunlight is almost non-existent.[xxvii]
Again: the greater the exposure to sunlight, the less is the risk of melanoma. How, then can sunlight cause melanoma? Keep in mind that sunscreen use has increased dramatically in the last four decades, paralleling the increase in melanoma. Sunscreens are meant to block sunlight, no? This is one more indication that melanoma risk is increased by sunlight deficiency.
4. A question: If melanoma is caused by sunlight exposure, why do melanomas occur on areas that seldom or never receive sunlight exposure—areas such as inside the mouth,[xxviii] on sexual organs[xxix] and armpits?[xxx]
Mull over this information and you will see that the promoting of sunlight as the cause of melanoma is the promoting of a fraud—a fraud that is creating death and destruction due to vitamin D deficiency, which correlates to more than 100 serious diseases and disorders (see my book for documentation). The Powers of Darkness will continue spreading falsehoods about sunlight and melanoma until the truth is brought forth. Join the sunshine movement and help to spread truth and light. And remember: when you enjoy the sunlight, be sure never to burn.
Be sure to look for Part 2 in my next blog. Perhaps the biggest fraud of all is that some dermatologists are diagnosing harmless skin spots as melanoma--a means to defraud insurance companies and increase profits. We will also show that melanoma incidence may not be increasing at all. Stay tuned. The next blog will provide information from enlightened dermatologists who believe that their own profession is misleading the public!
[i] Melanoma International Foundation, 2007 Facts about melanoma.
[ii] Melanoma International Foundation, 2007 Facts about melanoma.
[iii] Ian D. Wyatt and Daniel E. Hecker. Occupational changes in the 20th century. Monthly Labor Review, March 2006 pp 35-57: Office of Occupational Statistics and Employment Projections, Bureau of Labor Statistics
[iv] U.S. Congress, Office of Technology Assessment, Catching Our Breath: Next Steps for Reducing Urban Ozone, OTA-O-412 (Washington, DC: U.S. Government Printing Office, July 1989).
[v] J. Moan and A. Dahlback. The relationship between skin cancers, solar radiation and ozone depletion. Br J Cancer 1992; 65: 916–21
[vi] Godar DE, Landry RJ, Lucas AD. Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma. Med hypothesis (2009), doi:10.1016/j.mehy.2008.09.056
[vii] Godar D. UV doses worldwide. Photochem Photobiol 2005;81:736–49.
[viii] Thieden E, Philipsen PA, Sandby-Møller J, Wulf HC. UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Arch Dermatol 2004;140:197–203.
[ix] Lee J. Melanoma and exposure to sunlight. Epidemiol Rev 1982;4:110–36.
[x] Vågero D, Ringbäck G, Kiviranta H. Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961–1979 Brit J Cancer 1986;53:507–12.
[xi] Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN; Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. Invest Dermatol 2003;120:1087–93.
[xii] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[xiii] Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs. Br J Dermatol 2001;145:602-09.
[xiv] Garsaud P, Boisseau-Garsaud AM, Ossondo M, Azaloux H, Escanmant P, Le Mab G. Epidemiology of cutaneous melanoma in the French West Indies (Martinique). Am J Epidemiol 1998;147:66-8.
[xv] Le Marchand l, Saltzman S, Hankin JH, Wilkens LR, Franke SJM, Kolonel N. Sun exposure, diet and melanoma in Hawaii Caucasians. Am J Epidemiol 2006;164:232-45.
[xvi] Armstong K, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Biol 2001;63:8-18
[xvii] Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981;43:842-9.
[xviii] Crombie IK. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer 1979;40:774-81.
[xix]Weinstock MA, Colditz,BA, Willett WC, Stampfer MJ. Bronstein, BR, Speizer FE. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989;84:199-204.
[xx] Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 20f03;22:3042-52.
[xxi] Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C. Sun exposure and mortality from melanoma. J Nat Cancer Inst 2005;97:95-199.
[xxii] Veierød MB, Weiderpass E, Thörn M, Hansson J, Lund E, Armstrong B. A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003;95:1530-8.
