Elsevier

Cancer Epidemiology

Volume 39, Supplement 1, December 2015, Pages S75-S83
Cancer Epidemiology

European Code against Cancer 4th Edition: Ultraviolet radiation and cancer

https://doi.org/10.1016/j.canep.2014.12.014Get rights and content
Under a Creative Commons license
open access

Abstract

Ultraviolet radiation (UVR) is part of the electromagnetic spectrum emitted naturally from the sun or from artificial sources such as tanning devices. Acute skin reactions induced by UVR exposure are erythema (skin reddening), or sunburn, and the acquisition of a suntan triggered by UVR-induced DNA damage. UVR exposure is the main cause of skin cancer, including cutaneous malignant melanoma, basal-cell carcinoma, and squamous-cell carcinoma. Skin cancer is the most common cancer in fair-skinned populations, and its incidence has increased steeply over recent decades. According to estimates for 2012, about 100,000 new cases of cutaneous melanoma and about 22,000 deaths from it occurred in Europe. The main mechanisms by which UVR causes cancer are well understood. Exposure during childhood appears to be particularly harmful. Exposure to UVR is a risk factor modifiable by individuals’ behaviour. Excessive exposure from natural sources can be avoided by seeking shade when the sun is strongest, by wearing appropriate clothing, and by appropriately applying sunscreens if direct sunlight is unavoidable. Exposure from artificial sources can be completely avoided by not using sunbeds. Beneficial effects of sun or UVR exposure, such as for vitamin D production, can be fully achieved while still avoiding too much sun exposure and the use of sunbeds. Taking all the scientific evidence together, the recommendation of the 4th edition of the European Code Against Cancer for ultraviolet radiation is: “Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds.”

Abbreviations

AAD
American Academy of Dermatology
AK
actinic keratosis
ASR
age-standardised incidence rates
BCC
basal cell carcinoma
CI
confidence interval
CM
malignant melanoma
CPDs
cyclobutane-pyrimidine dimers
DT
delayed tanning
IARC
International Agency for Research on Cancer
IPD
immediate pigment darkening
MED
minimal erythemal dose
NMSC
non-melanoma skin cancer
ROS
reactive oxygen species
SCC
squamous-cell carcinoma
SPF
sun protection factor
UVI
ultraviolet index
UVR
ultraviolet radiation
US FDA
Food and Drug Administration of the United States
WHO
World Health Organization

Keywords

Ultraviolet radiation
Ultraviolet light
Skin cancer
Melanoma
Sunburn
Tanning
Adverse effects
Primary prevention
Europe

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