Environmental exposures such as smoking and low vitamin D are predictive of poor outcome in cutaneous melanoma rather than other deprivation measures

Abstract Lack of basic resources within a society (deprivation) is associated with increased cancer mortality and this relationship has been described for melanoma. We have previously reported the association of smoking and low vitamin D levels with melanoma death. In this study we further explored the associations of these with melanoma, in addition to deprivation and socio-economic stressors. In this analysis of 2183 population-ascertained primary cutaneous melanoma patients; clinical, demographic and socio-economic variables were assessed as predictors of tumour thickness, melanoma death and overall death. Using the Townsend deprivation score, the most deprived group did not have thicker tumors compared to the least deprived. Of the WHO 25x25 risk factors for premature death, smoking and BMI were independently associated with thicker tumors. Low vitamin D was also independently associated with thicker tumors. No socio-economic stressors were independent predictors of thickness. Smoking was confirmed as a key predictor of melanoma death and overall death as were low vitamin D levels, independent of other measures of deprivation. Neither BMI nor Townsend deprivation score were predictive in either survival analysis. We report evidence for the role of smoking, vitamin D and BMI in melanoma progression independent of a postcode derived measure of deprivation.