Can Oral Non-steroidal Anti-inflammatory Drugs help prevent Basal Cell Carcinoma?: A Systematic Review and Meta-analysis

Chiho Muranushi, Catherine M Olsen, Adele Green, Nirmala Pandeya

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Abstract

Background

Evidence for an association between aspirin or other nonsteroidal antiinflammatory drug (NSAID) use and basal cell carcinoma (BCC) has been inconsistent.

Objective

We conducted a systematic review and metaanalysis to assess the effect of oral NSAIDs on BCC.

Methods

PubMed, Web of Science, and Embase databases were searched up to December 3, 2014. A random effects model metaanalysis was used to calculate summary estimates of the effects of aspirin, nonaspirin NSAIDs, or any (aspirin or nonaspirin) NSAID use in patients with BCC.

Results

The summary estimates from 11 studies (1 randomized controlled trial, 5 cohort studies, and 5 case control studies) found a 10% risk reduction of BCC among those using any NSAID (relative risk [RR], 0.90 [95% confidence interval {CI}, 0.84-0.97]). A similar but not statistically significant inverse association was observed for nonaspirin NSAIDs (RR, 0.93 [95% CI, 0.86-1.02]), while aspirin use was more weakly associated (RR, 0.95 [95% CI, 0.91-1.00]). The strongest inverse associations were noted among those with either a history of skin cancers or a high prevalence of actinic keratoses.

Limitations

Dose-effect estimates could not be calculated because the available data were too heterogeneous to pool.

Conclusion

The intake of NSAIDs may help prevent BCC, particularly in high-risk populations. A large randomized controlled trial is required to confirm these findings.
Original languageEnglish
Pages (from-to)108-119
Number of pages11
JournalJournal of the American Academy of Dermatology
Volume74
Issue number1
Early online date1 Oct 2015
DOIs
Publication statusPublished - Jan 2016

Keywords

  • Aspirin
  • Basal cell carcinoma
  • metaanalysis
  • NSAIDs
  • Skin cancer
  • Systematic review

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