Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis.
OBJECTIVE
To perform a systematic review and meta-analysis to collate evidence of the effects of smoking on the risk of nonmelanoma skin cancer.


METHODS
We searched 4 electronic databases (from inception to October 2010) and scanned the reference lists of the publications retrieved to identify eligible comparative epidemiologic studies.


METHODS
Titles, abstracts, and full text were assessed independently by 2 authors against prespecified inclusion/exclusion criteria.


METHODS
Data were extracted and quality was assessed independently by 2 authors using the Newcastle-Ottawa Scale.


RESULTS
Meta-analysis was performed using random-effects models. Results are presented as odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using I2. Twenty-five studies were included. Smoking was significantly associated with cutaneous squamous cell carcinoma (OR, 1.52; 95% CI, 1.15-2.01; I2 = 64%; 6 studies). Smoking was not significantly associated with basal cell carcinoma (OR, 0.95; 95% CI, 0.82-1.09; I2 = 59%; 14 studies) or nonmelanoma skin cancer (OR, 0.62; 95% CI, 0.21-1.79; I2 = 34%; 2 studies).


CONCLUSIONS
This study clearly demonstrates that smoking increases the risk of cutaneous squamous cell carcinoma; however, smoking does not appear to modify the risk of basal cell carcinoma.
Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies, Nottingham, Englan. jo.leonardi-bee@nottingham.ac.uk
Jo
J
Leonardi-Bee
Thomas
T
Ellison
Fiona
F
Bath-Hextall
D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016001:Confidence Intervals; D006801:Humans; D016017:Odds Ratio; D012878:Skin Neoplasms / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*