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NSAIDS May Not Protect Against Skin Cancer

Posted Feb 18 2010 10:09pm

squamous cell carcinomaPrevious research suggests that the use of NSAIDS (non-steroidal anti-inflammatory drugs, such as ibuprofen) may help protect against the development of skin cancer. A new study published in the Archives of Dermatology has found the opposite to be true. Long term use of anti-inflammatory medications offer no protection against the development of squamous cell carcinoma.

The study was performed at Kaiser Permamente in Oakland, California. Questionnaires were administered to a random pool of 415 patients who were diagnosed with skin cancer by pathologic exam (specifically squamous cell carcinoma) and a random pool of 415 healthy patients without a diagnosis of skin cancer in 2004. The age of the participants ranged from 43 and 85 with race and gender similar among both groups. The questionnaire asked for self-reported NSAID use between 1994-2004 and this data was matched with pharmacy-dispensed NSAIDs in the same time period. Routine NSAID use was reported in 61% of all patients, with aspirin use at 41%, ibuprofen use at 18% and naproxen use at 5%.

There was no statistically significant difference between use of NSAIDS, regardless of dosage or type, and the development of squamous cell carcinoma. The results did not vary based on whether the NSAIDS were prescription or over the counter.

Basal cell carcinoma is the most common type of skin cancer and accounts for about 75% of skin cancers. Malignant melanoma is the most deadly of the skin cancers. Cutaneous squamous cell carcinoma, the type of skin cancer evaluated in this study and the second most common type of skin cancer, is directly related to sun exposure, but it’s not aggressive.

The mechanism linking NSAID use to cancer is based on the inflammatory pathway. NSAIDS are anti-inflammatory medications. Chronic inflammation has found to enhance carcinogenesis and tumor progression. In addition, researchers have found specific inflammatory chemicals (cytokines) and the genes that express them to be regulated by NSAIDS. Although some research has shown NSAIDS to regulate certain tumor suppressor genes, these findings cannot be extrapolated to all types of cancer. Cancer is not one disease and the development, physiologic and genetic controls are unique to each type of cancer. The research presented above is specific for cutaneous squamous cell carcinoma.

Arch Dermatol. 2010;146(4):(doi:10.1001/archdermatol.2009.374)

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