Skip to main content

Advertisement

SpringerLink
Log in

Association between non-steroidal anti-inflammatory drug use and melanoma risk: a meta-analysis of 13 studies

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

Results of the association between non-steroidal anti-inflammatory drugs (NSAIDs) and melanoma risk have been inconsistent. We performed a meta-analysis of relevant studies to investigate the hypothesis of an association between NSAID use and melanoma risk.

Methods

Systematic searches of the PubMed and several other databases up to 23 March 2013 were retrieved. All epidemiologic studies regarding NSAIDs and melanoma risk were included. Fixed- or random-effects meta-analytical models were used to calculate relative risk (RR) and corresponding 95 % confidence intervals (CIs). Sensitivity analyses, Galbraith plots, and subgroup analyses were also performed.

Results

Six case–control studies including 93,432 melanoma cases and 401,251 controls, six cohort studies consisting of 563,380 subjects, and one randomized controlled trial encompassing 39,876 participants were included in this analysis. Compared to non-use, ever use of any NSAIDs was not statistically significantly associated with melanoma risk based on the random-effects models (RR = 0.97, 95 % CI = 0.90–10.4, p = 0.401). No differences were found in the effects on melanoma risk of aspirin, non-aspirin NSAIDs, and cyclooxygenase-2 inhibitor use overall and stratified by gender. However, a slight reduction in the risk of melanoma by taking aspirin was observed in case–control studies (RR = 0.88, 95 % CI = 0.80–0.96, p = 0.004).

Conclusions

Findings from this pooled analysis do not support the hypothesis that NSAID use provides potential benefits in preventing melanoma. More and larger randomized trials, including adequate numbers of patients, are required to further evaluate the relationship between NSAID use and melanoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Garbe C, Leiter U (2009) Melanoma epidemiology and trends. Clin Dermatol 27:3–9

    Article  PubMed  Google Scholar 

  2. Erdmann F, Lortet-Tieulent J, Schuz J et al (2013) International trends in the incidence of malignant melanoma 1953–2008 uare recent generations at higher or lower risk? Int J Cancer 132:385–400

    Article  PubMed  CAS  Google Scholar 

  3. Hollestein LM, van den Akker SAW, Nijsten T, Karim-Kos HE, Coebergh JW, de Vries E (2012) Trends of cutaneous melanoma in The Netherlands: increasing incidence rates among all Breslow thickness categories and rising mortality rates since 1989. Ann Oncol 23:524–530

    Article  PubMed  CAS  Google Scholar 

  4. Franks AL, Slansky JE (2012) Multiple associations between a broad spectrum of autoimmune diseases, chronic inflammatory diseases and cancer. Anticancer Res 32:1119–1136

    PubMed  CAS  Google Scholar 

  5. Pires I, Garcia A, Prada J, Queiroga FL (2010) COX-1 and COX-2 expression in canine cutaneous, oral and ocular melanocytic tumours. J Comp Pathol 143:142–149

    Article  PubMed  CAS  Google Scholar 

  6. Vane JR, Botting RM (1998) Mechanism of action of antiinflammatory drugs. Int J Tissue React 20:3–15

    PubMed  CAS  Google Scholar 

  7. Vane JR, Botting RM (1998) Mechanism of action of nonsteroidal anti-inflammatory drugs. Am J Med 104:2S–8S discussion 21S-2S

    Article  PubMed  CAS  Google Scholar 

  8. Zerbini LF, Czibere A, Wang Y et al (2006) A novel pathway involving melanoma differentiation associated gene-7/interleukin-24 mediates nonsteroidal anti-inflammatory drug-induced apoptosis and growth arrest of cancer cells. Cancer Res 66:11922–11931

    Article  PubMed  CAS  Google Scholar 

  9. Vinogradova Y, Coupland C, Hippisley-Cox J (2011) Exposure to cyclooxygenase-2 inhibitors and risk of cancer: nested case-control studies. Br J Cancer 105:452–459

    Article  PubMed  CAS  Google Scholar 

  10. Sorensen HT, Friis S, Norgard B et al (2003) Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study. Br J Cancer 88:1687–1692

    Article  PubMed  CAS  Google Scholar 

  11. Joosse A, Koomen ER, Casparie MK, Herings RM, Guchelaar HJ, Nijsten T (2009) Non-steroidal anti-inflammatory drugs and melanoma risk: large Dutch population-based case-control study. J Invest Dermatol 129:2620–2627

    Article  PubMed  CAS  Google Scholar 

  12. Johannesdottir SA, Chang ET, Mehnert F, Schmidt M, Olesen AB, Sorensen HT (2012) Nonsteroidal anti-inflammatory drugs and the risk of skin cancer: a population-based case-control study. Cancer 118:4768–4776

    Article  PubMed  CAS  Google Scholar 

  13. Jeter JM, Han J, Martinez ME, Alberts DS, Qureshi AA, Feskanich D (2012) Non-steroidal anti-inflammatory drugs, acetaminophen, and risk of skin cancer in the Nurses’ Health Study. CCC 23:1451–1461

    PubMed  CAS  Google Scholar 

  14. Jeter JM, Bonner JD, Johnson TM, Gruber SB (2011) Nonsteroidal anti-inflammatory drugs and risk of melanoma. J Skin Cancer 2011:598571

    PubMed  Google Scholar 

  15. Jacobs EJ, Thun MJ, Bain EB, Rodriguez C, Henley SJ, Calle EE (2007) A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst 99:608–615

    Article  PubMed  CAS  Google Scholar 

  16. Harris RE, Beebe-Donk J, Namboodiri KK (2001) Inverse association of non-steroidal anti-inflammatory drugs and malignant melanoma among women. Oncol Rep 8:655–657

