It has been demonstrated in several studies that serum calcidiol (25 OH vitamin D(3)) concentration is in a reversed and linear relationship with cancer risk. However, there are also studies showing no such association and some even suggest the opposite. The risk of pancreatic and oesophageal cancer seems to increase, when serum calcidiol concentration increases. A bias in these studies might be that their basic assumption is linear dependence of cancer on serum calcidiol concentration. Some studies suggest a U-shaped association between the disease and the serum calcidiol concentration. Evidence, in the literature, of the relationship between serum calcidiol concentration and disease is reviewed and an optimal level of 40-80 nmol/L (16-32 ng/ml) is suggested. Serum calcidiol seems to be a better predictor of cancer development than calcitriol (1α, 25 (OH)(2) vitamin D(3)). A calcidiol insufficiency, as well as an insufficient solar exposure, is associated with an increased risk of several solid carcinomas. In a recent study, our group demonstrated that calcidiol is an active hormone in CYP24 (24-hydroxylase) deficient cells. In these cells, calcidiol and calcitriol act synergistically, therefore fluctuations of the serum calcidiol concentration may define the hormonal activity and cancer development.Serum calcidiol concentration and the risk of many common diseases and aging phenomena seem to show a U-shaped association suggesting a lower and upper limit for healthy serum calcidiol concentration. An imbalance of hormonal calcidiol rather than that of calcitriol is a risk factor in carcinomas and chronic diseases, which might be prevented by an optimal serum calcidiol concentration. Multiple daily dosing of cholecalcipherol or skin patches could best provide an optimal dosing and stable serum concentration. Alternatively, narrow-band UV-B lamps are a possible optimal solution, when given by trained personnel.