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. 2013 Nov 4;8(11):e78820.
doi: 10.1371/journal.pone.0078820. eCollection 2013.

Sunny holidays before and after melanoma diagnosis are respectively associated with lower Breslow thickness and lower relapse rates in Italy

Sara Gandini  1 , Esther De Vries, Giulio Tosti, Edoardo Botteri, Giuseppe Spadola, Patrick Maisonneuve, Chiara Martinoli, Arjen Joosse, Pier Francesco Ferrucci, Federica Baldini, Emilia Cocorocchio, Elisabetta Pennacchioli, Francesco Cataldo, Barbara Bazolli, Alessandra Clerici, Massimo Barberis, Veronique Bataille, Alessandro Testori
Affiliations

Sunny holidays before and after melanoma diagnosis are respectively associated with lower Breslow thickness and lower relapse rates in Italy

Sara Gandini et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(7):e101732

Abstract

Background: Previous studies have reported an association between sun exposure and improved cutaneous melanoma (CM) survival. We analysed the association of UV exposure with prognostic factors and outcome in a large melanoma cohort.

Methods: A questionnaire was given to 289 (42%) CM patients at diagnosis (Group 1) and to 402 CM patients (58%) during follow-up (Group 2). Analyses were carried out to investigate the associations between sun exposure and melanoma prognostic factors and survival.

Results: Holidays in the sun two years before CM diagnosis were significantly associated with lower Breslow thickness (p=0.003), after multiple adjustment. Number of weeks of sunny holidays was also significantly and inversely associated with thickness in a dose-dependent manner (p=0.007). However when stratifying by gender this association was found only among women (p=0.0004) the risk of CM recurrence in both sexes was significantly lower in patients (n=271) who had holidays in the sun after diagnosis, after multiple adjustment including education: HR=0.30 (95%CI:0.10-0.87; p=0.03) conclusions: Holidays in the sun were associated with thinner melanomas in women and reduced rates of relapse in both sexes. However, these results do not prove a direct causal effect of sun exposure on survival since other confounding factors, such as vitamin D serum levels and socio-economic status, may play a role. Other factors in sun seeking individuals may also possibly affect these results.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study design.
Figure 2
Figure 2. Group 1, at diagnosis.
A) Percentages of each Breslow category by sunny holidays. B) Percentages of very thick CM (Breslow>4mm) by weeks of sunny holidays.
Figure 3
Figure 3. Group 1, at diagnosis.
A) Breslow thickness by UV exposure indicators. B) Breslow thickness by duration of sunny holidays. C) Breslow thickness by gender and sunny holidays.
Figure 4
Figure 4. Group 1, at diagnosis: cumulative incidence for melanoma recurrence by sunny holidays (A).
Group 2, during follow-up: cumulative incidence for melanoma recurrence by sunny holidays.
See this image and copyright information in PMC

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Grants and funding

The authors thank the “Fondazione Grazia Focacci“ for the financial support. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.