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A prospective study of cigarette smoking and basal cell carcinoma

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Abstract

To investigate the relationship between smoking and primary basal cell carcinoma (BCC), we analyzed data from a 16 year prospective study among randomly selected adults in Nambour, Queensland, Australia. Participants underwent a skin examination in 1992 and took part in an intervention study and follow-up. Information about complexion type and smoking habits including duration and number of cigarettes smoked per day and sun exposure behavior were collected at baseline in 1992, with updates to end of follow-up in 2007. Newly-diagnosed BCCs were ascertained from regional pathology laboratories. Relative risks (RR) of BCC among former and current smokers were estimated using generalized linear models specifying a Poisson distribution with robust error variance and (log) person-years at-risk as offset, adjusting for BCC risk factors. From 1992 to 2007, 281 BCCs were diagnosed in 1,277 participants with available smoking history and no past BCC. Relative to non-smokers, a non-significant inverse association between current smoking and BCC was seen (RR 0.69; 95 % CI 0.45–1.05) but not for former smokers (RR 1.05; 95 % CI 0.84–1.31). Amongst current smokers, inverse associations with BCC were found in those who smoked for up to 18 years (RR 0.44) but not more and those who smoked up to 15 cigarettes per day but not more. The associations with both current and former smoking varied by degree of sunburn propensity. The modest inverse association between current smoking and BCC is considered unlikely to be causal given lack of clear relation with duration or intensity of smoking.

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References

  1. Baron JA (1996) Beneficial effects of nicotine and cigarette smoking: the real, the possible and the spurious. Br Med Bull 52:58–73

    Article  PubMed  CAS  Google Scholar 

  2. Chen JG, Fleischer AB Jr, Smith ED, Kancler C, Goldman ND, Williford PM, Feldman SR (2001) Cost of nonmelanoma skin cancer treatment in the United States. Dermatol Surg 27:1035–1038

    PubMed  CAS  Google Scholar 

  3. Corona R, Dogliotti E, D’Errico M, Sera F, Iavarone I, Baliva G, Chinni LM, Gobello T, Mazzanti C, Puddu P, Pasquini P (2001) Risk factors for basal cell carcinoma in a Mediterranean population: role of recreational sun exposure early in life. Arch Dermatol 137:1162–1168

    PubMed  CAS  Google Scholar 

  4. De Hertog SA, Wensveen CA, Bastiaens MT, Kielich CJ, Berkhout MJ, Westendorp RG, Vermeer BJ, Bouwes Bavinck JN (2001) Relation between smoking and skin cancer. J Clin Oncol 19:231–238

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  6. English DR, Armstrong BK, Kricker A (1998) Reproducibility of reported measurements of sun exposure in a case-control study. Cancer Epidemiol Biomarkers Prev 7:857–863

    PubMed  CAS  Google Scholar 

  7. Ferrucci LM, Cartmel B, Molinaro AM, Leffell DJ, Bale AE, Mayne ST (2014) Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study. Eur J Cancer Prev 23:296–302

    Article  PubMed  CAS  Google Scholar 

  8. Fransen M, Karahalios A, Sharma N, English DR, Giles GG, Sinclair RD (2012) Non-melanoma skin cancer in Australia. Med J Aust 197:565–568

    Article  PubMed  Google Scholar 

  9. Freedman DM, Sigurdson A, Doody MM, Mabuchi K, Linet MS (2003) Risk of basal cell carcinoma in relation to alcohol intake and smoking. Cancer Epidemiol Biomarkers Prev 12:1540–1543

    PubMed  CAS  Google Scholar 

  10. Green A, Battistutta D, Hart V, Leslie D, Marks G, Williams G, Gaffney P, Parsons P, Hirst L, Frost C et al (1994) The Nambour skin cancer and actinic eye disease prevention trial: design and baseline characteristics of participants. Control Clin Trials 15:512–522

    Article  PubMed  CAS  Google Scholar 

  11. Green A, Beardmore G, Hart V, Leslie D, Marks R, Staines D (1988) Skin cancer in a Queensland population. J Am Acad Dermatol 19:1045–1052

    Article  PubMed  CAS  Google Scholar 

  12. Green A, Williams G, Neale R, Hart V, Leslie D, Parsons P, Marks GC, Gaffney P, Battistutta D, Frost C, Lang C, Russell A (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354:723–729

    Article  PubMed  CAS  Google Scholar 

  13. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2012) Radiation: solar and UV radiation. IARC Monogr Eval Carcinog Risks Hum 100(Pt D):35–101

    Google Scholar 

  14. Jensen J, Christiansen C, Rodbro P (1985) Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause. N Engl J Med 313:973–975

    Article  PubMed  CAS  Google Scholar 

  15. Johnson JD, Houchens DP, Kluwe WM, Craig DK, Fisher GL (1990) Effects of mainstream and environmental tobacco smoke on the immune system in animals and humans: a review. Crit Rev Toxicol 20:369–395

    Article  PubMed  CAS  Google Scholar 

  16. Karagas MR, Stukel TA, Greenberg ER, Baron JA, Mott LA, Stern RS (1992) Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prevention Study Group. J Am Med Assoc 267:3305–3310

