Department of Medicine, University of Arizona College of Medicine, 1515 N. Campbell Ave, PO Box 245024, Tucson, AZ 85724, USA.
Cancer Causes Control. 2012 Sep;23(9):1451-61. doi: 10.1007/s10552-012-0019-6. Epub 2012 Jul 5.
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.
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.
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).
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.
非甾体抗炎药（NSAIDs）已被证明与某些癌症的风险降低有关，但有关其对皮肤癌风险影响的数据有限且存在矛盾。我们前瞻性地研究了 NSAIDs 或对乙酰氨基酚的使用是否与女性皮肤癌风险降低有关。
参加护士健康研究的 92125 名白种人女性于 1980 年报告了阿司匹林的使用情况。1990 年增加了其他 NSAIDs 和对乙酰氨基酚的使用情况。药物使用、频率和剂量在每两年一次的问卷调查中重新评估。截至 2008 年，我们共确诊了 658 例黑色素瘤病例、1337 例鳞状细胞癌（SCC）病例和 15079 例基底细胞癌（BCC）自我报告病例。我们使用 COX 比例风险模型计算了经已知皮肤癌危险因素调整后的相对风险（RR）。
无论是阿司匹林还是非阿司匹林 NSAIDs 的使用均与黑色素瘤、SCC 或 BCC 的风险降低无关，即使对于使用量、频率或持续时间较高的女性也是如此。相反，我们发现当前使用阿司匹林的女性患黑色素瘤的风险增加（RR=1.32，95%CI 1.03-1.70），尽管过去使用者的增加幅度相似且没有剂量-反应关系，并不支持药物作用机制。我们发现当前使用对乙酰氨基酚的女性 SCC 风险略有降低（RR=0.88，95%CI 0.75-1.02），且使用频率越高风险越低（p=0.04）。
在女性中，阿司匹林和其他 NSAIDs 与黑色素瘤、SCC 或 BCC 的风险降低无关。我们的大型前瞻性研究不支持 NSAIDs 对皮肤癌具有化学预防作用。
