Nonsteroidal anti-inflammatory drugs and the risk of skin cancer: a population-based case-control study.
BACKGROUND
Nonsteroidal anti-inflammatory drugs (NSAIDs) may prevent the development of cancer by inhibiting cyclooxygenase (COX) enzymes, which are involved in carcinogenesis. Therefore, the authors of this report examined the association between NSAID use and the risk of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM).


METHODS
From 1991 through 2009, all incident cases of SCC (n = 1974), BCC (n = 13,316), and MM (n = 3242) in northern Denmark were identified. Approximately 10 population controls (n = 178,655) were matched to each case by age, gender, and county of residence. The use of aspirin, other nonselective NSAIDs, or selective COX-2 inhibitors was ascertained through a prescription database. Conditional logistic regression analyses adjusted for potential confounders were used to compute odds ratios as estimates of incidence rate ratios (IRRs).


RESULTS
For NSAIDs overall, ever use (>2 prescriptions) compared with nonuse (≤2 prescriptions) was associated with a decreased risk of SCC (IRR, 0.85; 95% confidence interval [CI], 0.76-0.94) and MM (IRR, 0.87; 95% CI, 0.80-0.95), especially for long-term use (≥7 years) and high-intensity use (>25% prescription coverage during the total duration of use). NSAID use was not associated with a reduced risk of BCC overall (IRR, 0.97; 95% CI, 0.93-1.01), but the risk of BCC at sites other than the head and neck was reduced in association with long-term use (IRR, 0.85; 95% CI, 0.76-0.95) and high-intensity use (IRR, 0.79; 95% CI, 0.69-0.91). All estimates of reduced risk were driven primarily by the use of nonselective NSAIDs and older COX-2 inhibitors (diclofenac, etodolac, and meloxicam).


CONCLUSIONS
The current results indicated that NSAID use may decrease the risk of SCC and MM.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. saj@dce.au.dk
Sigrun Alba
SA
Johannesdottir
Ellen T
ET
Chang
Frank
F
Mehnert
Morten
M
Schmidt
Anne Braae
AB
Olesen
Henrik Toft
HT
Sørensen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000494:pharmacology; D016588:Anticarcinogenic Agents / Q000008:administration & dosage*; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000517:prevention & control; D016022:Case-Control Studies; D015897:Comorbidity; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D003718:Denmark / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000517:prevention & control; D008875:Middle Aged; D016017:Odds Ratio; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016588:Anticarcinogenic Agents; D016861:Cyclooxygenase Inhibitors