Cigarette Smoking and the Risks of Basal Cell Carcinoma and Squamous Cell Carcinoma
Open accessAbstract
Sunlight is the principal environmental risk factor for keratinocyte cancers, but other carcinogens have also been implicated, including tobacco smoke. Findings have been conflicting, however. We investigated associations between cigarette smoking and incidence of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in QSkin, a prospective study of skin cancer (N = 43,794). Smoking history was self-reported at baseline; newly diagnosed BCCs and SCCs were ascertained through data linkage and verified by histopathology reports. We restricted analyses to white participants who at baseline reported no past history of skin cancer excisions and no more than five destructively treated actinic skin lesions. We fitted Cox proportional hazards models, adjusted for known confounders. Compared with never smokers, current smokers had significantly lower risks of BCC (hazard ratio = 0.6; 95% confidence interval = 0.4-0.9) but significantly higher risks of SCC (hazard ratio = 2.3; 95% confidence interval = 1.5-3.6). Former smokers had similar risks for BCC and SCC as never smokers. Among smokers, we observed no dose-response trends with duration of smoking, intensity, or time since quitting. On further analysis, current smokers had fewer skin examinations and procedures than never smokers, suggesting greater opportunities for detection among never smokers. Strengths include large sample size, prospective design, and virtually complete follow-up; however, histologic details were missing for a proportion of excised tumors. In conclusion, current smokers had a lower incidence of BCC (possibly because of detection bias) but higher rates of SCC.
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In recent prospective studies on skin cancer, current smoking was associated with SCC, but an inverse association was found for basal cell carcinoma (BCC) or melanoma.
“In recent prospective studies on skin cancer, current smoking was associated with SCC,60 but an inverse association was found for basal cell carcinoma (BCC)60 or melanoma.61”
From The impact of airborne pollution on skin (2019) · cites this paper as [60]
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- Authors
- Dusingize, J. C., Olsen, C. M., Pandeya, N. P., Subramaniam, P., Thompson, B. S., Neale, R. E., Green, A. C., & Whiteman, D. C.
- Affiliations
- The University of Queensland (AU)
- QIMR Berghofer Medical Research Institute (AU)
- Queensland University of Technology (AU)
- Corresponding author
- Whiteman, David C.
- ORCID
- Venue
- Journal of Investigative Dermatology
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 137
- Issue
- 8
- Pages
- 1700-1708
- ISSN
- 0022-202X (ISSN-L)
- OpenAlex
- W2605432373
- Cited by
- 75
- References
- 28
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 13 · 2021: 7 · 2020: 11 · 2019: 10 · 2018: 8 · 2017: 4
- FWCI
- 7.07
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Investigative Dermatology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Funders
- QIMR Berghofer Medical Research Institute
- Medical Research Council
- National Health and Medical Research Council (552429)
- Topics
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Keywords
- cigarette smoking, basal cell carcinoma, squamous cell carcinoma, skin cancer incidence, non-melanoma skin cancer, tobacco smoke, detection bias, skin assessment
- MeSH terms
- Adult, Aged, Basal Cell Carcinoma, Carcinoma, Squamous Cell, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Queensland, Risk Factors, Skin Neoplasms, Smoking, Sunlight, Time Factors, Keratinocytes, Incidence, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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