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Nonsteroidal anti-inflammatory drugs and the risk of skin cancer†
A population-based case-control study
Article first published online: 29 MAY 2012
Copyright © 2011 American Cancer Society
Volume 118, Issue 19, pages 4768–4776, 1 October 2012
How to Cite
Johannesdottir, S. A., Chang, E. T., Mehnert, F., Schmidt, M., Olesen, A. B. and Sørensen, H. T. (2012), Nonsteroidal anti-inflammatory drugs and the risk of skin cancer. Cancer, 118: 4768–4776. doi: 10.1002/cncr.27406
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- Issue published online: 19 SEP 2012
- Article first published online: 29 MAY 2012
- Manuscript Accepted: 13 DEC 2011
- Manuscript Revised: 7 DEC 2011
- Manuscript Received: 7 OCT 2011
- case-control study;
- nonsteroidal anti-inflammatory drugs;
- skin neoplasm
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).
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).
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).
The current results indicated that NSAID use may decrease the risk of SCC and MM. Cancer 2012. © 2012 American Cancer Society.