Effect of non-steroidal anti-inflammatory drugs on non-melanoma skin cancer incidence in the SKICAP-AK trial

Pharmacoepidemiol Drug Saf. 2009 Apr;18(4):276-83. doi: 10.1002/pds.1718.


Recent studies link the prostaglandin metabolic pathway to skin carcinogenesis expanding possibilities that cyclooxygenase (COX) inhibitors may be utilized in non-melanoma skin cancer (NMSC) chemoprevention. Using data from a study of the efficacy of retinol supplementation on incidence of NMSC, we sought to determine the role of non-steroidal anti-inflammatory drugs (NSAIDs) in NMSC development. Cox proportional hazards models describe the relationship between NSAID use and time to first squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) among participants categorized by use pattern: continuous users (use for length of study duration), new users (use for less than study duration), and non-users. For SCC and BCC, there was a statistically significant protective effect for participants who reported use for less than the study duration (HR = 0.49, 95%CI 0.28-0.87 and HR = 0.43, 95%CI 0.25-0.73, respectively). Categorical examination of NSAIDs (aspirin (ASA) vs. non-ASA NSAIDs) showed significant effects for BCC among those using non-ASA NSAIDs for less than the study duration (HR = 0.33, 95%CI 0.13-0.80). For SCC and BCC, NSAID use of shorter duration and potentially more recent, was more protective than longer duration of use. These results are counter to the idea that longer duration of NSAID use is more protective. Additional investigations are needed into the role NSAIDs play in the chemoprevention of NMSC.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Anticarcinogenic Agents / administration & dosage
  • Anticarcinogenic Agents / therapeutic use*
  • Arizona / epidemiology
  • Aspirin / therapeutic use
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Basal Cell / prevention & control*
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / prevention & control*
  • Cell Transformation, Neoplastic / drug effects*
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Assessment
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / prevention & control*
  • Time Factors
  • Vitamin A / therapeutic use


  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticarcinogenic Agents
  • Vitamin A
  • Aspirin