International Journal of Epidemiology

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© 1990 Oxford University Press

research-article

Sunlight and Breast Cancer Incidence in the USSR

EDWARD D GORHAM^*, FRANK C GARLAND^* and CEDRIC F GARLAND^*,

^*Department of Community and Family Medicine, University of California, San Diego, School of Medicine (M-007) La Jolla, California 92093, USA
Cancer Center Epidemiology Program, University of California, San Diego, School of Medicine La Jolla, Califomia 92093, USA

Epidemiological and laboratory evidence suggest that vitamin D may play a role in reducing risk of breast cancer. Lack of exposure to ultraviolet sunlight can increase the prevalence of vitamin D deficiency, and may place some populations at higher risk of breast cancer. The association between total average annual sunlight energy striking the ground and age-adjusted breast cancer incidence rates in the USSR was evaluated. Breast cancer had a threefold range of incidence. Sunlight levels varied from 210 to 400 calories per cm² per day. A statistically significant negative association was found between breast cancer incidence rates and total sunlight levels (R = –0.75, p = 0.001). The slope of the regression line corresponded to two additional cases per 100 000 per year for each reduction of 35 calories per cm² of sunlight. The pattern of increased breast cancer incidence in regions of low solar radiation in the USSR is consistent with the geographical pattern seen for breast cancer mortality in the US and worldwide. A positive relationship between socioeconomic status and breast cancer incidence was also present in the Soviet Union, based on an approximate socioeconomic measure, the number of doctors per 1000 population (R = +0.89, p = 0.0001). The possibility that correlates of socioeconomic status, such as dietary, ethnic, or behavioural factors, could account for the association is discussed.

Received 1 May 1990

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