Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Cancer. 2012 Oct 1;118(19):4768-76. doi: 10.1002/cncr.27406. Epub 2012 May 29.
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).
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).
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).
The current results indicated that NSAID use may decrease the risk of SCC and MM.
非甾体抗炎药（NSAIDs）通过抑制环氧化酶（COX）酶来预防癌症的发生，COX 酶与致癌作用有关。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）和恶性黑素瘤（MM）风险之间的关系。
1991 年至 2009 年，丹麦北部所有新诊断的 SCC（n = 1974）、BCC（n = 13316）和 MM（n = 3242）病例均被确定。通过处方数据库确定了大约 10 个人群对照（n = 178655），以年龄、性别和居住地与每个病例相匹配。使用阿司匹林、其他非选择性 NSAIDs 或选择性 COX-2 抑制剂的情况通过处方数据库确定。采用条件逻辑回归分析调整潜在混杂因素，计算比值比作为发病率比（IRR）的估计值。
对于 NSAIDs 整体而言，与不使用（≤2 次处方）相比，长期使用（≥7 年）和高强度使用（在使用总持续时间内≥25%的处方覆盖率）与 SCC（IRR，0.85；95%置信区间[CI]，0.76-0.94）和 MM（IRR，0.87；95%CI，0.80-0.95）风险降低相关，曾使用（>2 次处方）与 SCC（IRR，0.85；95%CI，0.76-0.94）和 MM（IRR，0.87；95%CI，0.80-0.95）风险降低相关。NSAID 使用与 BCC 风险总体降低无关（IRR，0.97；95%CI，0.93-1.01），但与长期使用（IRR，0.85；95%CI，0.76-0.95）和高强度使用（IRR，0.79；95%CI，0.69-0.91）相关的非头颈部 BCC 风险降低。所有风险降低的估计值主要归因于非选择性 NSAIDs 和较老的 COX-2 抑制剂（双氯芬酸、依托度酸和美洛昔康）的使用。
目前的结果表明，NSAID 使用可能降低 SCC 和 MM 的风险。
