Abstract
Frank Caldwell Garland, Ph.D., died August 17, 2010 after a year-long battle with cancer. He will be remembered for his seminal work with his brother Cedric F. Garland in proposing the ultraviolet-B (UVB)-vitamin D-cancer hypothesis to explain the geographical variation of colon cancer mortality rates in the United States in 1980. This hypothesis has been extended to about 20 types of cancer using the ecological approach, and supported strongly by observational studies of prediagnostic serum 25-hydroxyvitamin D [25(OH) D] for incidence of breast, colorectal and ovarian cancer, and a randomized controlled trial that used sufficient vitamin D (1,150 IU/day) to and found a strongly beneficial effect on cancer incidence. The UVB-vitamin D-cancer hypothesis is also supported by studies that used as the index of solar UVB irradiance the amount of sunlight exposure in childhood or incidence of non-melanoma skin cancer. Survival after diagnosis was increased for individuals with higher serum 25(OH)D levels at the time of cancer diagnosis for six types of cancer: breast, colorectal, lung and prostate cancer; melanoma and non-Hodgkin's lymphoma. The ecological study approach is ideally suited to studying cancer risk-modifying factors since the lag between cancer initiation and detection or death can be 20-40 years or more, making ordinary observational studies difficult. The impact on vitamin D research by both Frank Garland and Cedric Garland has been immense. Health policy leaders will realize this in the near future, providing a rich legacy for humanity.