Nonsteroidal anti‐inflammatory drugs and the risk of nonmelanoma skin cancer. Issue 1 (3rd December 2014)

• Record Type: Journal Article
• Authors: Reinau, Daphne; Surber, Christian; Jick, Susan S.; Meier, Christoph R.
• Is Part Of: International journal of cancer. Volume 137:Issue 1(2015:Jul. 01)
• Page Start: 144
• Page End: 153
• Publication Date: 2014-12-03
• Subjects: nonsteroidal anti‐inflammatory drugs -- nonmelanoma skin cancer -- basal cell carcinoma -- squamous cell carcinoma -- case‐control analysis; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.29357
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Nonsteroidal anti‐inflammatory drugs (NSAIDs) have been assigned a promising role in the chemoprevention of various malignancies. However, epidemiological data on the association between NSAID use and nonmelanoma skin cancer (NMSC) are limited. To explore whether patients regularly exposed to systemic NSAIDs are at a reduced risk of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), we conducted a population‐based case‐control analysis using the Clinical Practice Research Datalink, a United Kingdom primary care database. We identified 65, 398 patients with incident BCC and 7, 864 patients with incident SCC diagnosed between 1995 and 2013 and matched 1 and 4 NMSC‐free controls to each BCC and SCC case, respectively, on age, sex, general practice, calendar time and years of history in the database. We compared prior NSAID exposure between cases and controls using multivariate conditional logistic regression analyses controlling for several potential confounders. Overall, we found no association between NSAID use and BCC, but when looking exclusively at users of single NSAID substances there was a suggestion of a reduced BCC risk in regular users of aspirin and ibuprofen (adjusted odds ratio [adj. OR]: 0.92, 95% confidence interval [CI]: 0.85–0.99 and adj. OR: 0.61, 95% CI: 0.48–0.78, respectively). The risk of SCC was slightly decreased in regular users of any NSAIDs (adj. OR: 0.89, 95% CI: 0.82–0.97), with the strongest risk reduction observed in current users of coxibs (adj. OR: 0.77, 95% CI: 0.62–0.95). These findings provide evidence that patients predisposed to NMSC might benefit from chemoprevention with NSAIDs. Abstract : What's new? Nonsteroidal anti‐inflammatory drugs (NSAIDs) could help prevent nonmelanoma skin cancer (NMSC). However, epidemiological data on the relationship between the use of systemic NSAIDs and NMSC are limited. Here, drawing on records in the Clinical Practice Research Datalink for more than 70, 000 case patients in the UK, regular NSAID exposure is shown to moderately reduce NMSC risk, particularly in the case of cutaneous SCC. The findings provide additional evidence that patients predisposed to NMSC might benefit from chemoprevention with NSAIDs.