Department of Epidemiology Research, American Cancer Society, Atlanta, GA, USA.
Cancer Causes Control. 2011 Jun;22(6):937-42. doi: 10.1007/s10552-011-9766-z. Epub 2011 May 5.
Previous studies suggest that smoking may be inversely associated with risk of melanoma. We attempted to replicate this finding using data from the Cancer Prevention Study II (CPS-II) and CPS-II Nutrition cohort, two large prospective cohort studies of cancer mortality and incidence, respectively, with long-term follow-up.
Cox proportional hazards regression analysis was used to examine the association between smoking status and risk of melanoma mortality and incidence among Caucasians in these cohorts. Analyses were adjusted by age, occupation, latitude and educational status.
The incidence rate of melanoma was lower in current than never smokers in both men [hazard ratio (HR): 0.70, 95% confidence interval (CI): (0.48-1.02)] and women [0.50 (0.30-0.83)]; incidence was not lower in former than in never smokers for either sex. The death rate from melanoma was lower in male current than never smokers [0.77 (0.62-0.94)], and in male and female former smokers [0.86 (0.73-1.01)] and [0.83 (0.65-1.06)], respectively. No trends in incidence or mortality were observed in male or female current smokers with years of smoking or cigarettes per day.
This study provides limited support for the hypothesis that smoking reduces melanoma risk. The inconsistent results by smoking status and lack of clear dose-response relationships weaken the evidence for causality.
先前的研究表明，吸烟可能与黑色素瘤风险呈负相关。我们试图使用癌症预防研究 II（CPS-II）和 CPS-II 营养队列的数据来复制这一发现，这两个队列分别是关于癌症死亡率和发病率的大型前瞻性队列研究，具有长期随访。
Cox 比例风险回归分析用于检查这两个队列中白种人吸烟状况与黑色素瘤死亡率和发病率之间的关系。分析通过年龄、职业、纬度和教育程度进行调整。
在男性[风险比（HR）：0.70，95%置信区间（CI）：（0.48-1.02）]和女性[0.50（0.30-0.83）]中，当前吸烟者的黑色素瘤发病率低于从不吸烟者；而在男性和女性中，前吸烟者的发病率并不低于从不吸烟者。男性当前吸烟者的黑色素瘤死亡率低于从不吸烟者[0.77（0.62-0.94）]，男性和女性前吸烟者的死亡率也分别低于从不吸烟者[0.86（0.73-1.01）]和[0.83（0.65-1.06）]。在男性或女性当前吸烟者中，吸烟年限或每天吸烟支数与发病率或死亡率均无趋势。
这项研究对吸烟降低黑色素瘤风险的假设提供了有限的支持。吸烟状况的不一致结果和缺乏明确的剂量-反应关系削弱了因果关系的证据。
