The use of nonsteroidal anti-inflammatory drugs does not reduce the risk of cutaneous squamous cell carcinoma, according to the findings of a retrospective study.
In a case-control study involving more than 800 subjects, the dose, duration, and type of NSAID exposure exerted “no clear effect” on the risk of developing squamous cell cancer (SCC), said Dr. Maryam M. Asgari of Kaiser Permanente of Northern California, Oakland, and associates.
NSAIDs block the synthesis of proinflammatory prostaglandins and “inhibit neoplastic proliferation by inducing apoptosis and inhibiting angiogenesis,” the authors wrote. They have been reported to protect against colorectal, breast, prostate, and lung cancer, and have shown activity against SCCs both in animal and in vitro studies. However, human studies have produced conflicting results.
Dr. Asgari and her colleagues assessed NSAID use during the preceding decade in 415 patients with pathologically confirmed SCC who were diagnosed in 2004 and 415 control subjects matched for age, sex, and race. Only cases of extragenital and nonmucosal SCC were included.
The subjects (aged 43-85 years) completed 3-page questionnaires detailing medication use, health history, skin cancer history, and risk factors. NSAID use was analyzed by four categories: any NSAIDs, aspirin, ibuprofen, and nonaspirin NSAIDs. Regular use was defined as taking the medication at least once per week for at least 1 year.
Most of the subjects (61%) reported regular use of NSAIDs at some time during the preceding 10 years, most commonly aspirin (48%), followed by ibuprofen (18%), naproxen (5%), and nabumetone (4%).
There was no association between self-reported NSAID use and SCC risk.
This finding was validated in a separate analysis of pharmacy records of NSAIDs that were dispensed to the same group of subjects, the investigators said (Arch. Dermatol. 2010 Feb. 15 [doi:10.1001/archdermatol.2009.374]).
Dose and duration of exposure had no effect on the results.
“Our results are largely consistent with” three of the four published articles examining the association of NSAIDs with SCC risk, they added.
Disclosures: This study was funded by the National Institute of Arthritis, Musculoskeletal, and Skin Diseases and the National Cancer Institute. One of Dr. Asgari's associates reported serving on an advisory committee for Roche Laboratories and consulting for law firms serving both plaintiffs and Ortho-McNeil-Janssen Pharmaceuticals in legal cases. No other potential conflicts of interest were reported.