Skip to main content

Advertisement

SpringerLink
Log in

The association between smoking and risk of skin cancer: a meta-analysis of cohort studies

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

The association between smoking and the risk of skin cancers has been studied without reaching consistent findings. This study aims to assess this association through an updated meta-analysis of cohort studies.

Methods

We retrieved cohort studies that investigated the temporal association between smoking and the risk of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). Pooled relative risks (RRs) and confidence intervals (CIs) of the included articles were calculated for current, former, and heavy smoking compared with never smoking. Publication bias was detected using the Egger’s regression.

Results

A total of 15 studies, published between 1990 and 2018, were included. Current smoking was associated with a higher risk of SCC (pooled RR = 1.32, 95% CI 1.15, 1.52) but with a lower risk of BCC (pooled RR = 0.85, 95% CI 0.75, 0.96) and MM (pooled RR = 0.72, 95% CI 0.64, 0.82). No publication bias was detected, and no single study had a substantial impact on the pooled results. Similar results were detected for heavy smoking, while former smoking was not associated with the risk of skin cancer.

Conclusion

Current smoking and heavy smoking were associated with a higher risk of SCC but a decreased risk of BCC and MM, while former smoking was not associated with skin cancer risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Perera E, Gnaneswaran N, Staines C et al (2015) Incidence and prevalence of non-melanoma skin cancer in Australia: a systematic review. Aust J Dermatol 56:258–267

    Article  Google Scholar 

  2. Whiteman DC, Green AC, Olsen CM (2016) The growing burden of invasive melanoma: projections of incidence rates and numbers of new cases in six susceptible populations through 2031. J Invest Dermatol 136:1161–1171

    Article  CAS  Google Scholar 

  3. Apalla Z, Nashan D, Weller R et al (2017) Skin cancer: epidemiology, disease burden, pathophysiology, diagnosis, and therapeutic approaches. Dermatol Ther 7:5–19

    Article  Google Scholar 

  4. Etzkorn JR, Parikh RP, Marzban SS et al (2013) Identifying risk factors using a skin cancer screening program. Cancer Control 20:248–254

    Article  Google Scholar 

  5. Jacob L, Freyn M, Kalder M et al (2018) Impact of tobacco smoking on the risk of developing 25 different cancers in the UK: a retrospective study of 422,010 patients followed for up to 30 years. Oncotarget 9:17420–17429

    Article  Google Scholar 

  6. Song F, Qureshi AA, Gao X et al (2012) Smoking and risk of skin cancer: a prospective analysis and a meta-analysis. Int J Epidemiol 41:1694–1705

    Article  Google Scholar 

  7. Pirie K, Beral V, Heath AK et al (2018) Heterogeneous relationships of squamous and basal cell carcinomas of the skin with smoking: the UK Million Women Study and meta-analysis of prospective studies. Br J Cancer 119:114–120

    Article  Google Scholar 

  8. Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  CAS  Google Scholar 

  9. Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ Clin Res Ed 339:b2535

    Article  Google Scholar 

  10. Higgins JP, Thompson SG, Deeks JJ et al (2003) Measuring inconsistency in meta-analyses. BMJ Clin Res Ed 327:557–560

    Article  Google Scholar 

  11. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  CAS  Google Scholar 

  12. Egger M, Davey Smith G, Schneider M et al (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ Clin Res Ed 315:629–634

    Article  CAS  Google Scholar 

  13. Hunter DJ, Colditz GA, Stampfer MJ et al (1990) Risk factors for basal cell carcinoma in a prospective cohort of women. Ann Epidemiol 1:13–23

    Article  CAS  Google Scholar 

  14. Karagas MR, Stukel TA, Greenberg ER et al (1992) Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prev Study Group JAMA 267:3305–3310

    CAS  Google Scholar 

  15. Veierod MB, Thelle DS, Laake P (1997) Diet and risk of cutaneous malignant melanoma: a prospective study of 50,757 Norwegian men and women. Int J Cancer 71:600–604

    Article  CAS  Google Scholar 

  16. Freedman DM, Sigurdson A, Doody MM et al (2003) Risk of melanoma in relation to smoking, alcohol intake, and other factors in a large occupational cohort. Cancer Causes Control 4:847–857

    Article  Google Scholar 

  17. Odenbro A, Bellocco R, Boffetta P et al (2005) Tobacco smoking, snuff dipping and the risk of cutaneous squamous cell carcinoma: a nationwide cohort study in Sweden. Br J Cancer 92:1326–1328

    Article  CAS  Google Scholar 

  18. Odenbro A, Gillgren P, Bellocco R et al (2007) The risk for cutaneous malignant melanoma, melanoma in situ and intraocular malignant melanoma in relation to tobacco use and body mass index. Br J Dermatol 156:99–105

