Korean J Dermatol.
2017 Jul;55(6):337-345.
Increased Prevalence of Left-sided Skin Cancer: A Systematic Review and Meta-analysis
- Affiliations
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- 1Department of Dermatology, Soonchunhyang University Hospital, Cheonan, Korea. dermsung@schmc.ac.kr
- 2Department of Dermatology, Soonchunhyang University Hospital, Bucheon, Korea.
- 3Department of Dermatology, Soonchunhyang University Hospital, Seoul, Korea.
- 4Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Hospital, Cheonan, Korea.
- 5Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, Cheonan, Korea.
- 6Institute for Evidence-based Medicine, Cochrane Korea, Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
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.
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