title: Environmental risk factors for relapse of melanoma.
abstract: OBJECTIVE
  To identify lifestyle factors affecting risk of relapse.
  
  
  METHODS
  A comparison of 131 relapsed melanoma patients with 147 non-relapsers.
  
  
  RESULTS
  Relapsers were more likely to report financial hardship using a number of different measures including access to holidays and feeling financially insecure (odds ratio (OR) 5.7, 95% confidence interval (CI) (1.5, 21.4)). Relapsers worked longer hours (mean 37h per week compared with 31, p=0.02). There was no reported difference in stress associated with recent life events. There was no effect of housing quality, employment factors or body mass index (BMI) on risk of relapse. There was a protective effect of antibiotics in the peri-operative period.
  
  
  CONCLUSIONS
  The study provides preliminary evidence for adverse effects of chronic financial hardship, but not recent stressful events on cancer relapse. As these data were collected in a retrospective case-control study subject to recall bias, the data must now be explored in a prospective study.
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Cancer Research UK Clinical Centre at Leeds, St James's University Hospital, Leeds, United Kingdom.
authors.forename: Samantha
authors.initials: S
authors.lastname: Beswick
authors.forename: Paul
authors.initials: P
authors.lastname: Affleck
authors.forename: Faye
authors.initials: F
authors.lastname: Elliott
authors.forename: Edwina
authors.initials: E
authors.lastname: Gerry
authors.forename: Andy
authors.initials: A
authors.lastname: Boon
authors.forename: Linda
authors.initials: L
authors.lastname: Bale
authors.forename: Clarissa
authors.initials: C
authors.lastname: Nolan
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Barrett
authors.forename: Chandra
authors.initials: C
authors.lastname: Bertram
authors.forename: Jerry
authors.initials: J
authors.lastname: Marsden
authors.forename: D Timothy
authors.initials: DT
authors.lastname: Bishop
authors.forename: Julia A
authors.initials: JA
authors.lastname: Newton-Bishop
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000502:physiology; D008297:Male; D008545:Melanoma / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D016019:Survival Analysis