Background: Non-melanoma skin cancer (NMSC) is the most frequent cancer in fair-skinned populations and represents a growing public health concern due to its impact in terms of morbidity and treatment costs. While some meta-analyses have investigated cigarette smoking as a risk factor for NMSC, less is known about its prognostic implications in patients with NMSC. This systematic review and meta-analysis aims to fill this gap by assessing the association between smoking habits and survival in patients with NMSC. Methods: A systematic search was conducted in PubMed and EMBASE up to 25 February 2025, to identify prospective studies of patients with histologically confirmed NMSC that evaluated the association between smoking habits and survival. Study-specific hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were pooled using random effects meta-analysis models. Results: A total of five studies published between 2015 and 2022 were included. The meta-analysis revealed that being a current or ever smoker at diagnosis was associated with a worse overall survival (summary HR 2.42, 95% CI 1.91–3.06). A similar result was observed when smoking exposure was assessed in terms of pack-years or number of cigarettes per day (summary HR 2.44, 95% CI 2.02–2.93). Conclusions: Our findings indicate that cigarette smoking is a negative prognostic factor in these patients, despite the generally excellent prognosis of NMSC. It is reasonable to assume that this unfavourable effect is largely due to the increased risk of developing other life-threatening conditions, in which smoking plays a causal role. These results underscore the clinical relevance of systematically integrating smoking cessation counselling into the routine management of patients with NMSC.
背景：非黑色素瘤皮肤癌（NMSC）是浅肤色人群中最常见的癌症，因其发病率和治疗成本的影响，已成为日益严重的公共卫生问题。尽管已有荟萃分析探讨吸烟作为NMSC的风险因素，但关于其对NMSC患者预后的影响尚不明确。本系统综述与荟萃分析旨在通过评估吸烟习惯与NMSC患者生存率之间的关联来填补这一空白。方法：系统检索截至2025年2月25日的PubMed和EMBASE数据库，纳入经组织学确诊的NMSC患者的前瞻性研究，这些研究评估了吸烟习惯与生存率的关系。采用随机效应荟萃分析模型汇总各研究的风险比（HR）及相应95%置信区间（CI）。结果：共纳入2015年至2022年间发表的五项研究。荟萃分析显示，确诊时为当前或曾经吸烟者与较差的总体生存率相关（汇总HR 2.42，95% CI 1.91–3.06）。按包年或每日吸烟量评估吸烟暴露时，也观察到类似结果（汇总HR 2.44，95% CI 2.02–2.93）。结论：尽管NMSC总体预后良好，但本研究表明吸烟是这类患者的不良预后因素。这种不利影响很大程度上可归因于吸烟导致的其他致命性疾病风险增加。这些结果强调了将戒烟咨询系统纳入NMSC患者常规管理的临床重要性。
肿瘤(癌症)患者之家