[xxiii] Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child 2006;91:131-8.
[xxiv] Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the western Canada melanoma study. Int J Cancer 2006;35:427-33
[xxv] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[xxvi] Rivers, J. Is there more than one road to melanoma? Lancet 2004;363:728-30.
[xxvii] Crombie, I. Racial differences in melanoma incidence. Br J Cancer 1979;40:185-93.
[xxviii] Burgess, A. et al. Parotidectomy: preoperative investigations and outcomes in a single surgeon practice. ANZ J Surg 2008 Sep;78(9):791-3.
[xxix] Ribé, A Melanocytic lesions of the genital area with attention given to atypical genital nevi. J Cutan Pathol. 2008 Nov;35 Suppl 2:24-7.
[xxx] Rhodes, A. Melanoma’s Public Message. Guest editorial, Skin and Allergy News 2003;34
Thursday, July 8, 2010
Food poisoning is increasing rapidly. Is vitamin D deficiency the reason?
--
According to the Organic Consumers Association (OCA), there has been an explosion in USA food poisoning since 1994.[1] In addition, the OCA states, “Food related illnesses are on the increase. At the end of 2000, more than 250 foodborne diseases were described, but in the vast majority of cases, the causal agent is unknown. Diarrhea and vomiting are the most common symptoms, with serious after-effects that include blood poisoning, abortion, infections, blood in the urine, and death. Chronic disorders of the heart and nervous system can also result, as well as arthritis, renal disease, and disease of the digestive system.”
The OCA further emphasizes, “To see foodborne illnesses in perspective, total illnesses from known pathogens are estimated at 38.6 million, and that includes 5.2 million (13%) due to bacteria, 2.5 million (7%) due to parasites and 30.9 million (80%) due to viruses. The breakdown for foodborne illnesses in terms of known etiological agents is similar, with the highest proportion due to viruses.”
The OCA’s main concern is the proliferation of genetically modified foods (GMF), which it feels may be responsible for the increase in foodborne disease, and indeed GMF may be one of the causes. However, recent research regarding vitamin D may provide further answers to the surging risk of these illnesses. In a previous post I stated that blood levels of this all-important hormone are dropping precipitously in the American population, with a near doubling of the prevalence of vitamin D insufficiency that existed 10 years ago. Now, 90% of Blacks, Hispanics and Asians, and 75% of the white population suffer from the disorder. [2]
But how does that fact relate to foodborne illnesses? Research by Wu and colleagues[3] showed that pathogens such as salmonella are killed in the intestine by vitamin D, provided that there are vitamin D receptors available. The researchers found that in mice with no vitamin D receptors (VDR), intestinal salmonella quickly caused severe illness and death; in those with receptors, there was little or no illness.
Of course, VDR’s do not work unless vitamin D is available. Since 90% of vitamin D in the body is provided by the stimulation of cholesterol in the skin, non-burning sunlight exposure is vitally important in keeping vitamin D at optimal levels.
Here are the mechanisms by which vitamin D may thwart food poisoning:
Vitamin D has been known for some time to be able to stimulate the production of a potent antibiotic, known as cathelicidin, which breaks down the cell walls of both bacteria and viruses. However, it is not a “broad-spectrum” antibiotic, defined as an antibiotic that kills both the disease-causing pathogens, and friendly intestinal bacteria that work to keep such pathogens at bay. Vitamin D also works by stimulating the immune system’s army of cells such as T cells[4] and macrophages[5] to attack and destroy pathogens.
So, it is entirely possible that the surge in foodborne illnesses is due to vitamin D deficiency, which results in a compromised intestinal immune system. It is time to return to the sun.
Also, see my blog on vitamin D and Diarrhea. http://drsorenson.blogspot.com/2010/05/vitamin-d-deficiency-and-death-from.html
[1] http://www.organicconsumers.org/toxic/foodpoison111101.cfm
[2] Adams, J and Hewison, M. Update in Vitamin D. J Clin Endocrinol Metab 2010;95: 471–478.
