ArticlePloS one2020
Women with fair phenotypes seem to confer a survival advantage in a low UV milieu. A nested matched case control study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- The effects of sunlight exposure on mortality: a systematic review of epidemiological studies.NIHR open research · 2025Pooled it
- Herbal medicine for melanin regulation: biological synthesis, effective formulas/compounds, and biopharmaceutical methods.Journal of natural medicines · 2026Review
- Beneficial health effects of ultraviolet radiation: expert review and conference report.Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology · 2025Review
- Photosensitizing Drugs and Risk of Skin Cancer in Women-A Prospective Population-Based Study.Photodermatology, photoimmunology & photomedicine · 2025Article
- The evolution of human skin pigmentation involved the interactions of genetic, environmental, and cultural variables.Pigment cell & melanoma research · 2021Review
- Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort.Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology · 2021Article
- Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort.Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSun exposure in combination with skin pigmentation is the main determinant for vitamin D status. Human skin color seems to be adapted and optimized for regional sun ultraviolet (UV) intensity. However, we do not know if fair, UV-sensitive skin is a survival advantage in regions with low UV radiation.
methodsA population-based nested case-control study of 29,518 Caucasian women, ages 25 to 64 years from Southern Sweden who responded to a questionnaire regarding risk-factors for malignant melanoma in 1990 and followed for 25 years. For each fair woman, defined as having red hair or freckles (n = 11,993), a control was randomly selected from all non-fair women from within the cohort of similar age, smoking habits, education, marital status, income, and comorbidity, i.e., 11,993 pairs. The main outcome was the difference in all-cause mortality between fair and non-fair women in a low UV milieu, defined as living in Sweden and having low-to-moderate sun exposure habits. Secondary outcomes were mortality by sun exposure, and among those non-overweight.
resultsIn a low UV milieu, fair women were at a significantly lower all-cause mortality risk as compared to non-fair women (log rank test p = 0.04) with an 8% lower all-cause mortality rate (hazard ratio [HR] = 0.92, 95% CI 0.84‒1.0), including a 59% greater risk of dying from skin cancer among fair women (HR 1.59, 95% CI 1.26‒2.0). Thus, it seem that the beneficial health effect from low skin coloration outweigh the risk of skin cancer at high latitudes.
conclusionIn a region with low UV milieu, evolution seems to improve all-cause survival by selecting a fair skin phenotype, i.e., comprising fair women with a survival advantage.
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