Cervical cancer starts on the surface of the cervix. This is the lower part of the uterus (womb), which opens at the top of the vagina.
Cervical cancer affects 12,700 women in the United States annually and kills 4,300.
There are two major risk factors for cervical cancer:
- Human papilloma virus (HPV)
- Smoking, especially in combination with HPV. Smoking weakens the tight junctions of surface cells and allows HPV to invade. Smoking also lowers vitamin D blood levels.
Women who eat more fruit, vegetables, and fiber have a lower risk of developing cervical cancer.
Sunlight exposure and cervical cancer risk
Several studies show a connection between lack of sunlight exposure and cervical cancer risk.
One U.S. study and two studies in China came to the same conclusion – they found a reduced risk of cervical cancer incidence and/or mortality rate due to UVB exposure. In Germany, lower cervical cancer rates and higher skin cancer rates were noted in the highest winegrowing region compared to the region with the least winegrowing region.
Vitamin D and cervical cancer
Vitamin D levels
In Japan, researchers found a lower rate of invasive cervical cancer and higher vitamin D intake in nonsmokers. This was not true for smokers, however. Smoking reduces the amount of vitamin D in the blood.
How vitamin D works
Vitamin D has been shown to block the growth of cancer tumors. Vitamin D is processed by the liver. The body then produces calcitriol, an active form of vitamin D. Calcitriol provides numerous benefits against cancer. This form of vitamin D encourages cells to either adapt to their organ or commit apoptosis (cell suicide). Calcitriol also limits blood supply to the tumor and reduces the spread of cancer. In addition, calcitriol helps keep the surface layer of organs intact. This reduces the likelihood that cancer cells can invade the organ.
Based on the studies reviewed here, it appears that vitamin D may reduce the risk of cervical cancer. The effects are better for nonsmokers than smokers. Smokers would likely have to have higher vitamin D intake or production to receive the same benefits as nonsmokers.
Based on results for other cancers, vitamin D levels in the 40–60 ng/mL (100–150 nmol/L) range may provide reasonable protection.
There might be a role for vitamin D in treating cervical cancer. But more research is needed. Based on studies of other cancers, women with cervical cancer might have a better prognosis when using vitamin D.
This evidence summary was written by:
William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA 94164-1603, USA
Complete bibliography of research used in this summary
The research we have cited in our summary is listed below, with links to PubMed abstracts and full-text for those who wish to explore further.
- Brot, C. Jorgensen, N. R. Sorensen, O. H. The influence of smoking on vitamin D status and calcium metabolism. Eur J Clin Nutr. 1999 Dec; 53 (12): 920-6.
- Chen, P. Hu, P. Xie, D. Qin, Y. Wang, F. Wang, H. Meta-analysis of vitamin D, calcium and the prevention of breast cancer. Breast Cancer Res Treat. 2010 Jun; 121 (2): 469-77.
- Friedrich, M. Rafi, L. Mitschele, T. Tilgen, W. Schmidt, W. Reichrath, J. Analysis of the vitamin D system in cervical carcinomas, breast cancer and ovarian cancer. Recent Results Cancer Res. 2003; 164239-46.
- Garland, C. F. Gorham, E. D. Mohr, S. B. Garland, F. C. Vitamin D for cancer prevention: global perspective. Ann Epidemiol. 2009 Jul; 19 (7): 468-83.
- Grant, W. B. Does solar ultraviolet irradiation affect cancer mortality rates in China?. Asian Pac J Cancer Prev. 2007 Apr-Jun; 8 (2): 236-42.
- Grant, W. B. A meta-analysis of second cancers after a diagnosis of nonmelanoma skin cancer: additional evidence that solar ultraviolet-B irradiance reduces the risk of internal cancers. J Steroid Biochem Mol Biol. 2007 Mar; 103 (3-5): 668-74.
- Grant, W. B. Benefits of vitamin D in reducing the risk of cancer: Time to include vitamin D in cancer treatment?. J Soc Integr Oncol. 2010 Summer; 8 (3): 81-8.
