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No new light regarding skin cancer

By James DiClerico

Light aspirin, with its growing record of benefit to heart and colon health, also protect against common skin cancers? Not to any great extent was the conclusion of a recent study by researchers in DMS's Department of Community and Family Medicine.

Maria Grau, M.D., M.P.H., was the first author on the paper, which was published in the International Journal of Cancer. "Our results indicated only a weak and inconsistent preventive effect of aspirin and other nonsteroidal anti-inflammatory drugs [NSAIDs] against nonmelanoma skin cancers," she explains. The study focused on basal cell cancer and squamous cell cancer (BCC/SCC), two common forms of skin cancer. Earlier experimental studies had consistently shown NSAIDs as having a protective effect against BCC/SCC, but this new epidemiological study provided little indication of an impact.

Data: Working with Grau on the study were John Baron, M.D., and Margaret Karagas, Ph.D. The team gleaned data on NSAID use from 1,805 subjects enrolled in a skin cancer trial that ran from 1983 to 1989. Its original purpose was to look at the effect on BCC/SCC of beta-carotene; subjects all had had a BCC and/or SCC in the previous three years and were randomized to receive either beta- carotene or a placebo. Data on their use of other medications, including NSAIDs, was collected quarterly; 1,256 of

Avoiding too much sun exposure remains the best way to prevent skin cancer.

the subjects (about 70% of the total) reported NSAID use at least once. So the team decided to look at the data again to see if NSAIDs conferred any protection against a recurrence of BCC/SCC. But after controlling for assorted variables, there was only a "modest, insignificant reduction" in BCC/SCC among the subjects who reported taking NSAIDs.

The strength of the new analysis, say the authors, despite its equivocal finding, is that it was "the first to address the association between the use of aspirin

and other NSAIDs and the risk of non- melanoma skin cancer in a closely monitored cohort of high-risk patients."

Unfortunately, the original aim of the study—to see if betacarotene was effective at preventing skin cancer—did not prove out either. That means that "avoiding excessive exposure to the sun remains the most effective way to prevent skin cancer," concludes Baron. The conundrum, he adds wryly, is that sunlight delivers vitamin D, which is a known cancer preventative.

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