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  • Title: Can oral nonsteroidal antiinflammatory drugs play a role in the prevention of basal cell carcinoma? A systematic review and metaanalysis.
    Author: Muranushi C, Olsen CM, Green AC, Pandeya N.
    Journal: J Am Acad Dermatol; 2016 Jan; 74(1):108-119.e1. PubMed ID: 26433247.
    Abstract:
    BACKGROUND: Evidence for an association between aspirin or other nonsteroidal antiinflammatory drug (NSAID) use and basal cell carcinoma (BCC) has been inconsistent. OBJECTIVE: We conducted a systematic review and metaanalysis to assess the effect of oral NSAIDs on BCC. METHODS: PubMed, Web of Science, and Embase databases were searched up to December 3, 2014. A random effects model metaanalysis was used to calculate summary estimates of the effects of aspirin, nonaspirin NSAIDs, or any (aspirin or nonaspirin) NSAID use in patients with BCC. RESULTS: The summary estimates from 11 studies (1 randomized controlled trial, 5 cohort studies, and 5 case control studies) found a 10% risk reduction of BCC among those using any NSAID (relative risk [RR], 0.90 [95% confidence interval {CI}, 0.84-0.97]). A similar but not statistically significant inverse association was observed for nonaspirin NSAIDs (RR, 0.93 [95% CI, 0.86-1.02]), while aspirin use was more weakly associated (RR, 0.95 [95% CI, 0.91-1.00]). The strongest inverse associations were noted among those with either a history of skin cancers or a high prevalence of actinic keratoses. LIMITATIONS: Dose-effect estimates could not be calculated because the available data were too heterogeneous to pool. CONCLUSION: The intake of NSAIDs may help prevent BCC, particularly in high-risk populations. A large randomized controlled trial is required to confirm these findings.
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