title: Can oral nonsteroidal antiinflammatory drugs play a role in the prevention of basal cell carcinoma? A systematic review and metaanalysis.
abstract: BACKGROUND
  Evidence for an association between aspirin or other nonsteroidal antiinflammatory drug (NSAID) use and basal cell carcinoma (BCC) has been inconsistent.
  
  
  OBJECTIVE
  We conducted a systematic review and metaanalysis to assess the effect of oral NSAIDs on BCC.
  
  
  METHODS
  PubMed, Web of Science, and Embase databases were searched up to December 3, 2014. A random effects model metaanalysis was used to calculate summary estimates of the effects of aspirin, nonaspirin NSAIDs, or any (aspirin or nonaspirin) NSAID use in patients with BCC.
  
  
  RESULTS
  The summary estimates from 11 studies (1 randomized controlled trial, 5 cohort studies, and 5 case control studies) found a 10% risk reduction of BCC among those using any NSAID (relative risk [RR], 0.90 [95% confidence interval {CI}, 0.84-0.97]). A similar but not statistically significant inverse association was observed for nonaspirin NSAIDs (RR, 0.93 [95% CI, 0.86-1.02]), while aspirin use was more weakly associated (RR, 0.95 [95% CI, 0.91-1.00]). The strongest inverse associations were noted among those with either a history of skin cancers or a high prevalence of actinic keratoses.
  
  
  CONCLUSIONS
  Dose-effect estimates could not be calculated because the available data were too heterogeneous to pool.
  
  
  CONCLUSIONS
  The intake of NSAIDs may help prevent BCC, particularly in high-risk populations. A large randomized controlled trial is required to confirm these findings.
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia. Electronic address: chiho.muranushi@uqconnect.edu.au.
authors.forename: Chiho
authors.initials: C
authors.lastname: Muranushi
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, Australia; CRUK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pandeya
mesh_terms: D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D002280:Basal Cell Carcinoma / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011322:Primary Prevention / Q000379:methods; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: NSAIDs; aspirin; basal cell carcinoma; metaanalysis; skin cancer; systematic review