[3] Wu S, Liao AP, Xia Y, Li YC, Li JD, Sartor RB, Sun J. Vitamin D Receptor Negatively Regulates Bacterial-Stimulated NF-{kappa}B Activity in Intestine. Am J Pathol 2010;Jun 21. [Epub ahead of print]
[4] von Essen MR, Kongsbak M, Schjerling P, Olgaard K, Odum N, Geisler C.. Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol 2010;11:344-49.
[5] Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med 2010;88:441-50.
According to the Organic Consumers Association (OCA), there has been an explosion in USA food poisoning since 1994.[1] In addition, the OCA states, “Food related illnesses are on the increase. At the end of 2000, more than 250 foodborne diseases were described, but in the vast majority of cases, the causal agent is unknown. Diarrhea and vomiting are the most common symptoms, with serious after-effects that include blood poisoning, abortion, infections, blood in the urine, and death. Chronic disorders of the heart and nervous system can also result, as well as arthritis, renal disease, and disease of the digestive system.”
The OCA further emphasizes, “To see foodborne illnesses in perspective, total illnesses from known pathogens are estimated at 38.6 million, and that includes 5.2 million (13%) due to bacteria, 2.5 million (7%) due to parasites and 30.9 million (80%) due to viruses. The breakdown for foodborne illnesses in terms of known etiological agents is similar, with the highest proportion due to viruses.”
The OCA’s main concern is the proliferation of genetically modified foods (GMF), which it feels may be responsible for the increase in foodborne disease, and indeed GMF may be one of the causes. However, recent research regarding vitamin D may provide further answers to the surging risk of these illnesses. In a previous post I stated that blood levels of this all-important hormone are dropping precipitously in the American population, with a near doubling of the prevalence of vitamin D insufficiency that existed 10 years ago. Now, 90% of Blacks, Hispanics and Asians, and 75% of the white population suffer from the disorder. [2]
But how does that fact relate to foodborne illnesses? Research by Wu and colleagues[3] showed that pathogens such as salmonella are killed in the intestine by vitamin D, provided that there are vitamin D receptors available. The researchers found that in mice with no vitamin D receptors (VDR), intestinal salmonella quickly caused severe illness and death; in those with receptors, there was little or no illness.
Of course, VDR’s do not work unless vitamin D is available. Since 90% of vitamin D in the body is provided by the stimulation of cholesterol in the skin, non-burning sunlight exposure is vitally important in keeping vitamin D at optimal levels.
Here are the mechanisms by which vitamin D may thwart food poisoning:
Vitamin D has been known for some time to be able to stimulate the production of a potent antibiotic, known as cathelicidin, which breaks down the cell walls of both bacteria and viruses. However, it is not a “broad-spectrum” antibiotic, defined as an antibiotic that kills both the disease-causing pathogens, and friendly intestinal bacteria that work to keep such pathogens at bay. Vitamin D also works by stimulating the immune system’s army of cells such as T cells[4] and macrophages[5] to attack and destroy pathogens.
So, it is entirely possible that the surge in foodborne illnesses is due to vitamin D deficiency, which results in a compromised intestinal immune system. It is time to return to the sun.
Also, see my blog on vitamin D and Diarrhea. http://drsorenson.blogspot.com/2010/05/vitamin-d-deficiency-and-death-from.html
[1] http://www.organicconsumers.org/toxic/foodpoison111101.cfm
[2] Adams, J and Hewison, M. Update in Vitamin D. J Clin Endocrinol Metab 2010;95: 471–478.
[3] Wu S, Liao AP, Xia Y, Li YC, Li JD, Sartor RB, Sun J. Vitamin D Receptor Negatively Regulates Bacterial-Stimulated NF-{kappa}B Activity in Intestine. Am J Pathol 2010;Jun 21. [Epub ahead of print]
[4] von Essen MR, Kongsbak M, Schjerling P, Olgaard K, Odum N, Geisler C.. Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol 2010;11:344-49.
