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General Discussions

NSAIDs for Skin Cancer Prevention

By Lisa Schulmeister, RN, MN, APRN-BC, OCN, FAAN
It is well recognized that non-steroidal anti-inflammatory drugs (NSAIDs) may prevent the development of cancer by inhibiting cyclooxygenase (COX) enzymes, which are involved in carcinogenesis. Researchers in Denmark examined the association between NSAID use and the risk of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM). From 1991-2009, all cases of SCC (n = 1974), BCC (n = 13,316), and MM (n = 3242) in northern Denmark were identified. Ten population controls (n = 178,655) were matched to each case by age, gender, and county of residence. A prescription database was used to ascertain the use of aspirin, other nonselective NSAIDs, or selective COX-2 inhibitors.

For NSAIDs overall, ever use (>2 prescriptions) compared with nonuse (≤2 prescriptions) was associated with a decreased risk of SCC (IRR, 0.85) and MM (IRR, 0.87), 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), but the risk of BCC at sites other than the head and neck was reduced in association with long-term use (IRR, 0.85) and high-intensity use (IRR, 0.79). When the researchers looked specifically at people who had filled prescriptions for the drugs over at least seven years, and used them twice a week or more, they found a stronger link: long-term, high-frequency NSAID users had a 46% lower risk of melanoma, a 35% lower risk of squamous cell carcinoma, and a 17% lower risk of basal cell carcinoma.

These findings add to growing evidence that long-term use of NSAIDs may help protect people against skin cancers, including melanoma. However, NSAIDs also are associated with risks, such as bleeding. The best defense against developing skin cancer is non-pharmacologic—sun protection.
Johannesdottir SA, Chang ET, Mehnert F, et al. Nonsteroidal and anti-inflammatory drugs and the risk of cancer: A population based case-control study. Cancer. 2012. Article first published online: 29 MAY 2012 | DOI: 10.1002/cncr.27406
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