Cutaneous melanoma (CM) is the deadliest skin cancer, and vitamin D insufficiency has been suggested as a risk factor. We evaluated the relationship between both vitamin D insufficiency and 25-hydroxy vitamin D levels with the incidence and stage of CM. Five databases were searched from inception until 11 July 2022. Inclusion criteria were cohort and case-control studies that reported mean 25-hydroxy vitamin D levels or the presence of vitamin D insufficiency in CM patients and compared with healthy controls; or those that reported vitamin D insufficiency and Breslow tumor depth or the development of metastasis in CM. Fourteen studies were included in the analysis. Statistically significant relationships were found between vitamin D level <20 ng/dl and incidence of CM [pooled RR 1.45, 95% confidence interval (CI) 1.04–2.02]; lower mean vitamin D level and Breslow depth >1 mm (SMD 0.19, 95% CI 0.11–0.28); and vitamin D level >20 ng/dl and Breslow depth <1 mm (pooled RR 0.69, 95% CI 0.58–0.82). Statistical significance was not found in the relationships between vitamin D levels and the presence of metastasis (pooled SMD −0.13, 95% CI, −0.38 to 0.12); or mean vitamin D level and the incidence of CM (pooled SMD −0.39, 95% CI, −0.80 to 0.01). We identified an association of increased incidence of CM and vitamin D insufficiency, as well as less favorable Breslow tumor depth with lower levels of vitamin D and the presence of vitamin D insufficiency.

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Screening for reducing morbidity and mortality in malignant melanomaTo the Editor: Melanoma incidence has increased over the last 4 decades, with an especially dramatic rise in the diagnosis of melanoma in situ, which has increased 50 times since 1975 (0.5 to 25 per 100,000 people). 1,2 There is debate regarding whether this represents a true epidemic or is secondary to increased screening and lower biopsy thresholds. 2 Currently, the US Preventive Service Task Force does not recommend skin cancer screenings for the general population; however, this recommendation does not apply to high-risk groups. 1 A 2019 Cochrane review, ''Screening for Reducing Morbidity and Mortality in Malignant Melanoma,'' examined clinical trials to determine if there is sufficient evidence to recommend melanoma screening in the general population. 3 Given the existing controversy surrounding melanoma screening, this review 3 aimed to establish evidence pertaining to melanoma screening. Only 2 studies met the inclusion criteria of a randomized control trial (RCT) of melanoma screening versus no screening within a population not suspected of having melanoma. The first was an RCT of melanoma screening through self-examination conducted in the United States. 4 The second was an Australian pilot study for a cluster RCT of community-based melanoma screening programs; the larger, planned follow-up