On 2015 Jan 09, William Grant commented:

Differences in vitamin D status may help explain the black-white disparities in breast cancer survival rates

The paper by Coughlin discussed some of the reasons for black-white disparities in breast cancer survival [1]. Overlooked in that discussion was any mention of the role of vitamin D from solar UVB exposure and oral vitamin D intake in reducing breast cancer risk and increasing survival rates. Geographical ecological studies in the U.S. and elsewhere have found significant inverse correlations between solar UVB indices and incidence and/or mortality rates of breast cancer [2, 3] as well as many other types of cancer [3]. An important reason why black women in the U.S. have a greater risk of dying from breast cancer is that due to darker skin pigmentation, they have 25-hydroxyvitamin D [25(OH)D] concentrations about 40% lower than white women [4]. In a review of black-white disparities in cancer survival rates for 13 types of cancer, it was found that after consideration of socioeconomic status, stage at diagnosis, and treatment, blacks an average of 25% (0% to 50+%) increased relative risk of dying after diagnosis of cancer than did whites [5]. There are many other health outcomes for which blacks have poorer outcomes than whites, including cardiovascular disease and diabetes mellitus [6]. Both of these diseases have been linked to low 25(OH)D concentrations in observational studies [7,8]. Thus, any intervention programs for addressing breast cancer disparities among African American women should consider including information about the health benefits of solar UVB exposure and vitamin D supplementation to increase 25(OH)D concentrations to above 30-40 ng/mL [9].

References 1. Coughlin SS. Intervention approaches for addressing breast cancer disparities among African American women. Ann Transl Med Epidemiol. 2014 Sep 8;1(1). pii: 1001. 2. Grant WB. Lower vitamin-D production from solar ultraviolet-B irradiance may explain some differences in cancer survival rates. J Natl Med Assoc. 2006;98(3):357-64. 3. Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5(10):3993-4023. 4. Ginde AA, Liu MC, Camargo CA Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009;169(6):626-32. 5. Grant WB, Peiris AN. Differences in vitamin D status may account for unexplained disparities in cancer survival rates between African and White Americans. Dermatoendocrinol. 2012;4(2):85-94. 6. Grant WB, Peiris AN. Possible role of serum 25-hydroxyvitamin D in Black–White health disparities in the United States. J Am Med Directors Assoc. 2010;11(9):617-28. 7. Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819-29. 8. Song Y, Wang L, Pittas AG, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2013;36(5):1422-8. 9. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2011;96(7):1911-30.

Disclosure I receive funding from Bio-Tech Pharmacal (Fayetteville, AR) and MediSun Technology (Highland Park, IL).

On 2015 Jan 09, William Grant commented:

Differences in vitamin D status may help explain the black-white disparities in breast cancer survival rates

The paper by Coughlin discussed some of the reasons for black-white disparities in breast cancer survival [1]. Overlooked in that discussion was any mention of the role of vitamin D from solar UVB exposure and oral vitamin D intake in reducing breast cancer risk and increasing survival rates. Geographical ecological studies in the U.S. and elsewhere have found significant inverse correlations between solar UVB indices and incidence and/or mortality rates of breast cancer [2, 3] as well as many other types of cancer [3]. An important reason why black women in the U.S. have a greater risk of dying from breast cancer is that due to darker skin pigmentation, they have 25-hydroxyvitamin D [25(OH)D] concentrations about 40% lower than white women [4]. In a review of black-white disparities in cancer survival rates for 13 types of cancer, it was found that after consideration of socioeconomic status, stage at diagnosis, and treatment, blacks an average of 25% (0% to 50+%) increased relative risk of dying after diagnosis of cancer than did whites [5]. There are many other health outcomes for which blacks have poorer outcomes than whites, including cardiovascular disease and diabetes mellitus [6]. Both of these diseases have been linked to low 25(OH)D concentrations in observational studies [7,8]. Thus, any intervention programs for addressing breast cancer disparities among African American women should consider including information about the health benefits of solar UVB exposure and vitamin D supplementation to increase 25(OH)D concentrations to above 30-40 ng/mL [9].

References 1. Coughlin SS. Intervention approaches for addressing breast cancer disparities among African American women. Ann Transl Med Epidemiol. 2014 Sep 8;1(1). pii: 1001. 2. Grant WB. Lower vitamin-D production from solar ultraviolet-B irradiance may explain some differences in cancer survival rates. J Natl Med Assoc. 2006;98(3):357-64. 3. Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5(10):3993-4023. 4. Ginde AA, Liu MC, Camargo CA Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009;169(6):626-32. 5. Grant WB, Peiris AN. Differences in vitamin D status may account for unexplained disparities in cancer survival rates between African and White Americans. Dermatoendocrinol. 2012;4(2):85-94. 6. Grant WB, Peiris AN. Possible role of serum 25-hydroxyvitamin D in Black–White health disparities in the United States. J Am Med Directors Assoc. 2010;11(9):617-28. 7. Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819-29. 8. Song Y, Wang L, Pittas AG, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2013;36(5):1422-8. 9. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2011;96(7):1911-30.

Disclosure I receive funding from Bio-Tech Pharmacal (Fayetteville, AR) and MediSun Technology (Highland Park, IL).