NSAIDs may protect against skin cancer

NEW YORK (Reuters Health) - Regular, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against the development of actinic keratosis, a precancerous skin condition caused by long-term exposure to the sun, and squamous cell cancers (SCC) of the skin, according to a study conducted in subtropical Queensland, Australia.

Co-author Dr. David Whiteman, of the Queensland Institute of Medical Research in Brisbane, said he was not particularly surprised by the findings, noting that "previous findings from animal studies, from molecular studies of human skin cancers and findings from studies of other human...cancers all suggested that aspirin and NSAIDs may be negatively associated with risk of SCC of the skin. Our study was therefore designed to specifically test this hypothesis."

The study, reported in the Journal of the American Academy of Dermatology, involved 86 individuals with SCC and 187 "control" subjects of the same age and sex who were randomly selected from the community.

The important findings, according to Whiteman, were that use of aspirin or NSAIDS, which include drugs like ibuprofen and naproxen, more than two times per week for more than five years was associated with about a 60-percent reduction in the risk of SCC of the skin. In addition, among subjects without SCC, current regular NSAIDs users had significantly lower counts of actinic keratoses than nonusers.

Whiteman stressed that these results require confirmation in other studies before any change to clinical practice could be advocated. "In particular, a randomized trial is required to definitively answer the question as to whether our observation reflects a real protective effect of NSAIDs, or whether the effect is due to other confounding factors," he said.

"Perhaps in the future, there may be subgroups in the population at very high risk of skin cancer who might be advised to take NSAIDs to reduce their risk of skin cancer, Whiteman said.

However, the skin cancer prevention message is not altered by the current findings, Whiteman said. The prevention message used in Australia is: Stay out of the sun and Slip! Slop! Slap! (i.e., slip on a shirt, slop on sunscreen, and slap on a hat)."

SOURCE: Journal of the American Academy of Dermatology, December 2005.