BACKGROUND: This study examines whether insufficient ultraviolet B (UVB) irradiance, a marker of vitamin D inadequacy, might contribute to lung cancer incidence. METHODS: The association of latitude and UVB irradiance with age-adjusted incidence rates of lung cancer in 111 countries was investigated. Independent associations with UVB irradiance, cloud cover, anthropogenic aerosols, and cigarette smoking, were assessed using multiple regression. RESULTS: Latitude was positively related to incidence rates in men (R(2) Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.55, p<0.01) and women (R(2) Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.36, p<0.01). In men, cigarette consumption (p<0.001) was positively related to risk, whereas UVB irradiance was inversely associated (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.003). There were positive associations with UVB absorbers, in particular cloud cover (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.05) and aerosol optical depth (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.005). The R(2) for the model was 0.78 (p<0.001). UVB irradiance was also inversely associated with incidence rates in women (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.0002), whereas cigarette consumption (p<0.001), total cloud cover (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.02) and aerosol optical depth (p Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 0.005) were positively associated. The R(2) for the model was 0.77 (p<0.001). CONCLUSIONS: Lower levels of UVB irradiance were independently associated with higher incidence rates of lung cancer in 111 countries.