Smoking and risk of skin cancer: a prospective analysis and a meta-analysis.
BACKGROUND
The association between smoking and the risk of skin cancer has not been well established.


METHODS
In two large cohorts in the USA, we prospectively examined the risks of melanoma, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) among participants grouped according to smoking variables.


RESULTS
Among men, compared with never smokers, ever smokers had a significantly lower risk of melanoma [relative risk (RR) = 0.72; 95% confidence interval (CI): 0.58-0.86]; those who smoked for ≥30 years had an RR of 0.65 (95% CI: 0.48-0.89) (P(trend) = 0.003); those who smoked ≥15 cigarettes per day had an RR of 0.32 (95% CI: 0.13-0.78) (P(trend) = 0.006) and those who smoked for > 45 pack years had an RR of 0.66 (95% CI: 0.45-0.97) (P(trend) = 0.03). Ever smokers also had a slightly lower risk of BCC (RR = 0.94; 95% CI: 0.90-0.98). There was no significant association for SCC (RR = 0.99; 95% CI: 0.89-1.12). In women, no significant association was found for melanoma (RR = 0.96; 95% CI: 0.83-1.10). Compared with never smokers, ever smokers had a slightly higher risk of BCC (RR = 1.06; 95% CI: 1.03-1.08) and a higher risk of SCC (RR = 1.19; 95% CI: 1.08-1.31). A significant inverse association between smoking and melanoma was limited to the head and neck (RR = 0.65; 95% CI: 0.42-0.89).


CONCLUSIONS
Smoking was inversely associated with melanoma risk, especially on the head and neck. Further studies are warranted to investigate the underlying mechanism(s).
Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Fengju
F
Song
Abrar A
AA
Qureshi
Xiang
X
Gao
Tricia
T
Li
Jiali
J
Han
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*; D014481:United States