Non-steroidal anti-inflammatory drugs, acetaminophen, and risk of skin cancer in the Nurses’ Health Study
- 372 Downloads
Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with lower risk of certain cancers, but data on the effect on skin cancer risk have been limited and contradictory. We prospectively examined whether use of NSAIDS or acetaminophen was associated with a lower risk of skin cancer in women.
The 92,125 Caucasian women in the Nurses’ Health Study provided information on aspirin use in 1980. Other NSAIDs and acetaminophen were added in 1990. Medication use, frequency, and quantity were reassessed on biennial questionnaires. Through 2008, we confirmed 658 melanoma cases, 1,337 squamous cell carcinoma (SCC) cases, and had 15,079 self-reports of basal cell carcinoma (BCC). We used COX proportional hazards models to compute relative risks (RR) adjusted for known skin cancer risk factors.
Neither aspirin nor non-aspirin NSAID use was associated with a lower risk of melanoma, SCC, or BCC, even for women with high quantity, frequency, or duration of use. Instead, we observed an increased risk of melanoma among current aspirin users (RR = 1.32, 95 % CI 1.03–1.70), though an increase of similar magnitude among past users and lack of a dose–response effect did not support a pharmacologic mechanism. We observed a mild reduction in SCC risk in current acetaminophen users (RR = 0.88, 95 % CI 0.75–1.02), with a linear decrease in risk with greater frequency of use (p = 0.04).
Aspirin and other NSAIDs were not associated with a lower risk of melanoma, SCC, or BCC in women. Our large, prospective study does not support a chemoprotective effect of NSAIDs against skin cancers.
KeywordsSkin cancer Melanoma Basal cell carcinoma (Cutaneous) Squamous cell carcinoma Aspirin Acetaminophen Non-steroidal anti-inflammatory medications (NSAIDs)
We are indebted to the participants in the NHS for their dedication to this study. We thank the following state cancer registries for their help: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, and Wyoming. This research was supported by R03CA125821, P30CA023074, and P01CA87969 from the National Institutes of Health and a Career Development Award from the American Society for Clinical Oncology.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Lotze MT, Dallal RM, Kirkwood JM, Flickinger JC (2001) Cutaneous melanoma. In: Devita VT Jr, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 2012–2013Google Scholar
- 3.Gruber S, Roush G, Barnhill R (1993) Sensitivity and specificity of self-examination for cutaneous malignant melanoma risk factors. Am J Prevent Med 9:50–53Google Scholar
- 8.Jeter J, Bonner JD, Johnson TH, Gruber SB (2011) Nonsteroidal anti-inflammatory drugs and risk of melanoma. J Skin Cancer 598571. Epub 2011 May 26Google Scholar
- 17.Available from: http://www.channing.harvard.edu/nhs/
- 18.Scotto J, Fears TR, Fraumeni JF Jr (1996) In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention, 2nd edn. Oxford University Press, New York, pp 355–372Google Scholar
- 28.Curiel-Lewandrowski C, Nijsten T, Gomez ML, Hollestein LM, Atkins MB, Stern RS (2011) Long-term use of nonsteroidal anti-inflammatory drugs decreases the risk of cutaneous melanoma: results of a United States case–control study. J Invest Dermatol 131(7):1460–1468. doi: 10.1038/jid.2011.58 PubMedCrossRefGoogle Scholar
- 36.Elmets C, Viner JL, Pentland AP, Cantrell W, Lin H-Y, Bailey H, Kang S, Linden KG, Heffernan M, Duvic M, Richmond E, Elewski BE, Umar A, Bell W, Gordon GB (2010) Chemoprevention of nonmelanoma skin cancer with celecoxib: a randomized, double-blind, placebo-controlled trial. J Nat Cancer Inst 102:1–10CrossRefGoogle Scholar