Epidemiology

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Life course sun exposure and risk of prostate cancer: Population-based nested case-control study and meta-analysis

  1. Rebecca Gilbert1,†,*,
  2. Chris Metcalfe1,
  3. Steven E. Oliver2,
  4. David C. Whiteman3,
  5. Chris Bain4,
  6. Andy Ness5,
  7. Jenny Donovan1,
  8. Freddie Hamdy6,
  9. David E. Neal7,
  10. J. Athene Lane1,
  11. Richard M. Martin1

Article first published online: 4 MAR 2009

DOI: 10.1002/ijc.24411

Issue

International Journal of Cancer

International Journal of Cancer

Volume 125, Issue 6, pages 1414–1423, 15 September 2009

Additional Information

How to Cite

Gilbert, R., Metcalfe, C., Oliver, S. E., Whiteman, D. C., Bain, C., Ness, A., Donovan, J., Hamdy, F., Neal, D. E., Lane, J. A. and Martin, R. M. (2009), Life course sun exposure and risk of prostate cancer: Population-based nested case-control study and meta-analysis. International Journal of Cancer, 125: 1414–1423. doi: 10.1002/ijc.24411

Author Information

  1. 1

    Department of Social Medicine, University of Bristol, Bristol, United Kingdom

  2. 2

    Department of Health Sciences, University of York and the Hull York Medical School, York, United Kingdom

  3. 3

    Division of Population Studies and Human Genetics, Queensland Institute of Medical Research, Queensland, Australia

  4. 4

    School of Population Health, The University of Queensland, Queensland, Australia

  5. 5

    Department of Oral and Dental Science, University of Bristol, Bristol, United Kingdom

  6. 6

    Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom

  7. 7

    Department of Oncology, University of Cambridge, Cambridge, United Kingdom

  1. †

    Fax: +44-117-3313914.

*University of Bristol, Department of Social Medicine, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom

Publication History

  1. Issue published online: 14 JUL 2009
  2. Article first published online: 4 MAR 2009
  3. Manuscript Accepted: 18 FEB 2009
  4. Manuscript Received: 24 NOV 2008

Funded by

  • World Cancer Research Fund. Grant Number: 2006/15
  • UK NIHR (Health Technology Assessment Programme). Grant Numbers: 96/20/06, 96/20/99

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Keywords:

  • prostate cancer;
  • sun exposure;
  • pigmentation

Abstract

There is currently no means of primary prevention for prostate cancer. Increased exposure to ultraviolet-radiation may be protective, but the literature is inconclusive. We investigated associations of life course exposure to sunlight with prostate cancer. The study design was a UK-wide nested case-control study, based on 1,020 prostate specific antigen-detected cases and 5,044 matched population controls and a systematic review with meta-analysis. Men with olive/brown skin (OR = 1.47; 95% CI: 1.00 to 2.17), men who burnt rarely/never (OR = 1.11; 0.95 to 1.29) and men with the lowest levels of intense sun exposure in the 2 years prior to diagnosis (OR = 1.24; 1.03 to 1.50) had an increased prostate cancer risk. However, amongst men with prostate cancer, spending less time outside was associated with a reduced risk of advanced cancer (OR = 0.49; 0.27 to 0.89) and high Gleason grade (OR = 0.62; 0.43 to 0.91), and men who burnt rarely/never had a reduced risk of advanced cancer (OR = 0.71; 0.47 to 1.08). The meta-analysis provided weak evidence that men with the lowest (versus highest) sunlight exposure had an increased prostate cancer risk (4 studies, random-effects pooled relative risk = 1.13; 0.98 to 1.29) and higher advanced or fatal prostate cancer risk (6 studies, random-effects pooled relative risk = 1.14; 0.98 to 1.33). Our data and meta-analyses provide limited support for the hypothesis that increased exposure to sunlight may reduce prostate cancer risk. The findings warrant further investigation because of their implications for vitamin D chemoprevention trials. © 2009 UICC

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