    Article  CAS  Google Scholar 

  19. DeLancey JO, Hannan LM, Gapstur SM et al (2011) Cigarette smoking and the risk of incident and fatal melanoma in a large prospective cohort study. Cancer Causes Control 22:937–942

    Article  Google Scholar 

  20. McBride P, Olsen CM, Green AC (2011) Tobacco smoking and cutaneous squamous cell carcinoma: a 16-year longitudinal population-based study. Cancer Epidemiol Biomark Prev 20:1778–1783

    Article  Google Scholar 

  21. Blakely T, Barendregt JJ, Foster RH et al (2013) The association of active smoking with multiple cancers: national census-cancer registry cohorts with quantitative bias analysis. Cancer Causes Control 24:1243–1255

    Article  Google Scholar 

  22. Hughes MC, Olsen CM, Williams GM et al (2014) A prospective study of cigarette smoking and basal cell carcinoma. Arch Dermatol Res 306:851–856

    Article  CAS  Google Scholar 

  23. Henderson MT, Kubo JT, Desai M et al (2015) Smoking behavior and association of melanoma and nonmelanoma skin cancer in the Women's Health Initiative. J Am Acad Dermatol 72:190–191

    Article  Google Scholar 

  24. Dusingize JC, Olsen CM, Pandeya NP et al (2017) Cigarette smoking and the risks of basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 137:1700–1708

    Article  CAS  Google Scholar 

  25. Dusingize JC, Olsen CM, Pandeya N et al (2018) Smoking and cutaneous melanoma: findings from the QSkin Sun and Health Cohort Study. Cancer Epidemiol Biomark Prev 27:874–881

    Article  Google Scholar 

  26. De Hertog SA, Wensveen CA, Bastiaens MT et al (2001) Relation between smoking and skin cancer. J Clin Oncol 19:231–238

    Article  Google Scholar 

  27. D'Errico M, Calcagnile A, Iavarone I et al (1999) Factors that influence the DNA repair capacity of normal and skin cancer-affected individuals. Cancer Epidemiol Biomark Prev 8:553–559

    CAS  Google Scholar 

  28. Rees JR, Stukel TA, Perry AE et al (2007) Tea consumption and basal cell and squamous cell skin cancer: results of a case-control study. J Am Acad Dermatol 56:781–785

    Article  Google Scholar 

  29. Kessides MC, Wheless L, Hoffman-Bolton J et al (2011) Cigarette smoking and malignant melanoma: a case-control study. J Am Acad Dermatol 64:84–90

    Article  Google Scholar 

  30. Shors AR, Solomon C, McTiernan A et al (2001) Melanoma risk in relation to height, weight, and exercise (United States). Cancer Causes Control 12:599–606

    Article  CAS  Google Scholar 

  31. Nan H, Xu M, Kraft P et al (2011) Genome-wide association study identifies novel alleles associated with risk of cutaneous basal cell carcinoma and squamous cell carcinoma. Hum Mol Genet 20:3718–3724

    Article  CAS  Google Scholar 

  32. Stacey SN, Gudbjartsson DF, Sulem P et al (2008) Common variants on 1p36 and 1q42 are associated with cutaneous basal cell carcinoma but not with melanoma or pigmentation traits. Nat Genet 40:1313–1318

    Article  CAS  Google Scholar 

  33. Sopori M (2002) Effects of cigarette smoke on the immune system. Nat Rev Immunol 2:372–377

    Article  CAS  Google Scholar 

  34. Yerger VB, Malone RE (2006) Melanin and nicotine: a review of the literature. Nicotine Tob Res 8:487–498

    Article  CAS  Google Scholar 

  35. Grant WB (2008) Skin aging from ultraviolet irradiance and smoking reduces risk of melanoma: epidemiological evidence. Anticancer Res 28:4003–4008

    PubMed  Google Scholar 

  36. Thompson CA, Zhang ZF, Arah OA (2013) Competing risk bias to explain the inverse relationship between smoking and malignant melanoma. Eur J Epidemiol 28:557–567

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871, Japan

    Ahmed Arafa & Jia-Yi Dong

  2. Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Ahmed Arafa

  3. Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Alshimaa Mostafa

  4. Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Alshimaa Mostafa

  5. Department of Dermatology, University Hospital Basel, Basel, Switzerland

    Alexander A. Navarini

Authors
  1. Ahmed Arafa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alshimaa Mostafa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander A. Navarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jia-Yi Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed Arafa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arafa, A., Mostafa, A., Navarini, A.A. et al. The association between smoking and risk of skin cancer: a meta-analysis of cohort studies. Cancer Causes Control 31, 787–794 (2020). https://doi.org/10.1007/s10552-020-01319-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-020-01319-8

Keywords

Search

Navigation