Journal of the National Cancer Institute Advance Access originally published online on June 24, 2008
JNCI Journal of the National Cancer Institute 2008 100(13):967-971; doi:10.1093/jnci/djn154
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author 2008. Published by Oxford University Press.
A Large Cohort Study of Nonsteroidal Anti-inflammatory Drug Use and Melanoma Incidence
Affiliations of authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA (MMA); Department of Dermatology, University of California at San Francisco, San Francisco, CA (MMA); Department of Epidemiology, University of Washington, Seattle, Washington, DC (SSM, EW); Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, DC (SSM, EW)
Correspondence to: Maryam M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (e-mail: maryam.m.asgari{at}kp.org).
Results of laboratory studies indicate that nonsteroidal anti-inflammatory drugs (NSAIDs) may have chemopreventive activity and therapeutic efficacy against melanoma. However, few published epidemiological studies have examined the association between NSAID use and melanoma risk. We examined whether NSAID use was associated with melanoma risk among 63 809 men and women in the Vitamins and Lifestyle (VITAL) cohort study. Participants self-reported NSAID use (low-dose aspirin, regular or extra-strength aspirin, and nonaspirin NSAIDs) during the previous 10 years and data related to their melanoma risk factors on a baseline questionnaire. After linkage of the VITAL database to the NCI Surveillance, Epidemiology, and End Results cancer registry, 349 patients with incident melanoma were identified through December 31, 2005. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of melanoma by NSAID use as categorized by overall use, duration of use, and dose (expressed as average number of days of use during the past 10 years). All statistical tests were two-sided. After adjusting for melanoma risk factors and indications for NSAID use, no association between NSAID use and melanoma risk was found. When use of at least 4 d/wk was compared with nonuse, no melanoma risk reduction was detected for any NSAID dose (HR = 1.12, 95% CI = 0.84 to 1.48), for any NSAID excluding low-dose aspirin (HR = 1.03, 95% CI = 0.74 to 1.43), for regular- or extra-strength aspirin (HR = 1.10, 95% CI = 0.76 to 1.58), or for nonaspirin NSAIDs (HR = 1.22, 95% CI = 0.75 to 1.99). Moreover, NSAID use was not associated with tumor invasion (Pinteraction = .38), tumor thickness (Ptrend = .98), or risk of metastasis (HR = 1.09, 95% CI = 0.32 to 3.62). NSAIDs do not appear to be good candidates for the chemoprevention of melanoma.
| CONTEXT AND CAVEATS Prior knowledge Results of laboratory studies indicate that nonsteroidal anti-inflammatory drugs (NSAIDs) may have chemopreventive activity and therapeutic efficacy against melanoma. Study design Prospective cohort study to investigate whether commonly used over-the-counter and prescription NSAIDs are associated with melanoma risk. Contribution After adjusting for melanoma risk factors and indications for NSAID use, no association between NSAID use and melanoma risk was found. Implications NSAIDs do not appear to be good candidates for the chemoprevention of melanoma. Limitations Detailed information on some known melanoma risk factors such as sunlight exposure and number of nevi was not available. The actual NSAIDs dose per day was not ascertained. The average follow-up was only 5 years, which may be insufficient to detect an effect because the lag time between the initiation and diagnosis of melanoma may be on the order of decades.
|
Manuscript received January 6, 2008; revised April 11, 2008; accepted April 14, 2008.
Related Article in JNCI
CiteULike 
Connotea 
Del.icio.us What's this?
J Natl Cancer Inst 2008 100: 907.