    PubMed  CAS  Google Scholar 

  17. Gamba CA, Swetter SM, Stefanick ML, et al. (2013) Aspirin is associated with lower melanoma risk among postmenopausal Caucasian women: the women’s health initiative. Cancer

  18. Friis S, Sorensen HT, McLaughlin JK, Johnsen SP, Blot WJ, Olsen JH (2003) A population-based cohort study of the risk of colorectal and other cancers among users of low-dose aspirin. Br J Cancer 88:684–688

    Article  PubMed  CAS  Google Scholar 

  19. Curiel-Lewandrowski C, Nijsten T, Gomez ML, Hollestein LM, Atkins MB, Stern RS (2011) Long-term use of nonsteroidal anti-inflammatory drugs decreases the risk of cutaneous melanoma: results of a United States case-control study. J Invest Dermatol 131:1460–1468

    Article  PubMed  CAS  Google Scholar 

  20. Cook NR, Lee IM, Gaziano JM et al (2005) Low-dose aspirin in the primary prevention of cancer: the women’s health study: a randomized controlled trial. JAMA 294:47–55

    Article  PubMed  CAS  Google Scholar 

  21. Asgari MM, Maruti SS, White E (2008) A large cohort study of nonsteroidal anti-inflammatory drug use and melanoma incidence. J Natl Cancer Inst 100:967–971

    Article  PubMed  CAS  Google Scholar 

  22. Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  PubMed  CAS  Google Scholar 

  23. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  Google Scholar 

  24. Higgins JP, Altman DG, Gotzsche PC et al (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928

    Article  PubMed  Google Scholar 

  25. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute

  26. Greenland S (1987) Quantitative methods in the review of epidemiologic literature. Epidemiol Rev 9:1–30

    PubMed  CAS  Google Scholar 

  27. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  PubMed  CAS  Google Scholar 

  28. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634

    Article  PubMed  CAS  Google Scholar 

  29. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  30. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  Google Scholar 

  31. Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:719–748

    PubMed  CAS  Google Scholar 

  32. Galbraith RF (1988) A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med 7:889–894

    Article  PubMed  CAS  Google Scholar 

  33. Zhao YS, Zhu S, Li XW et al (2009) Association between NSAIDs use and breast cancer risk: a systematic review and meta-analysis. Breast Cancer Res Tr 117:141–150

    Article  CAS  Google Scholar 

  34. Xu JL, Yin ZQ, Gao W et al (2012) Meta-analysis on the association between nonsteroidal anti-inflammatory drug use and lung cancer risk. Clin Lung Cancer 13:44–51

    Article  PubMed  CAS  Google Scholar 

  35. Tian WJ, Zhao YS, Liu SY, Li X (2010) Meta-analysis on the relationship between nonsteroidal anti-inflammatory drug use and gastric cancer. Eur J Cancer Prev 19:288–298

    Article  PubMed  CAS  Google Scholar 

  36. Din FVN, Theodoratou E, Farrington SM et al (2010) Effect of aspirin and NSAIDs on risk and survival from colorectal cancer. Gut 59:1670-U114

    Article  Google Scholar 

  37. Mahmud SM, Franco EL, Aprikian AG (2010) Use of nonsteroidal anti-inflammatory drugs and prostate cancer risk: a meta-analysis. Int J Cancer 127:1680–1691

    Article  PubMed  CAS  Google Scholar 

  38. Hu H, Xie Y, Yang G, Jian C, Deng Y (2013) Nonsteroidal anti-inflammatory drug use and the risk of melanoma: a meta-analysis. European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP)

  39. Ioannidis JP, Patsopoulos NA, Evangelou E (2007) Uncertainty in heterogeneity estimates in meta-analyses. BMJ 335:914–916

    Article  PubMed  Google Scholar 

  40. Hercberg S, Ezzedine K, Guinot C et al (2007) Antioxidant supplementation increases the risk of skin cancers in women but not in men. J nut 137:2098–2105

    CAS  Google Scholar 

  41. Grimes DA, Schulz KF (2002) Bias and causal associations in observational research. Lancet 359:248–252

    Article  PubMed  Google Scholar 

  42. Gandini S, Sera F, Cattaruzza MS et al (2005) Meta-analysis of risk factors for cutaneous melanoma: I. common and atypical naevi. Eur J Cancer 41:28–44

    Article  PubMed  Google Scholar 

  43. Gandini S, Sera F, Cattaruzza MS et al (2005) Meta-analysis of risk factors for cutaneous melanoma: II sun exposure. Eur J Cancer 41:45–60

    Article  PubMed  Google Scholar 

  44. Gandini S, Sera F, Cattaruzza MS et al (2005) Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer 41:2040–2059

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No funding was provided for the analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China

    Shan Li, Yanqiong Liu, Qiliu Peng, Li Xie & Xue Qin

  2. Department of Geriatrics, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China

    Zhiyu Zeng

  3. Department of Medicine Research, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China

    Ruolin Li

  4. Department of Orthopedic Trauma Surgery, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China

    Jinmin Zhao

Authors
  1. Shan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yanqiong Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiyu Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qiliu Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruolin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Li Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xue Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jinmin Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Xue Qin or Jinmin Zhao.

Additional information

Shan Li, Yanqiong Liu, Zhiyu Zeng contributed equally to this study and should be considered as co-first authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 2 (PDF 71 kb)

Supplementary material 1 (PDF 73 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, S., Liu, Y., Zeng, Z. et al. Association between non-steroidal anti-inflammatory drug use and melanoma risk: a meta-analysis of 13 studies. Cancer Causes Control 24, 1505–1516 (2013). https://doi.org/10.1007/s10552-013-0227-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-013-0227-8

Keywords

Search

Navigation