Health benefits of sunlight may outweigh the risks of skin cancer in gloomier parts of the UK, research suggests

We are all told to lather on sunscreen and stay in the shade, but the benefits of sunlight may outweigh the risks of skin cancer in gloomier parts of the UK.

Scientists from the University of Edinburgh found exposure to higher levels of ultraviolet (UV) radiation is linked to a drop in deaths due to cancer and cardiovascular disease — including heart attacks and strokes.

The researchers believe adapting public health advice to reflect both risks and benefits may help improve life expectancy in low-sunlight countries, such as Scotland. 

Their report said: 'The benefits of UV exposure may outweigh the risks in low-sunlight countries.'

But experts continued to warn that people should still take protective measures to prevent sunburn and skin cancer.

Scientists from the University of Edinburgh found exposure to higher levels of ultraviolet (UV) radiation is linked to a drop in deaths due to cancer and cardiovascular disease ¿ including heart attacks and strokes

Scientists from the University of Edinburgh found exposure to higher levels of ultraviolet (UV) radiation is linked to a drop in deaths due to cancer and cardiovascular disease — including heart attacks and strokes

The researchers believe adapting public health advice to reflect both risks and benefits may help improve life expectancy in low-sunlight countries, such as Scotland

The researchers believe adapting public health advice to reflect both risks and benefits may help improve life expectancy in low-sunlight countries, such as Scotland

Statisticians commenting on the report said it is important to avoid causation, and other factors may contribute.

Scientists used UK BioBank data to examine the UV exposure of 395,000 people from white European backgrounds — however 'limitations' were raised by commentators, as participants were aged between 37 and 73 at the time of recruitment.

Living in locations with higher UV levels, for example Cornwall, was associated with a lower risk of death from cardiovascular disease and cancer — 19 per cent and 12 per cent respectively — than areas with lower UV levels, such as Edinburgh or Glasgow, according to the report.

HOW TO STAY SAFE IN THE SUN

Sunburn increases a person's risk of skin cancer.

It can happen abroad or in the UK. 

To stay sun safe, experts recommend people:

  • Seek shade between 11am and 3pm, which is when the sun's rays are typically strongest
  • Wear at least SPF 30 sunscreen
  • Apply sunscreen 30 minutes, and again just before, UV exposure
  • Opt for water-resistant sunscreen if necessary and reapply after swimming, sweating or using a towel 
  • Cover up with protective clothing, a wide-brimmed hat and sunglasses
  • Be extra careful with babies and young children. Infants under six months should be kept out of direct sunlight
  • Do not use sunbeds or sunlamps 
  • Checks moles and skin for any changes 

Source: NHS Choices 

Advertisement

The team asked participants if they used sunbeds and calculated average annual UV exposure based on region, and looked at the cause of death for participants who died.

Smoking, exercise, deprivation and gender were considered to reduce the chance these factors were responsible for any changes observed, and the report noted 'evidence of a healthy volunteer selection bias'.

Sunbed use was linked to a 23 per cent lower risk of death from cardiovascular disease and a 14 per cent lower risk of fatal cancer in the report — however it was noted that sunbed users may potentially seek out greater sun exposure.

Those with a higher estimated UV exposure had a slightly increased risk of being diagnosed with melanoma, a type of skin cancer, but their risk of dying from the condition was not raised, the report said.

The findings are of most relevance to low-sunlight countries, and experts said research into locations with higher UV exposure is needed to build a clearer picture of the potential benefits.

Professor Chris Dibben, of the university’s School of GeoSciences, said: 'Our paper adds to a growing body of evidence suggesting that in lower-light environments, relatively higher exposure to UV is good for your health.

'Though there may be an increased risk of skin cancer incidence with higher UV exposure, this risk appears to be outweighed by a larger reduction in the risk of death from cancer and cardiovascular-related disease.'

Professor Richard Weller, from the university’s Centre for Inflammation Research, said: 'Dermatologists traditionally only considered possible harm to the skin caused by sunlight, much of which dates from the experience of white-skinned individuals in sunny countries such as Australia. When the UV index is very high, protecting skin is important.

'Research shows that in the UK, the balance of benefit and risk is probably very different from that in sunnier countries.'

The study, Higher Ultraviolet Light Exposure Is Associated With Lower Mortality: An Analysis Of Data From The UK Biobank Cohort Study, was published in Health & Place, funded by Health Data Research UK.

Rachel Richardson, of the evidence synthesis network Cochrane, said: 'Participants are not representative of the population — the UK BioBank only includes people between the ages of 37 and 73 at recruitment. These findings may not apply to older and younger age groups.

'A second limitation is that some results are based on small numbers of participants, for example mortality from melanoma. This means there is not enough information to draw conclusions about whether there was an association between UV exposure.'

Professor Kevin McConway, an emeritus professor of applied statistics at the Open University, said: 'On average, deaths occurred later in people who lived in sunnier parts of the UK, or used a sunbed at least once a year.

