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Journal of the American Academy of Dermatology
Volume 74, n° 1
page 108 (janvier 2016)
Doi : 10.1016/j.jaad.2015.08.034
accepted : 15 August 2015
Original Articles

Can oral nonsteroidal antiinflammatory drugs play a role in the prevention of basal cell carcinoma? A systematic review and metaanalysis
 

Chiho Muranushi, MPH a, b, , Catherine M. Olsen, PhD b, Adèle C. Green, MBBS, PhD b, c, Nirmala Pandeya, PhD a, b
a School of Population Health, The University of Queensland, Brisbane, Australia 
b QIMR Berghofer Medical Research Institute, Brisbane, Australia 
c CRUK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom 

Correspondence to: Chiho Muranushi, MPH, Public Health Building, School of Public Health, The University of Queensland, Herston Road, Queensland 4006, Australia.
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.

The full text of this article is available in PDF format.

Key words : aspirin, basal cell carcinoma, metaanalysis, NSAIDs, skin cancer, systematic review

Abbreviations used : BCC, CI, COX, NSAID, OR, RCT



 Supported by Program Grant 552429 from the National Health and Medical Research Council of Australia (Dr Olsen) and a postdoctoral fellowship of The University of Queensland (Dr Pandeya).
 Conflicts of interest: None declared.



© 2015  American Academy of Dermatology, Inc.@@#104156@@