    Article  CAS  Google Scholar 

  17. Kaskel P, Lange U, Sander S, Huber MA, Utikal J, Leiter U, Krahn G, Meurer M, Kron M (2014) Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden. J Eur Academy Dermatol Venereol JEADV, Germany. doi:10.1111/jdv.12488

    Google Scholar 

  18. Leonardi-Bee J, Ellison T, Bath-Hextall F (2012) Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis. Arch Dermatol 148:939–946

    PubMed  Google Scholar 

  19. Mahid SS, Minor KS, Soto RE, Hornung CA, Galandiuk S (2006) Smoking and inflammatory bowel disease: a meta-analysis. Mayo Clin Proc 81:1462–1471

    Article  PubMed  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 Biomarkers Prev 20:1778–1783

    Article  PubMed  PubMed Central  Google Scholar 

  21. Milan T, Verkasalo PK, Kaprio J, Koskenvuo M (2003) Lifestyle differences in twin pairs discordant for basal cell carcinoma of the skin. Br J Dermatol 149:115–123

    Article  PubMed  CAS  Google Scholar 

  22. Miura K, Hughes MC, Green AC, van der Pols JC (2014) Caffeine intake and risk of basal cell and squamous cell carcinomas of the skin in an 11 year prospective study. Eur J Nutr 53:511–520

    Article  PubMed  CAS  Google Scholar 

  23. Nan H, Xu M, Kraft P, Qureshi AA, Chen C, Guo Q, Hu FB, Curhan G, Amos CI, Wang LE, Lee JE, Wei Q, Hunter DJ, Han J (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  PubMed  CAS  PubMed Central  Google Scholar 

  24. Noyce AJ, Bestwick JP, Silveira-Moriyama L, Hawkes CH, Giovannoni G, Lees AJ, Schrag A (2012) Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol 72:893–901

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Olsen CM, Hughes MC, Pandeya N, Green AC (2006) Anthropometric measures in relation to basal cell carcinoma: a longitudinal study. BMC Cancer 6:82

    Article  PubMed  PubMed Central  Google Scholar 

  26. Pfeiffer RM, Park Y, Kreimer AR, Lacey JV Jr, Pee D, Greenlee RT, Buys SS, Hollenbeck A, Rosner B, Gail MH, Hartge P (2013) Risk prediction for breast, endometrial, and ovarian cancer in white women aged 50 years or older: derivation and validation from population-based cohort studies. PLoS Med 10:e1001492

    Article  PubMed  PubMed Central  Google Scholar 

  27. Pirie K, R Peto, Reeves GK, Green J, Beral V, Million Women Study C (2013) The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet 381:133–141

    Article  PubMed  PubMed Central  Google Scholar 

  28. Richmond-Sinclair NM, Pandeya N, Ware RS, Neale RE, Williams GM, van der Pols JC, Green AC (2009) Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution: longitudinal study of an Australian population. J Invest Dermatol 129:323–328

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  30. Souza RJ, Mattedi AP, Correa MP, Rezende ML, Ferreira AC (2011) An estimate of the cost of treating non-melanoma skin cancer in the state of Sao Paulo, Brazil. Anais brasileiros de dermatologia 86:657–662

    Article  PubMed  Google Scholar 

  31. Stacey SN, Gudbjartsson DF, Sulem P, Bergthorsson JT, Kumar R, Thorleifsson G, Sigurdsson A, Jakobsdottir M, Sigurgeirsson B, Benediktsdottir KR, Thorisdottir K, Ragnarsson R, Scherer D, Rudnai P, Gurzau E, Koppova K, Hoiom V, Botella-Estrada R, Soriano V, Juberias P, Grasa M, Carapeto FJ, Tabuenca P, Gilaberte Y, Gudmundsson J, Thorlacius S, Helgason A, Thorlacius T, Jonasdottir A, Blondal T, Gudjonsson SA, Jonsson GF, Saemundsdottir J, Kristjansson K, Bjornsdottir G, Sveinsdottir SG, Mouy M, Geller F, Nagore E, Mayordomo JI, Hansson J, Rafnar T, Kong A, Olafsson JH, Thorsteinsdottir U, Stefansson K (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  PubMed  CAS  Google Scholar 

  32. Zou G (2004) A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 159:702–706

    Article  PubMed  Google Scholar 

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Acknowledgments

MCB Hughes, CM Olsen were supported by the National Health and Medical Research Council of Australia (NHMRC) Program Grant (No. 552429). AC Green was supported in part by a fellowship from the Medical Research Council (grant number 89912).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Brisbane, QLD, 4006, Australia

    M. C. B. Hughes, C. M. Olsen & A. C. Green

  2. School of Population Health, The University of Queensland, Herston Road, Herston, QLD, 4006, Australia

    G. M. Williams

  3. Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK

    A. C. Green

Authors
  1. M. C. B. Hughes
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  2. C. M. Olsen
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  3. G. M. Williams
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  4. A. C. Green
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Correspondence to M. C. B. Hughes.

Additional information

M. C. B. Hughes, C. M. Olsen contributed equally to this manuscript and recognized as equal first authors.

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Hughes, M.C.B., Olsen, C.M., Williams, G.M. et al. A prospective study of cigarette smoking and basal cell carcinoma. Arch Dermatol Res 306, 851–856 (2014). https://doi.org/10.1007/s00403-014-1503-5

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  • DOI: https://doi.org/10.1007/s00403-014-1503-5

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