'The snag is that people who live in different parts of the country differ in many other ways than the amount of UV radiation, and sunbeds. The correlation between UV exposure and death rates could be caused by other factors.

'The researchers rightly point out there may be some relevant confounding factors they did not adjust for — and it’s not possible to adjust for factors on which there is no data.

'Some doubt has to remain about the extent to which the different UV exposures explain the differences in death rates, in terms of cause and effect.'

 UV rays can penetrate the first two layers of skin — the epidermis and dermis — and damage cells' DNA.

Wearing sunscreen with at least an SFP 30 will help protect your skin from UVB rays. The NHS also advises to buy a sunscreen with at least a four star UVA protection. 

Daylight is also important for vitamin D, which helps regulate the amount of calcium and phosphate in the body.

These nutrients in turn keep bones, teeth and muscles healthy, the NHS explains.

Vitamin D is also necessary for the proper functioning of your immune system — which is your body's first line of defense against infection and disease. 

Most people can make all the vitamin D they need through sunlight on their skin and a balanced diet.

Food such as oily fish, red meat, egg yolks and fortified breakfast cereals are all good sources of vitamin D and become a more important source in winter when there are fewer daylight hours.

But dermatologists say we shouldn't worry about sunscreen impacting our Vitamin D absorption as it doesn't stop you getting your dose.

For lighter skin types daily sunlight exposure for 10-15 minutes between April and September provides sufficient year-round vitamin D while also minimising the risks of sunburn and skin cancer. 

For darker skin types, 25-40 minutes is recommended, according to the British Skin Foundation. 

What is malignant melanoma? 

Malignant melanoma is a serious form of skin cancer that begins in melanocytes, cells found in the upper layer of skin that produce melanin, which gives skin its colour.

While less common that other types of skin cancer, it is more dangerous because of its ability to spread to other organs more rapidly if it is not treated at an early stage.

Symptoms

A new mole or a change in an existing mole may be signs of melanoma.

Melanomas can appear anywhere on your body, but they're more common in areas that are often exposed to the sun.

Some rarer types can affect the eyes, soles of the feet, palms of the hands or genitals.

Check your skin for any unusual changes. Use a mirror or ask a partner or friend to check any areas you cannot see.

In particular, look for: 

  • Moles with an uneven shape or edges 
  • Moles with a mix of colours 
  • Large moles - melanomas often tend to be more than 6mm wide 
  • Moles that change size, shape or colour over time

Causes

Ultraviolet (UV) light is the most common cause of melanoma. It comes from the sun and is used in sunbeds.

Melanoma is more common in older people, but younger people can also get it.

You're also more likely to get melanoma if you have:

  • Pale skin that burns easily in the sun 
  • Red or blonde hair 
  • Blue or green eyes 
  • A large number of freckles or moles 
  • Had a lot of sun exposure and you've had sunburn a lot in the past 
  • Used sunbeds a lot 
  • A history of skin cancer in your family or you've had skin cancer before

If you have black or brown skin, you have a lower chance of getting melanoma, but you can still get it. 

 Prevention

Staying safe in the sun is the best way to lower your chance of getting skin cancer (both melanoma and non-melanoma). 

Do the following:

  • Stay out of the sun during the hottest part of the day (11am to 3pm in the UK)
  • Keep your arms and legs covered and wear a wide-brimmed hat and sunglasses that provide protection against ultraviolet (UV) rays
  • Use sunscreen with a sun protection factor (SPF) of at least 30 and at least 4-star UVA protection – make sure you reapply it regularly
  • Make sure babies and children are protected from the sun – their skin is much more sensitive than adult skin

Treatment 

Melanoma skin cancer can often be treated. The treatment you have will depend on where it is, if it has spread and your general health.

Surgery is the main treatment for melanoma. Radiotherapy, medicines and chemotherapy are also sometimes used.

Surgery could involve removing the melanoma and an area of healthy skin around it, swollen lymph nodes if the cancer has spread to them and other parts of the body if it has spread to them.

If a large part of skin has to be removed, a skin graft might be needed which could see kin taken from another part of the body to cover the area where the melanoma was.

Radiotherpay is sometimes used to reduce the size of large melanomas and help control and relieve symptoms.

Targeted medicines and immotherapy are used to treat melanomas that can't be dealt with by surgery, or have spread to lymph glands or other parts of the body.

Chemotherapy, which kills cancer cells, is sometimes used to treat advanced melanoma when it has spread to another part of the body. It does not work as well as other treatments, but can be used if you are unable to have them.

How dangerous is it?

Generally for people with melanoma in England:

  • almost all people (almost 100%) will survive their melanoma for 1 year or more after they are diagnosed
  • around 90 out of every 100 people (around 90%) will survive their melanoma for 5 years or more after diagnosis
  • more than 85 out of every 100 people (more than 85%) will survive their melanoma for 10 years or more after they are diagnosed

Sources: NHS, the Skin Cancer Foundation and Cancer Research UK