The association between nonsteroidal anti-inflammatory drugs and skin cancer: Different responses in American and European populations

Yukun Ma; Piaojian Yu; Shuhuang Lin; Qiqun Li; Zijing Fang; Zunnan Huang

doi:10.1016/j.phrs.2019.104499

The association between nonsteroidal anti-inflammatory drugs and skin cancer: Different responses in American and European populations

Pharmacol Res. 2020 Feb:152:104499. doi: 10.1016/j.phrs.2019.104499. Epub 2019 Nov 2.

Authors

Yukun Ma¹, Piaojian Yu¹, Shuhuang Lin¹, Qiqun Li¹, Zijing Fang¹, Zunnan Huang²

Affiliations

¹ Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China.
² Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; Institute of Marine Biomedical Research, Guangdong Medical University, Zhanjiang, Guangdong 524023, China. Electronic address: zn_huang@yahoo.com.

PMID: 31689521
DOI: 10.1016/j.phrs.2019.104499

Abstract

Objective: To conduct a comprehensive systematic meta-analysis investigating the association of nonsteroidal anti-inflammatory drugs (NSAIDs) and their subtypes with skin cancer (SC) and its subclasses (basal cell carcinoma BCC; squamous cell carcinoma SCC; melanoma; nonmelanoma skin cancer NMSC) in general, American and European populations.

Methods: PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure and ClinicalTrials.gov were searched up to 24 February 2019. Pooled effect sizes and 95% confidence intervals were used to estimate associations.

Results: Results based on 26 original studies including 223,619 cases and 1,398,507 controls showed both NSAIDs and nonselective Cyclooxygenase (COX) inhibitors to be statistically significantly associated with a reduced risk of SC, BCC, SCC and NMSC but not with melanoma. Conversely, no association was observed between selective Cyclooxygenase 2 (COX-2) inhibitors and SC or its subclasses. Further subgroup analysis showed that the results analyzed for American populations were almost the same as those for the general population. For European populations, neither NSAIDs nor its subtypes correlated significantly with susceptibility to SC or its subclasses.

Conclusions: The use of NSAIDs might reduce the risk of SC, but many factors including study population, drug subtype, and disease subclass affect the significance of the association.

Keywords: Aceclofenac (CID: 71771); Aspirin (CID: 2244); Celecoxib (CID: 2662); Cyclooxygenase 2 inhibitors; Cyclooxygenase inhibitors; Dexibuprofen (CID: 39912); Diclofenac (CID: 3033); Etodolac (CID: 3308); Etoricoxib (CID: 123619); Fenbufen (CID: 3335); Fenoprofen (CID: 3342); Flurbiprofen (CID: 3394); Ibuprofen (CID:3672); Indomethacin (CID: 3715); Ketoprofen (CID: 3825); Ketorolac (CID: 3826); Lornoxicam (CID: 54690031); Lumiracoxib (CID: 151166); Meloxicam (CID: 54677470); Meta-analysis; Nabumetone (CID: 4409); Naproxen (CID: 156391); Nonsteroidal anti-inflammatory drugs (NSAIDs); Phenylbutazone (CID: 4781); Piroxicam (CID: 54676228); Rofecoxib (CID: 5090); Salsalate (CID: 5161); Skin cancer (SC); Sub-diseases; Sulindac (CID: 1548887); Tenoxicam (CID: 54677971); Tiaprofenic acid (CID: 5468); Tolfenamic acid (CID: 610479); Tolmetin (CID: 5509); Valdecoxib (CID: 119607).

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Europe / epidemiology
Humans
Randomized Controlled Trials as Topic
Skin Neoplasms / epidemiology*
United States / epidemiology

Substances

Anti-Inflammatory Agents, Non-Steroidal