title: Aspirin is associated with lower melanoma risk among postmenopausal Caucasian women: the Women's Health Initiative.
abstract: BACKGROUND
  Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with decreased risk of gastric, colorectal, and breast cancer. However, the impact of NSAIDs on the risk of melanoma has been inconsistent. The authors evaluated the association between NSAID use and cutaneous melanoma risk in the Women's Health Initiative (WHI) Observational Study (OS).
  
  
  METHODS
  At study entry, use of aspirin (acetylsalicylic acid [ASA]) and nonaspirin NSAIDs was assessed among 59,806 postmenopausal Caucasian women ages 50 to 79 years. Cox proportional hazards models were constructed after adjusting for participant skin type, sun exposure history, and medical indications for NSAID use among other confounders.
  
  
  RESULTS
  During a median follow-up of 12 years, 548 incident melanomas were confirmed by medical review. Women who used ASA had a 21% lower risk of melanoma (hazard ratio, 0.79; 95% confidence interval, 0.63-0.98) relative to nonusers. Increased duration of ASA use (<1 year, 1-4 years, and ≥ 5 years) was associated with an 11% lower risk of melanoma for each categorical increase (Ptrend = .01), and women with ≥ 5 years of use had a 30% lower melanoma risk (hazard ratio, 0.70; 95% confidence interval, 0.55-0.94). In contrast, use of non-ASA NSAIDs and acetaminophen were not associated with melanoma risk.
  
  
  CONCLUSIONS
  Postmenopausal women who used ASA had a significantly lower risk of melanoma, and longer duration of ASA use was associated with greater protection. Although this study was limited by the observational design and self-report of NSAID use, the findings suggest that ASA may have a chemopreventive effect against the development of melanoma and warrant further clinical investigation.
authors.affiliation: Stanford University School of Medicine and Cancer Institute, Stanford, California, USA.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Gamba
authors.forename: Susan M
authors.initials: SM
authors.lastname: Swetter
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.forename: Jessica
authors.initials: J
authors.lastname: Kubo
authors.forename: Manisha
authors.initials: M
authors.lastname: Desai
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Spaunhurst
authors.forename: Animesh A
authors.initials: AA
authors.lastname: Sinha
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Asgari
authors.forename: Susan
authors.initials: S
authors.lastname: Sturgeon
authors.forename: Jean Y
authors.initials: JY
authors.lastname: Tang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin