The association of smoking and socioeconomic status on cutaneous melanoma: a population-based, data-linkage, case-control study.
17 September 2019
Gibson JAG, Dobbs TD, Griffiths R, Song J, Akbari A, Whitaker S, Watkins A, Langan SM, Hutchings HA, Lyons RA, Whitaker IS.
British Journal of Dermatology, (2019) pg 1-12
Previous studies have identified an inverse association between melanoma and smoking; however, data from population‐based studies are scarce.
To determine the association between smoking and socioeconomic (SES) on the risk of development of melanoma. Furthermore, we sought to determine the implications of smoking and SES on survival.
We conducted a population‐based case–control study. Cases were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU) during 2000–2015 and controls from the general population. Smoking and SES were obtained from data linkage with other national databases. The association of smoking status and SES on the incidence of melanoma were assessed using binary logistic regression. Multivariate survival analysis was performed on a melanoma cohort using a Cox proportional hazard model using survival as the outcome.
During 2000–2015, 9636 patients developed melanoma. Smoking data were obtained for 7124 (73·9%) of these patients. There were 26 408 controls identified from the general population. Smoking was inversely associated with melanoma incidence [odds ratio (OR) 0·70, 95% confidence interval (CI) 0·65–0·76]. Smoking was associated with an increased overall mortality [hazard ratio (HR) 1·30, 95% CI 1·09–1·55], but not associated with melanoma‐specific mortality. Patients with higher SES had an increased association with melanoma incidence (OR 1·58, 95% CI 1·44–1·73). Higher SES was associated with an increased chance of both overall (HR 0·67, 95% CI 0·56–0·81) and disease‐specific survival (HR 0·69, 95% CI 0·53–0·90).
Our study has demonstrated that smoking appeared to be associated with reduced incidence of melanoma. Although smoking increases overall mortality, no association was observed with melanoma‐specific mortality. Further work is required to determine if there is a biological mechanism underlying this relationship or an alternative explanation, such as survival bias.
Professor of Clinical Epidemiology at London School of Hygiene and Tropical Medicine (LSHTM)
Professor Sinead Langan is a Wellcome Senior Clinical Fellow and Professor of Clinical Epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM). Sinead is an Associate Director...
Health Data Research UK (HDR UK) London
Director Professor Harry Hemingway, Professor of Clinical Epidemiology, University College London Associate Directors Professor Carol Dezateux, Professor of Clinical Epidemiology and Health...
Association of troponin level and age with mortality in 250 000 patients: cohort study across five UK acute care centres
21 November 2019
Kaura A, Panoulas V, Glampson B, Davies J, Mulla A, Woods K, Omigie J, Shah AD, Channon KM, Weber JN, Thursz MR, Elliott P, Hemingway H, Williams B, Asselbergs F, O’Sullivan M, Kharbanda R, Lord...