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Non-steroidal anti-inflammatory drugs, acetaminophen, and risk of skin cancer in the Nurses’ Health Study

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Abstract

Purpose

Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with lower risk of certain cancers, but data on the effect on skin cancer risk have been limited and contradictory. We prospectively examined whether use of NSAIDS or acetaminophen was associated with a lower risk of skin cancer in women.

Methods

The 92,125 Caucasian women in the Nurses’ Health Study provided information on aspirin use in 1980. Other NSAIDs and acetaminophen were added in 1990. Medication use, frequency, and quantity were reassessed on biennial questionnaires. Through 2008, we confirmed 658 melanoma cases, 1,337 squamous cell carcinoma (SCC) cases, and had 15,079 self-reports of basal cell carcinoma (BCC). We used COX proportional hazards models to compute relative risks (RR) adjusted for known skin cancer risk factors.

Results

Neither aspirin nor non-aspirin NSAID use was associated with a lower risk of melanoma, SCC, or BCC, even for women with high quantity, frequency, or duration of use. Instead, we observed an increased risk of melanoma among current aspirin users (RR = 1.32, 95 % CI 1.03–1.70), though an increase of similar magnitude among past users and lack of a dose–response effect did not support a pharmacologic mechanism. We observed a mild reduction in SCC risk in current acetaminophen users (RR = 0.88, 95 % CI 0.75–1.02), with a linear decrease in risk with greater frequency of use (p = 0.04).

Conclusions

Aspirin and other NSAIDs were not associated with a lower risk of melanoma, SCC, or BCC in women. Our large, prospective study does not support a chemoprotective effect of NSAIDs against skin cancers.

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Acknowledgments

We are indebted to the participants in the NHS for their dedication to this study. We thank the following state cancer registries for their help: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, and Wyoming. This research was supported by R03CA125821, P30CA023074, and P01CA87969 from the National Institutes of Health and a Career Development Award from the American Society for Clinical Oncology.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, University of Arizona College of Medicine, 1515 N. Campbell Ave, PO Box 245024, Tucson, AZ, 85724, USA

    J. M. Jeter & D. S. Alberts

  2. Arizona Cancer Center, Tucson, AZ, USA

    J. M. Jeter & D. S. Alberts

  3. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    J. Han, A. A. Qureshi & D. Feskanich

  4. Clinical Research Program, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    J. Han & A. A. Qureshi

  5. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    J. Han

  6. Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, 92093, USA

    M. E. Martinez

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  1. J. M. Jeter
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  6. D. Feskanich
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Correspondence to J. M. Jeter.

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Jeter, J.M., Han, J., Martinez, M.E. et al. Non-steroidal anti-inflammatory drugs, acetaminophen, and risk of skin cancer in the Nurses’ Health Study. Cancer Causes Control 23, 1451–1461 (2012). https://doi.org/10.1007/s10552-012-0019-6

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  • DOI: https://doi.org/10.1007/s10552-012-0019-6

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