Background There is a strong correlation between cigarette smoking and the development of many cancer types. It is therefore paradoxical that multiple reports have suggested a reduced incidence of melanoma in smokers. This study aimed to analyze all existing studies of melanoma incidence in smokers relative to non-smokers. Methods Searches of MEDLINE and Embase were conducted for studies reporting data on melanoma in smokers and never-smokers. No study design limitations or language restrictions were applied. The outcome examined was the association between smoking status and melanoma. Analyses focussed on risk of melanoma in smokers and never-smokers generated from multivariable analyses and these were pooled using a fixed effects model. Risk of bias was assessed using the Newcastle-Ottawa tool. Findings Forty-nine studies that included 59,429 melanoma patients were identified. Pooled analyses showed that current-smokers had a significantly-reduced risk of melanoma both in males (risk ratio (RR) 0.60, 95%CI_0.56 to0.65, p < .001) and females (RR 0.79- 95%-CI-0.73-to-0.86, p < .001). Male former-smokers had a 16% reduction in melanoma risk compared to never-smokers (RR-0.84,-95%CI-0.77-to-0.93, p < .001), but no risk reduction was observed in female former-smokers (RR-1.0-95%CI-0.92-to-1.08). Interpretation Current-smokers have a significantly-reduced risk of developing melanoma compared to never-smokers, with a reduction in melanoma risk of 40% in men and 21% in women.

中文翻译：

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吸烟对黑色素瘤发病率的影响：系统评价与荟萃分析


背景 吸烟与许多癌症类型的发生有很强的相关性。因此，多项报告表明吸烟者黑色素瘤的发病率降低，这是自相矛盾的。本研究旨在分析所有现有的关于吸烟者相对于非吸烟者黑色素瘤发病率的研究。方法 对 MEDLINE 和 Embase 进行检索，以查找报告吸烟者和从不吸烟者黑色素瘤数据的研究。没有应用研究设计限制或语言限制。检查的结果是吸烟状况与黑色素瘤之间的关联。分析的重点是通过多变量分析得出的吸烟者和从不吸烟者的黑色素瘤风险，并使用固定效应模型对这些风险进行汇总。使用纽卡斯尔-渥太华工具评估偏倚风险。结果 确定了 49 项研究，纳入了 59,429 名黑色素瘤患者。汇总分析显示，当前吸烟者的黑色素瘤风险显着降低，男性（风险比 (RR) 0.60，95%CI_0.56 至 0.65，p < .001）和女性（RR 0.79-95%-CI） -0.73 至 0.86，p < .001）。与从不吸烟者相比，男性前吸烟者患黑色素瘤的风险降低了 16%（RR-0.84，-95%CI-0.77-to-0.93，p < .001），但在女性前吸烟者中没有观察到风险降低（RR-1.0-95%CI-0.92-1.08）。解释 与从不吸烟者相比，目前吸烟者患黑色素瘤的风险显着降低，男性患黑色素瘤的风险降低了 40%，女性患黑色素瘤的风险降低了 21%。