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A new study links smoking with a type of skin cancer called squamous cell carcinoma in women. The more a woman smokes, the greater her risk of developing the cancer, HealthDay reports. Women with squamous cell carcinoma were almost four times more likely than women without the cancer to have smoked for 20 or more years, according to a news release from Moffitt Cancer Center in Tampa, Florida, where the study was conducted.

Smoking did not appear to significantly increase men’s risk of skin cancer. Lead author Dana Rollison said she did not know why they found a gender difference in smoking risk. It is possible that the female hormone estrogen may affect the breakdown of nicotine in the body, and the body’s ability to repair damage to lung DNA that is caused by smoking, she noted.

The study included 383 patients with skin cancer and 315 people without the disease. They were asked how much they smoked, when they started, and how many years in total they smoked. The authors pointed out that while the study found a link between smoking and skin cancer risk, it did not prove smoking causes skin cancer.

The study appears in the journal Cancer Causes & Control.

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