The Good News: Breast Cancer Update

by Patricia E. Reykdal and Donald L. Smith

Imagine the frenzy that would result if a pharmaceutical company announced that it had developed a new drug that could reduce the annual breast cancer mortality rate by 20 percent to 30 percent. (More than 50,000 women die from breast cancer in the United States annually).

This exciting breakthrough would make headlines, the pharmaceutical company’s stock would skyrocket, and women everywhere understandably would be elated by the fact that 10,000 to 15,000 lives could be saved each year.

This is why it is hard to understand why the media completely ignored a recent British Medical Journal article titled “Sunlight and Mortality From Breast, Ovarian, Colon, Prostate, and Non- Melanoma Skin Cancer: A Composite Death Certificate Based Case-Control Study” by Freedman, et al, of the National Cancer Institute. The study showed that women who lived in high-sunlight areas of the United States and had occupations that allowed them to be outside during part of the day had 20 percent to 30 percent fewer mortalities from breast cancer (verified by death certificates) than women who lived in low-sunlight areas of the country and had occupations that required them to work inside.

The reduction in breast cancer mortality was attributed to the link between sunlight exposure and vitamin D levels. The authors concluded that “In this exploratory study, unlike mortality from non-melanoma skin cancer, mortality from female breast cancer and colon cancer were negatively associated with both residential and occupational sunlight.”

Since the number of deaths (1,000 per year) from non-melanoma skin cancer—basal cell carcinoma and squamous cell carcinoma—was positively associated with overexposure to residential and occupational sunlight, let’s take a look at whether the benefits associated with more sunlight exposure outweighs the risks.

The table below shows that there would be a net savings of 9,800 lives each year if there was a 20-percent reduction in breast cancer, and 14,700 lives saved each year if there was a 30-percent reduction. Thus, there would be 50 lives saved each year from death due to breast cancer as a result of more sunlight (UVR) exposure for every one life lost due to non-melanoma skin cancer as a result of sunlight (UVR) overexposure each year—a trade-off that definitely would appeal to American women.

The data clearly shows that women who live in low-sunlight areas of the United States and work indoors have a much higher relative risk of death due to breast cancer when compared to women who live in high-sunlight areas and work outdoors; however, changing the odds doesn’t require moving residences or changing occupations. Women who live in low-sunlight areas and work indoors can gain the same advantage as women who live in high-sunlight areas and work outdoors by simply visiting their local indoor tanning salon once or twice each week year-round.

The indoor tanning industry can take pride in the fact that it is the only entity telling the American public the truth about ultraviolet radiation, i.e., that while the benefits of sensible, moderate and responsible exposure to UVR in the controlled and consistent environment of an indoor tanning salon outweigh the minimal and manageable risks involved, overexposure to UVR always should be avoided. Scientific articles like the Freedman, et al, study prove the wisdom of our balanced message.