Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Smoking, a Dangerous Habit for the Skin: Comment on “Smoking and the Risk of Nonmelanoma Skin Cancer”

Smoking, a Dangerous Habit for the Skin: Comment on “Smoking and the Risk of Nonmelanoma Skin... The incidence of cutaneous malignant neoplasms, including BCCs and SCCs, is constantly rising globally. These keratinocytic cancers are the most common cancers in the white population.1 Knowing this, it is no surprise that dermatologists, surgeons, and general practitioners will encounter an increasing number of patients with these tumors. Keratinocytic cancers result from complex interactions between environmental exposure (eg, lifestyle factors), phenotypic characteristics, and genetic predisposition. This systematic review and meta-analysis by Leonardi-Bee et al2 has taken a closer look at smoking as a potential risk factor for BCC and SCC. The most important conclusion is confirmation of an independent association between smoking and the increased likelihood of SCC development by more than 50% (OR, 1.52; 95% CI, 1.15-2.01). This finding was based on pooled data of 6 relatively small studies, of which only 1 had a prospective cohort design. The generalizabilty of the findings is likely to be moderate because the heterogeneity was quite high (I2 = 64%). Nevertheless, how do these findings translate to clinical practice? The observed increase in SCC risk due to smoking is of the same magnitude as UV radiation exposure, the most well-known risk factor. Most of us will (re)inform patients with skin cancer about the hazardous effects of excessive UV radiation exposure and stimulate a sensible attitude toward sun exposure, but how many of us ask about their prior or current smoking habit and urge smokers to quit this habit? This gap exists because we may not be aware of it, minimize the dermatologic impact of smoking compared with other conditions, and try to avoid the discussion quagmire of smoking cessation with patients. Nonetheless, we should inform our patients about the cutaneous adverse events of smoking, use existing resources, and collaborate with smoking cessation programs as an element of good patient care. We believe all this can be done in a busy dermatology clinic. In contrast to several risk factors of SCC, including prior UV radiation exposure, smoking is a modifiable factor. Thus, active risk reduction by smoking cessation is possible, especially since the meta-analysis suggests that current smokers are at the highest SCC risk. Furthermore, physicians could make use of the current cancer experience in motivating patients to discontinue smoking, which has many additional important health benefits. Another part of the solution is to educate colleagues on how to find the right smoking cessation resources and inform them of this risk factor. Back to top Article Information Correspondence: Dr Nijsten, Department of Dermatology, Erasmus Medical Center, Burg. s’Jacobplein 51, Room Gk-016, 3000 CA Rotterdam, Zuid-Holland, the Netherlands (t.nijsten@erasmusmc.nl). Published Online: June 18, 2012. doi:10.1001/archdermatol.2012.1666 Financial Disclosure: None reported. References 1. Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. Lancet. 2010;375(9715):673-68520171403PubMedGoogle ScholarCrossref 2. Leonardi-Bee J, Ellison T, Bath-Hextall F. Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis [published online June 18, 2012]. Arch Dermatol. 2012;148(8):dev120001939-946Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Smoking, a Dangerous Habit for the Skin: Comment on “Smoking and the Risk of Nonmelanoma Skin Cancer”

Smoking, a Dangerous Habit for the Skin: Comment on “Smoking and the Risk of Nonmelanoma Skin Cancer”

Abstract

The incidence of cutaneous malignant neoplasms, including BCCs and SCCs, is constantly rising globally. These keratinocytic cancers are the most common cancers in the white population.1 Knowing this, it is no surprise that dermatologists, surgeons, and general practitioners will encounter an increasing number of patients with these tumors. Keratinocytic cancers result from complex interactions between environmental exposure (eg, lifestyle factors), phenotypic characteristics, and genetic...
Loading next page...
 
/lp/american-medical-association/smoking-a-dangerous-habit-for-the-skin-comment-on-smoking-and-the-risk-vvzhG6raEE
Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archdermatol.2012.1666
Publisher site
See Article on Publisher Site

Abstract

The incidence of cutaneous malignant neoplasms, including BCCs and SCCs, is constantly rising globally. These keratinocytic cancers are the most common cancers in the white population.1 Knowing this, it is no surprise that dermatologists, surgeons, and general practitioners will encounter an increasing number of patients with these tumors. Keratinocytic cancers result from complex interactions between environmental exposure (eg, lifestyle factors), phenotypic characteristics, and genetic predisposition. This systematic review and meta-analysis by Leonardi-Bee et al2 has taken a closer look at smoking as a potential risk factor for BCC and SCC. The most important conclusion is confirmation of an independent association between smoking and the increased likelihood of SCC development by more than 50% (OR, 1.52; 95% CI, 1.15-2.01). This finding was based on pooled data of 6 relatively small studies, of which only 1 had a prospective cohort design. The generalizabilty of the findings is likely to be moderate because the heterogeneity was quite high (I2 = 64%). Nevertheless, how do these findings translate to clinical practice? The observed increase in SCC risk due to smoking is of the same magnitude as UV radiation exposure, the most well-known risk factor. Most of us will (re)inform patients with skin cancer about the hazardous effects of excessive UV radiation exposure and stimulate a sensible attitude toward sun exposure, but how many of us ask about their prior or current smoking habit and urge smokers to quit this habit? This gap exists because we may not be aware of it, minimize the dermatologic impact of smoking compared with other conditions, and try to avoid the discussion quagmire of smoking cessation with patients. Nonetheless, we should inform our patients about the cutaneous adverse events of smoking, use existing resources, and collaborate with smoking cessation programs as an element of good patient care. We believe all this can be done in a busy dermatology clinic. In contrast to several risk factors of SCC, including prior UV radiation exposure, smoking is a modifiable factor. Thus, active risk reduction by smoking cessation is possible, especially since the meta-analysis suggests that current smokers are at the highest SCC risk. Furthermore, physicians could make use of the current cancer experience in motivating patients to discontinue smoking, which has many additional important health benefits. Another part of the solution is to educate colleagues on how to find the right smoking cessation resources and inform them of this risk factor. Back to top Article Information Correspondence: Dr Nijsten, Department of Dermatology, Erasmus Medical Center, Burg. s’Jacobplein 51, Room Gk-016, 3000 CA Rotterdam, Zuid-Holland, the Netherlands (t.nijsten@erasmusmc.nl). Published Online: June 18, 2012. doi:10.1001/archdermatol.2012.1666 Financial Disclosure: None reported. References 1. Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. Lancet. 2010;375(9715):673-68520171403PubMedGoogle ScholarCrossref 2. Leonardi-Bee J, Ellison T, Bath-Hextall F. Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis [published online June 18, 2012]. Arch Dermatol. 2012;148(8):dev120001939-946Google ScholarCrossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 2012

Keywords: smoking,habits,skin,skin carcinoma

References