- Grant, W. B. Relation between prediagnostic serum 25-hydroxyvitamin D level and incidence of breast, colorectal, and other cancers. J Photochem Photobiol B. 2010 May 12;
- Grant, W. B. Cancer risk ecological study in Rhineland-Palatinate, Germany, provides strong support for the ultraviolet B-vitamin D-cancer hypothesis. J Occup Med Toxicol. 2010 19 July 2010; 19 July 2010
- Grant, W. B. Garland, C. F. The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res. 2006 Jul-Aug; 26 (4A): 2687-99.
- Hosono, S. Matsuo, K. Kajiyama, H. Hirose, K. Suzuki, T. Kawase, T. Kidokoro, K. Nakanishi, T. Hamajima, N. Kikkawa, F. Tajima, K. Tanaka, H. Association between dietary calcium and vitamin D intake and cervical carcinogenesis among Japanese women. Eur J Clin Nutr. 2010 Apr; 64 (4): 400-9.
- Hrushesky, W. J. Sothern, R. B. Rietveld, W. J. Du Quiton, J. Boon, M. E. Season, sun, sex, and cervical cancer. Cancer Epidemiol Biomarkers Prev. 2005 Aug; 14 (8): 1940-7.
- Hrushesky, W. J. Sothern, R. B. Rietveld, W. J. Du-Quiton, J. Boon, M. E. Sun exposure, sexual behavior and uterine cervical human papilloma virus. Int J Biometeorol. 2006 Jan; 50 (3): 167-73.
- Ingraham, B. A. Bragdon, B. Nohe, A. Molecular basis of the potential of vitamin D to prevent cancer. Curr Med Res Opin. 2008 Jan; 24 (1): 139-49.
- Lappe, J. M. Travers-Gustafson, D. Davies, K. M. Recker, R. R. Heaney, R. P. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun; 85 (6): 1586-91.
- Oplander, C. Volkmar, C. M. Paunel-Gorgulu, A. van Faassen, E. E. Heiss, C. Kelm, M. Halmer, D. Murtz, M. Pallua, N. Suschek, C. V. Whole body UVA irradiation lowers systemic blood pressure by release of nitric oxide from intracutaneous photolabile nitric oxide derivates. Circ Res. 2009 Nov 6; 105 (10): 1031-40.
- Reinhold, U. Schmitz, B. Kurbacher, C. Nagel, W. Schmidt, M. Malaisse, W. J. Circulating 25-hydroxyvitamin D concentration in German cancer patients. Oncology reports. 2008 Dec; 20 (6): 1539-43.
- Seidler, A. Hammer, G. P. Husmann, G. Konig, J. Krtschil, A. Schmidtmann, I. Blettner, M. Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study. J Occup Med Toxicol. 2008; 312.
- Shaykhiev, R. Otaki, F. Bonsu, P. Dang, D. T. Teater, M. Strulovici-Barel, Y. Salit, J. Harvey, B. G. Crystal, R. G. Cigarette smoking reprograms apical junctional complex molecular architecture in the human airway epithelium in vivo. Cell Mol Life Sci. 2010 Sep 6;
- Tsai HT, Tsai YM, Yang SF, Wu KY, Chuang HY, Wu TN, Ho CK, Lin CC, Kuo YS, Wu MT. Lifetime cigarette smoke and second-hand smoke and cervical intraepithelial neoplasm–a community-based case-control study. Gynecol Oncol. 2007 Apr; 105 (1): 181-8.
- Villiotou, V. Deliconstantinos, G. Nitric oxide, peroxynitrite and nitroso-compounds formation by ultraviolet A (UVA) irradiated human squamous cell carcinoma: potential role of nitric oxide in cancer prognosis. Anticancer Res. 1995 May-Jun; 15 (3): 931-42.
- Wei, L. Gravitt, P. E. Song, H. Maldonado, A. M. Ozbun, M. A. Nitric oxide induces early viral transcription coincident with increased DNA damage and mutation rates in human papillomavirus-infected cells. Cancer Res. 2009 Jun 1; 69 (11): 4878-84.