Increased Prevalence of Left-sided Skin Cancer: A Systematic Review and Meta-analysis.
- Author:
Jung Eun KIM
1
;
Ga Hee JUNG
;
Jong Suk LEE
;
Young Lip PARK
;
Kyu Uang WHANG
;
Eun Young LEE
;
Jae Gun SUNWOO
;
Hyun Jung KIM
;
Sung Yul LEE
Author Information
1. Department of Dermatology, Soonchunhyang University Hospital, Cheonan, Korea. dermsung@schmc.ac.kr
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Left-side;
Melanoma;
Meta-analysis;
Skin neoplasm
- MeSH:
Bias (Epidemiology);
Carcinoma, Basal Cell;
Carcinoma, Squamous Cell;
Humans;
Melanoma;
Methods;
Population Characteristics;
Prevalence*;
Skin Neoplasms*;
Skin*;
United States
- From:Korean Journal of Dermatology
2017;55(6):337-345
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.