Aspirin, NSAIDs use and keratinocyte cancers risk: is there a link?

  • Pandeya N & al.
  • Br J Dermatol
  • 28 Mar 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • There was a weak and inconsistent inverse association between aspirin and non-steroidal anti-inflammatory drugs (NSAIDs; non-aspirin) use in the year before baseline and the incidence of keratinocyte cancers (KC) (namely, basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) in the next 3 years, suggesting a limited role of NSAIDs for KC.

Why this matters

  • Recent meta-analyses of observational studies and randomised controlled trials have suggested a potential benefit of NSAIDs in reducing BCC and SCC incidence, but there is substantial heterogeneity in studies.

Study design

  • This study included 34,630 participants using data from the QSkin Sun and Health Study.
  • The association between NSAIDs (aspirin and non-aspirin) and BCC and SCC was evaluated in high- (with a history of skin cancer excisions or >5 actinic lesions treated) and low-risk (without a history of skin cancer excision and ≤5 actinic lesions treated) participants.
  • Funding: National Health and Medical Research Council of Australia.

Key results

  • Over a median follow-up of 3 years, 3421 (10%) and 1470 (4%) participants developed ≥1 BCC and SCC, respectively.
  • After adjustment for confounders, infrequent (HR, 0.92; 95% CI, 0.83-1.01) and frequent (HR, 0.84; 95% CI, 0.71-0.99) non-aspirin NSAID use was associated with reduced risk for BCC vs never use in the high-risk group but not with SCC.
  • Infrequent aspirin use was associated with reduced risk for SCC (HR, 0.77; 95% CI, 0.64-0.93), but there was no significant association between frequent aspirin use and the risk for SCC (HR, 1.07; 95% CI, 0.87-1.31).
  • No significant association between aspirin use and risk for BCC was observed.
  • In the low-risk group, no significant association was observed between aspirin or non-aspirin NSAID use and the risk for BCC or SCC.

Limitations

  • Study did not obtain data on the dose and duration of NSAID use.
  • Self-reported NSAID use led to misclassification.

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