成年人中非黑色素瘤皮肤癌和黑色素瘤、皮肤外癌症与吸烟的关联：一项基于美国人群的研究。

Associations of non-melanoma skin cancer and melanoma, extra-cutaneous cancers and smoking in adults: a US population-based study.

机构信息

Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University, Chicago, IL, USA.

Department of Dermatology, Mount Sinai Beth Israel Medical Center, New York, NY, USA.

出版信息

J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1389-97. doi: 10.1111/jdv.12883. Epub 2014 Dec 10.

DOI:10.1111/jdv.12883

PMID:25491569

Abstract

BACKGROUND

Non-melanoma skin cancer (NMSC) and melanoma are common malignancies in the US and may be associated with other types of cancer.

OBJECTIVES

We sought to determine whether NMSC and melanoma are associated with extra-cutaneous cancers and identify modifiable risk factors for such an association.

METHODS

We analysed data from 447,801 adult participants in the 1997-2011 National Health Interview Surveys. Survey logistic regression models were constructed that accounted for the complex sample weights. History of NMSC, melanoma and 27 primary extra-cutaneous cancers was assessed.

RESULTS

NMSC was associated with increased odds of one (multinomial survey logistic regression, unadjusted odds ratio [95% CI]: 2.43 [2.20-2.68]) or multiple (2.94 [2.21-3.92]) extra-cutaneous malignancies. Melanoma was also associated with increased odds of one (3.25 [2.70-3.90]) or multiple (6.11 [4.34-8.61]) extra-cutaneous malignancies. Extra-cutaneous cancers were more common in younger patients (ages 18-39 and 40-49 years) and Caucasians with NMSC or melanoma (P < 0.0001). Smokers with a history of NMSC or melanoma had even higher odds of extra-cutaneous malignancy at ages 18-39 and 40-49 years compared to smokers without NMSC or melanoma (P < 0.0001). History of NMSC was associated with higher odds of malignancies of the bladder, brain, breast, colon, oesophagus, kidney, lung, lymphoma, melanoma, prostate, soft tissue, throat/pharynx, thyroid and uterus. Melanoma was associated with malignancies of the bladder, breast, colon, kidney, lung, pancreas, prostate, soft tissue, throat/pharynx, thyroid and uterus. The prevalence of extra-cutaneous cancers increased between 1997 and 2011 in all subjects (4.51% and 5.73%, P < 0.0001), with even higher rates of increase in those with history of NMSC or melanoma.

CONCLUSIONS

Patients with history of NMSC and melanoma have increased odds of developing extra-cutaneous cancers, especially those with younger age and smoking history.

摘要

背景

非黑素瘤皮肤癌（NMSC）和黑色素瘤是美国常见的恶性肿瘤，可能与其他类型的癌症有关。

目的

我们旨在确定 NMSC 和黑色素瘤是否与皮肤外癌症有关，并确定这种关联的可改变的危险因素。

方法

我们分析了 1997-2011 年全国健康访谈调查中 447801 名成年参与者的数据。构建了考虑复杂样本权重的调查逻辑回归模型。评估了 NMSC、黑色素瘤和 27 种原发性皮肤外癌症的病史。

结果

NMSC 与一种（多项调查逻辑回归，未调整的优势比[95%置信区间]：2.43[2.20-2.68]）或多种（2.94[2.21-3.92]）皮肤外恶性肿瘤的发生几率增加有关。黑色素瘤也与一种（3.25[2.70-3.90]）或多种（6.11[4.34-8.61]）皮肤外恶性肿瘤的发生几率增加有关。在 NMSC 或黑色素瘤患者中，年轻患者（18-39 岁和 40-49 岁）和白种人更容易发生皮肤外癌症（P < 0.0001）。与没有 NMSC 或黑色素瘤的吸烟者相比，有 NMSC 或黑色素瘤病史的吸烟者在 18-39 岁和 40-49 岁时，发生皮肤外恶性肿瘤的几率更高（P < 0.0001）。NMSC 病史与膀胱癌、脑癌、乳腺癌、结肠癌、食道癌、肾癌、肺癌、淋巴瘤、黑色素瘤、前列腺癌、软组织癌、喉/咽癌、甲状腺癌和子宫癌的发生几率增加有关。黑色素瘤与膀胱癌、乳腺癌、结肠癌、肾癌、肺癌、胰腺癌、前列腺癌、软组织癌、喉/咽癌、甲状腺癌和子宫癌的发生几率增加有关。在所有受试者中，1997 年至 2011 年期间，皮肤外癌症的患病率增加（分别为 4.51%和 5.73%，P < 0.0001），而有 NMSC 或黑色素瘤病史的患者的增加率更高。