[5] Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med 2010;88:441-50.
Wednesday, July 7, 2010
The Sunlight-avoidance insanity is causing severe vitamin D deficiency. Will you die from sunlight deprivation?
--
Due to fear of melanoma, a deadly disease that has been erroneously attributed to sunlight exposure, the people are leaving the sunlight and becoming more like cave dwellers. For those of you who believe in evolution, can you imagine that after millions of years under the sun, human beings have been frightened away from their heritage?
There is an inconvenient truth about melanoma that the Powers of Darkness (those who would take away our sunlight) would prefer you not know: people who work regularly outdoors have a lower risk of melanoma than those who work indoors.
Godar, et al.[1] present evidence that outdoor workers, while receiving 3-9 times the UVR exposure as indoor workers,[2] [3] have had no increase in melanoma since before 1940, whereas melanoma incidence in indoor workers has increased steadily and exponentially. Other research corroborates the idea that outdoor workers have fewer melanomas than indoor workers.[4] Vagero, et al.[5] showed that melanomas were more common among indoor office workers and other indoor workers than among outdoor workers, and Kennedy, et al.[6] showed that a lifetime of sunlight exposure correlated to a reduced risk of melanoma. Garland, et al.[7] showed that those who worked indoors had a 50% greater risk of melanoma than those who worked both indoors and outdoors, and Kaskel, et al.[8] demonstrated that children who engage in outdoor activities are less likely to develop melanoma than those who do not. Many other papers in the scientific literature show that both incidence and death rate from melanoma are reduced with increasing exposure to sunlight.[9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19]
This is not to say that sunburn does not contribute to melanoma, but it certainly shows that habitual, non-burning sun exposure correlates to a reduced risk of this deadly disease. In addition, there are approximately 105 additional diseases that are reduced among those who have higher sunlight exposure and therefore have higher levels of vitamin D (see my book for a discussion on each disease). We cannot live without vitamin D, which is not a vitamin at all, but in its most active form is a potent steroid hormone that controls at least 1,000 genes.[20] It is also important to understand that 90% of all vitamin D is produced in the skin by the action of sunlight on skin.[21]
However, blood levels of this important hormone are dropping precipitously in the American population, with a near doubling of the prevalence of vitamin D insufficiency that existed 10 years ago, and with 90% of Blacks, Hispanics and Asians, and 75% of the white population now suffering from the disorder.[22]
So what does this mean to the health of US citizens? I have calculated in a manuscript currently in preparation, that the diseases that correlate to sunlight deprivation/vitamin D deficiency kill approximately 1.42 million people per year in the US. Diseases that correlate to sunlight exposure kill approximately 1,500 people per year. That produces a ratio of about 948:1. I will continue with my mid-day sunbathing, thank you!
Remember that no one is advising the injudicious use of sunlight; baking in the sun for hours is neither necessary nor desirable, but regular sunlight exposure is a sine qua non for vibrant health. To say that we should avoid sunlight is like saying we should avoid water. Water correlates to drowning, but no one asks us to avoid water; if we did the results would be catastrophic, as are the results of vitamin D deficiency due to sunlight deprivation.
Of course, there are some extremely rare conditions that may preclude sunlight exposure. Check with your (enlightened) physician.
Is it time to return to reasonable, habitual, non-burning sunlight exposure? It could save your life!
[1] Godar DE, Landry RJ, Lucas AD. Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma. Med hypothesis (2009), doi:10.1016/j.mehy.2008.09.056
[2] Godar D. UV doses worldwide. Photochem Photobiol 2005;81:736–49.
[3] Thieden E, Philipsen PA, Sandby-Møller J, Wulf HC. UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Arch Dermatol 2004;140:197–203.
[4] Lee J. Melanoma and exposure to sunlight. Epidemiol Rev 1982;4:110–36.
[5] Vågero D, Ringbäck G, Kiviranta H. Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961–1979 Brit J Cancer 1986;53:507–12.
