Nonsteroidal anti-inflammatory drugs and the risk of skin cancer
Nonsteroidal anti-inflammatory drugs and the risk of skin cancer
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DOI：
10.1002/cncr.27406
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发表时间：
2012-10-01
期刊：
影响因子：
6.2
通讯作者：
Sorensen, Henrik Toft
中科院分区：
文献类型：
--
作者：
Johannesdottir, Sigrun Alba;Chang, Ellen T.;Sorensen, Henrik Toft
背景技术背景：非甾体抗炎药（NSAID）可通过抑制参与致癌作用的环氧合酶（考克斯）来预防癌症的发展。因此，本报告的作者研究了NSAID使用与鳞状细胞癌（SCC）、基底细胞癌（BCC）和恶性黑色素瘤（MM）风险之间的关系。方法：从1991年到2009年，确定了北方丹麦的所有SCC（n = 1974）、BCC（n = 13，316）和MM（n = 3242）事件病例。大约10个人群对照组（n = 178，655）按年龄、性别和居住县与每个病例相匹配。通过处方数据库确定阿司匹林、其他非选择性NSAID或选择性考克斯-2抑制剂的使用。调整潜在混杂因素的条件logistic回归分析用于计算比值比，作为发病率比（IRR）的估计值。研究结果：总体而言，对于NSAID，（>2个处方）与不使用相比（=2个处方）与SCC风险降低相关（IRR，0.85; 95%置信区间[CI]，0.76-0.94）和MM（IRR，0.87; 95% CI，0.80-0.95），特别是对于长期使用（≥ 7年）和高强度使用（在整个使用期间处方覆盖率>25%）。NSAID使用与BCC总体风险降低无关（IRR，0.97; 95% CI，0.93-1.01），但除头颈部以外部位的BCC风险降低与长期使用（IRR，0.85; 95% CI，0.76-0.95）和高强度使用（IRR，0.79; 95% CI，0.69-0.91）相关。所有降低风险的估计值主要由使用非选择性NSAID和较早的考克斯-2抑制剂（双氯芬酸、依托度酸和美洛昔康）驱动。结论：目前的结果表明，NSAID的使用可能会降低SCC和MM的风险。癌症2012。(c)2012年美国癌症协会
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) may prevent the development of cancer by inhibiting cyclooxygenase (COX) enzymes, which are involved in carcinogenesis. Therefore, the authors of this report examined the association between NSAID use and the risk of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM). METHODS: From 1991 through 2009, all incident cases of SCC (n = 1974), BCC (n = 13,316), and MM (n = 3242) in northern Denmark were identified. Approximately 10 population controls (n = 178,655) were matched to each case by age, gender, and county of residence. The use of aspirin, other nonselective NSAIDs, or selective COX-2 inhibitors was ascertained through a prescription database. Conditional logistic regression analyses adjusted for potential confounders were used to compute odds ratios as estimates of incidence rate ratios (IRRs). RESULTS: For NSAIDs overall, ever use (>2 prescriptions) compared with nonuse (=2 prescriptions) was associated with a decreased risk of SCC (IRR, 0.85; 95% confidence interval [CI], 0.76-0.94) and MM (IRR, 0.87; 95% CI, 0.80-0.95), especially for long-term use (=7 years) and high-intensity use (>25% prescription coverage during the total duration of use). NSAID use was not associated with a reduced risk of BCC overall (IRR, 0.97; 95% CI, 0.93-1.01), but the risk of BCC at sites other than the head and neck was reduced in association with long-term use (IRR, 0.85; 95% CI, 0.76-0.95) and high-intensity use (IRR, 0.79; 95% CI, 0.69-0.91). All estimates of reduced risk were driven primarily by the use of nonselective NSAIDs and older COX-2 inhibitors (diclofenac, etodolac, and meloxicam). CONCLUSIONS: The current results indicated that NSAID use may decrease the risk of SCC and MM. Cancer 2012. (c) 2012 American Cancer Society.