Federman

Green

Minami

Nijsten

Ramirez

Robert S. Kirsner

Susan Bard

Bard, Susan

Kirsner, Robert S.

Elsevier - Publisher Connector 

journal club
1394 Journal of Investigative Dermatology (2011), Volume 131 © 2011 The Society for Investigative Dermatology
For the article: http://dx.doi.org/10.1038/jid.2011.58
QUESTIONS
1. How might nonsteroidal anti-inflammatory drugs inhibit the development of skin cancer?
2. How did the investigators carry out their study?
3. What were the results and conclusions?
4. What are the clinical implications?
Melanoma is the deadliest of the common skin cancers. Unfortunately, 
the incidence of this type of malignancy continues to rise, and treat-
ment options for advanced melanoma remain limited (Federman et 
al., 2009). Therefore, prevention remains the best way to avoid the 
morbidity and mortality associated with melanoma. Recently, follow-
up data from a trial evaluating daily sunscreen use indicated that such 
use reduced the incidence of melanoma (Green et al., 2011); interest-
ingly, however, it was also found that individuals regularly ask what 
else they can do to reduce their risk of melanoma.
Experimental and clinical data suggest the potential of inhibiting 
cyclooxygenase (COX), the rate-limiting enzyme for the production 
of prostaglandins from arachidonic acid. Specifically, the inducible 
enzyme COX-2 is markedly overexpressed at sites of inflammation 
and neoplasia, including melanoma (Minami et al., 2011). Over the 
past several years, observational studies have suggested that regular 
use of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce 
melanoma development and progression (Ramirez et al., 2005).
To further evaluate chemoprevention for melanoma, Curiel-Lewandrowski and colleagues (2011, this issue) used 
a case–control design to evaluate the effects of NSAIDs and lipid-lowering statins on the incidence of cutaneous 
melanoma in a population of 400 patients recently diagnosed with melanoma as well as 600 case-matched controls. 
Although the investigators reported no benefit in cutaneous melanoma risk with statin use, they determined that 
long-term use of NSAIDs decreased the likelihood of developing melanoma by nearly 50%. A similar reduction in 
risk was found for the use of aspirin. This work offers insight into other strategies that patients can use to reduce their 
chances of developing melanoma. A better understanding of this association is critical to direct patient care. Through 
the following questions, we examine this paper in greater detail. For brief answers, please refer to the supplementary 
information online <http://www.nature.com/jid/journal/v131/n7/suppinfo/jid2011154s1.html>.
RefeRences
curiel-lewandrowski c, nijsten T, Gomez Ml et al. (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 131:1460–8
Federman DG, Concato J, Kirsner RS (2009) Screening for skin cancer: absence of evidence. Arch Dermatol 145:926–7
Green AC, Williams GM, Logan V et al. (2011) Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 29:257–63
Minami S, Lum CA, Kitagawa KM et al. (2011) Immunohistochemical expression of cyclooxygenage-2 in melanocytic skin lesions. Int J Dermatol 
50:24–9
Ramirez CC, Ma F, Federman DG et al. (2005) Use of cyclooxygenase inhibitors and risk of melanoma in high-risk patients. Dermatol Surg 31:748–52
Do nonsteroidal Anti-Inflammatory Drugs  
Prevent Melanoma?
Susan Bard1 and Robert S. Kirsner1
Journal of Investigative Dermatology (2011) 131, 1394. doi:10.1038/jid.2011.154
1Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Do Nonsteroidal Anti-Inflammatory Drugs Prevent Melanoma? 

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Journal of Investigative Dermatology

Do Nonsteroidal Anti-Inflammatory Drugs Prevent Melanoma?

Bard, Susan

Kirsner, Robert S

University of Miami: Scholarship Miami

Do nonsteroidal anti-inflammatory drugs prevent melanoma?

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Do Nonsteroidal Anti-Inflammatory Drugs Prevent Melanoma?

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