[6] Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN; Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. Invest Dermatol 2003;120:1087–93.
[7] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[8] Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs. Br J Dermatol 2001;145:602-09.
[9] Garsaud P, Boisseau-Garsaud AM, Ossondo M, Azaloux H, Escanmant P, Le Mab G. Epidemiology of cutaneous melanoma in the French West Indies (Martinique). Am J Epidemiol 1998;147:66-8.
[10] Le Marchand l, Saltzman S, Hankin JH, Wilkens LR, Franke SJM, Kolonel N. Sun exposure, diet and melanoma in Hawaii Caucasians. Am J Epidemiol 2006;164:232-45.
[11] Armstong K, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Biol 2001;63:8-18
[12] Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981;43:842-9.
[13] Crombie IK. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer 1979;40:774-81.
[14]Weinstock MA, Colditz,BA, Willett WC, Stampfer MJ. Bronstein, BR, Speizer FE. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989;84:199-204.
[15] Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 20f03;22:3042-52.
[16] Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C. Sun exposure and mortality from melanoma. J Nat Cancer Inst 2005;97:95-199.
[17] Veierød MB, Weiderpass E, Thörn M, Hansson J, Lund E, Armstrong B. A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003;95:1530-8.
[18] Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child 2006;91:131-8.
[19] Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the western Canada melanoma study. Int J Cancer 2006;35:427-33
[20] Luz E. Tavera-Mendoza and John H. White. Cell Defenses and the Sunshine Vitamin. Scientific American 2007;November, p.42.
[21] Reichrath J. The challenge resulting from positive and negative effects of sunlight: how much solar UV exposure is appropriate to balance between risks of vitamin D deficiency and skin cancer? Prog Biophys Mol Biol 2006;92(1):9-16.
[22] Adams, J and Hewison, M. Update in Vitamin D. J Clin Endocrinol Metab 2010;95: 471–478.
Due to fear of melanoma, a deadly disease that has been erroneously attributed to sunlight exposure, the people are leaving the sunlight and becoming more like cave dwellers. For those of you who believe in evolution, can you imagine that after millions of years under the sun, human beings have been frightened away from their heritage?
There is an inconvenient truth about melanoma that the Powers of Darkness (those who would take away our sunlight) would prefer you not know: people who work regularly outdoors have a lower risk of melanoma than those who work indoors.
Godar, et al.[1] present evidence that outdoor workers, while receiving 3-9 times the UVR exposure as indoor workers,[2] [3] have had no increase in melanoma since before 1940, whereas melanoma incidence in indoor workers has increased steadily and exponentially. Other research corroborates the idea that outdoor workers have fewer melanomas than indoor workers.[4] Vagero, et al.[5] showed that melanomas were more common among indoor office workers and other indoor workers than among outdoor workers, and Kennedy, et al.[6] showed that a lifetime of sunlight exposure correlated to a reduced risk of melanoma. Garland, et al.[7] showed that those who worked indoors had a 50% greater risk of melanoma than those who worked both indoors and outdoors, and Kaskel, et al.[8] demonstrated that children who engage in outdoor activities are less likely to develop melanoma than those who do not. Many other papers in the scientific literature show that both incidence and death rate from melanoma are reduced with increasing exposure to sunlight.[9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19]
This is not to say that sunburn does not contribute to melanoma, but it certainly shows that habitual, non-burning sun exposure correlates to a reduced risk of this deadly disease. In addition, there are approximately 105 additional diseases that are reduced among those who have higher sunlight exposure and therefore have higher levels of vitamin D (see my book for a discussion on each disease). We cannot live without vitamin D, which is not a vitamin at all, but in its most active form is a potent steroid hormone that controls at least 1,000 genes.[20] It is also important to understand that 90% of all vitamin D is produced in the skin by the action of sunlight on skin.[21]
However, blood levels of this important hormone are dropping precipitously in the American population, with a near doubling of the prevalence of vitamin D insufficiency that existed 10 years ago, and with 90% of Blacks, Hispanics and Asians, and 75% of the white population now suffering from the disorder.[22]
So what does this mean to the health of US citizens? I have calculated in a manuscript currently in preparation, that the diseases that correlate to sunlight deprivation/vitamin D deficiency kill approximately 1.42 million people per year in the US. Diseases that correlate to sunlight exposure kill approximately 1,500 people per year. That produces a ratio of about 948:1. I will continue with my mid-day sunbathing, thank you!
