On 2014 Dec 30, William Grant commented:

The review by Bonifazi and colleagues found that those with sarcoidosis have an increased risk of many types of cancer.1 The role of inflammation in explaining the link between sarcoidosis and cancer was discussed. However, no firm conclusion was reached regarding the link.

A factor not considered was vitamin D. Those with sarcoidosis often have low 25-hydroxyvitamin D [25(OH)D] concentrations due to concerns about hypercalcemia.2 There is evidence that low solar UVB doses and serum 25(OH)D concentrations are a risk factor for sarcoidosis. A summary of the geographical and temporal mortality rates for sarcoidosis in the United States for the period 2000-2007 found higher mortality rates for non-Hispanic black and white decedents in the higher latitude states, which have lower solar UVB doses, as well as moderately higher trends of mortality rates for non-Hispanic males and females from 1989 to 2007.3 Serum 25(OH)D concentrations decreased during that period due to a number of factors.

Low solar UVB exposure and 25(OH)D concentrations are an important risk factor for many types of cancer.4 Of the types of cancer with significant relative risks related to sarcoidosis, seven are significantly inversely related to solar UVB doses in ecological studies: colorectal, kidney, leukemia, liver, and upper digestive tract cancer, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. However, eight types of cancer inversely correlated with solar UVB doses in ecological studies were not found directly linked to sarcoidosis: bladder, breast, cervix/uterus, lung, ovary, pancreas, prostate, and stomach cancer. Of these types, only bladder and breast cancer are strongly linked to low UVB doses and/or 25(OH)D concentrations. As noted in Ref. 1, smoking may affect the sarcoidosis-cancer link, and four of these types of cancer are strongly linked to smoking: bladder, crevix/uterus, lung, and pancreas cancer.

Twelve of the 16 studies included in Ref. 1 were from Nordic countries. A study of cancer incidence rates with respect to a solar UVB exposure index in Nordic countries based on 54 occupational categories found much the same for males as summarized in Ref. 4.5 In addition, the melanoma incidence rate for males was inversely correlated with the UVB exposure index at the p=0.02 level, and the non-melanoma skin cancer rate was significantly inversely correlated with both the UVB index and lung cancer incidence rates in a multiple-linear regression analysis. Both melanoma and basal cell carcinoma are more frequent among people with limited solar UV exposure than those with chronic UV exposure.

References 1. Bonifazi M, Bravi F, Gasparini S, et al. Sarcoidosis and cancer risk: systematic review and meta-analysis of observational studies. Chest. 2014 Oct 23. doi: 10.1378/chest.14-1475. [Epub ahead of print] 2. Bolland MJ, Wilsher ML, Grey A, et al. Randomised controlled trial of vitamin D supplementation in sarcoidosis. BMJ Open. 2013;3:e003562. 3. Swigris JJ, Olson AL, Huie TJ, et al. Sarcoidosis-related mortality in the United States from 1988 to 2007. Am J Respir Crit Care Med. 2011;183:1524-1530. 4. Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5:3993-4023 5. Grant WB. Role of solar UV irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries. Dermatoendocrinol. 2012;4:203-211.

Disclosure I receive funding from Bio-Tech Pharmacal (Fayetteville, AR), the Sunlight Research Forum (Veldhoven), and Medi-Sun Engineering, LLC (Highland Park, IL).

On 2014 Dec 30, William Grant commented:

The review by Bonifazi and colleagues found that those with sarcoidosis have an increased risk of many types of cancer.1 The role of inflammation in explaining the link between sarcoidosis and cancer was discussed. However, no firm conclusion was reached regarding the link.

A factor not considered was vitamin D. Those with sarcoidosis often have low 25-hydroxyvitamin D [25(OH)D] concentrations due to concerns about hypercalcemia.2 There is evidence that low solar UVB doses and serum 25(OH)D concentrations are a risk factor for sarcoidosis. A summary of the geographical and temporal mortality rates for sarcoidosis in the United States for the period 2000-2007 found higher mortality rates for non-Hispanic black and white decedents in the higher latitude states, which have lower solar UVB doses, as well as moderately higher trends of mortality rates for non-Hispanic males and females from 1989 to 2007.3 Serum 25(OH)D concentrations decreased during that period due to a number of factors.

Low solar UVB exposure and 25(OH)D concentrations are an important risk factor for many types of cancer.4 Of the types of cancer with significant relative risks related to sarcoidosis, seven are significantly inversely related to solar UVB doses in ecological studies: colorectal, kidney, leukemia, liver, and upper digestive tract cancer, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. However, eight types of cancer inversely correlated with solar UVB doses in ecological studies were not found directly linked to sarcoidosis: bladder, breast, cervix/uterus, lung, ovary, pancreas, prostate, and stomach cancer. Of these types, only bladder and breast cancer are strongly linked to low UVB doses and/or 25(OH)D concentrations. As noted in Ref. 1, smoking may affect the sarcoidosis-cancer link, and four of these types of cancer are strongly linked to smoking: bladder, crevix/uterus, lung, and pancreas cancer.

Twelve of the 16 studies included in Ref. 1 were from Nordic countries. A study of cancer incidence rates with respect to a solar UVB exposure index in Nordic countries based on 54 occupational categories found much the same for males as summarized in Ref. 4.5 In addition, the melanoma incidence rate for males was inversely correlated with the UVB exposure index at the p=0.02 level, and the non-melanoma skin cancer rate was significantly inversely correlated with both the UVB index and lung cancer incidence rates in a multiple-linear regression analysis. Both melanoma and basal cell carcinoma are more frequent among people with limited solar UV exposure than those with chronic UV exposure.

References 1. Bonifazi M, Bravi F, Gasparini S, et al. Sarcoidosis and cancer risk: systematic review and meta-analysis of observational studies. Chest. 2014 Oct 23. doi: 10.1378/chest.14-1475. [Epub ahead of print] 2. Bolland MJ, Wilsher ML, Grey A, et al. Randomised controlled trial of vitamin D supplementation in sarcoidosis. BMJ Open. 2013;3:e003562. 3. Swigris JJ, Olson AL, Huie TJ, et al. Sarcoidosis-related mortality in the United States from 1988 to 2007. Am J Respir Crit Care Med. 2011;183:1524-1530. 4. Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5:3993-4023 5. Grant WB. Role of solar UV irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries. Dermatoendocrinol. 2012;4:203-211.

Disclosure I receive funding from Bio-Tech Pharmacal (Fayetteville, AR), the Sunlight Research Forum (Veldhoven), and Medi-Sun Engineering, LLC (Highland Park, IL).