Smoking and Cutaneous Melanoma: Findings from the QSkin Sun and Health Cohort Study

Abstract

Previous studies suggest that smokers have lower risks of cutaneous melanoma than nonsmokers, but data from population-based prospective studies are scarce. We investigated associations between smoking and melanoma in a cohort study purpose-designed to investigate skin cancer outcomes. Participants with no prior history of melanoma ( = 38,697) completed a risk factor survey at baseline (2011). Patients were followed through linkage to the cancer registry. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between smoking (including intensity, duration, time since quitting) and melanoma using multivariate Cox proportional hazards regression, accounting for death as a competing event. During a mean follow-up of 3.5 years, invasive melanomas developed in 247 participants. Compared with never smokers, former smokers (but not current smokers) had lower risks of invasive melanoma (HR 0.76; 95% CI, 0.57-1.01). Among former smokers, risks were lower with greater quantity of cigarettes smoked (HR 0.75; 95% CI, 0.56-0.98 per 10 cigarettes/day). No association was observed with duration of smoking while longer time since quitting was associated with a relative risk of melanoma that was not significantly different from the null (HR 1.18; 95% CI, 0.91-1.51, for every 10 years since quitting). We observed complex associations between smoking and melanoma, with some suggestion that former smokers had lower risks than never or current smokers. The apparent inverse association among former smokers may be due to residual confounding, although surveillance bias or biological effects cannot be excluded entirely. Smoking does not increase the risk of cutaneous melanoma. .

The association of smoking and socioeconomic status on cutaneous melanoma: a population‐based, data‐linkage, case–control study

“…A recent, prospective cohort study has further explored the association. After adjusting for potential confounding factors, no association was observed between current smoking and melanoma [odds ratio (OR) 1·01, 95% confidence interval (CI) 0·64–1·61] . Although the study addressed the aforementioned limitations by adjusting for confounding factors, the study was significantly underpowered; only a small proportion of the cohort developed melanoma and the average follow‐up duration was short (3·5 years).…”

Daily Lifestyle and Cutaneous Malignancies

“…Although smoking is negatively associated with melanoma incidence [ 80 , 81 , 82 ], smoking is not associated with melanoma-specific mortality [ 82 ] or sentinel lymph node metastasis [ 83 ]. On the contrary, another study also identified that current smoking is associated with sentinel lymph node metastasis and tumor ulceration [ 84 ].…”

MicroRNA-21-Enriched Exosomes as Epigenetic Regulators in Melanomagenesis and Melanoma Progression: The Impact of Western Lifestyle Factors

“…Smoking has recently been identified in some studies as a predictor of poor MM outcome [ 282 , 283 ], whereas other studies found no or even inverse relations between smoking and MM incidence [ 284 , 285 , 286 ]. In contrast to these conflicting epidemiological studies, molecular evidence appears to be more consistent.…”