Remember that no one is advising the injudicious use of sunlight; baking in the sun for hours is neither necessary nor desirable, but regular sunlight exposure is a sine qua non for vibrant health. To say that we should avoid sunlight is like saying we should avoid water. Water correlates to drowning, but no one asks us to avoid water; if we did the results would be catastrophic, as are the results of vitamin D deficiency due to sunlight deprivation.
Of course, there are some extremely rare conditions that may preclude sunlight exposure. Check with your (enlightened) physician.
Is it time to return to reasonable, habitual, non-burning sunlight exposure? It could save your life!
[1] Godar DE, Landry RJ, Lucas AD. Increased UVA exposures and decreased cutaneous Vitamin D3 levels may be responsible for the increasing incidence of melanoma. Med hypothesis (2009), doi:10.1016/j.mehy.2008.09.056
[2] Godar D. UV doses worldwide. Photochem Photobiol 2005;81:736–49.
[3] Thieden E, Philipsen PA, Sandby-Møller J, Wulf HC. UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Arch Dermatol 2004;140:197–203.
[4] Lee J. Melanoma and exposure to sunlight. Epidemiol Rev 1982;4:110–36.
[5] Vågero D, Ringbäck G, Kiviranta H. Melanoma and other tumors of the skin among office, other indoor and outdoor workers in Sweden 1961–1979 Brit J Cancer 1986;53:507–12.
[6] Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN; Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. Invest Dermatol 2003;120:1087–93.
[7] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[8] Kaskel P, Sander S, Kron M, Kind P, Peter RU, Krähn G. Outdoor activities in childhood: a protective factor for cutaneous melanoma? Results of a case-control study in 271 matched pairs. Br J Dermatol 2001;145:602-09.
[9] Garsaud P, Boisseau-Garsaud AM, Ossondo M, Azaloux H, Escanmant P, Le Mab G. Epidemiology of cutaneous melanoma in the French West Indies (Martinique). Am J Epidemiol 1998;147:66-8.
[10] Le Marchand l, Saltzman S, Hankin JH, Wilkens LR, Franke SJM, Kolonel N. Sun exposure, diet and melanoma in Hawaii Caucasians. Am J Epidemiol 2006;164:232-45.
[11] Armstong K, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Biol 2001;63:8-18
[12] Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981;43:842-9.
[13] Crombie IK. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer 1979;40:774-81.
[14]Weinstock MA, Colditz,BA, Willett WC, Stampfer MJ. Bronstein, BR, Speizer FE. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989;84:199-204.
[15] Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 20f03;22:3042-52.
[16] Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C. Sun exposure and mortality from melanoma. J Nat Cancer Inst 2005;97:95-199.
[17] Veierød MB, Weiderpass E, Thörn M, Hansson J, Lund E, Armstrong B. A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003;95:1530-8.
[18] Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child 2006;91:131-8.
[19] Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the western Canada melanoma study. Int J Cancer 2006;35:427-33
[20] Luz E. Tavera-Mendoza and John H. White. Cell Defenses and the Sunshine Vitamin. Scientific American 2007;November, p.42.
[21] Reichrath J. The challenge resulting from positive and negative effects of sunlight: how much solar UV exposure is appropriate to balance between risks of vitamin D deficiency and skin cancer? Prog Biophys Mol Biol 2006;92(1):9-16.
[22] Adams, J and Hewison, M. Update in Vitamin D. J Clin Endocrinol Metab 2010;95: 471–478.
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