Abstract 3491: COX-2 inhibitor use and risk of skin cancer: three prospective cohort studies

Abstract

Abstract Skin cancer is the most commonly diagnosed type of cancer, with continually rising incidence rates. Cyclooxygenase-2 (COX-2) inhibitor use has been associated with lower risk of several cancers, though epidemiological studies on skin cancer risk have been limited and inconclusive. To evaluate whether COX-2 inhibitor use is associated with decreased risk of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma, we analyzed COX-2 inhibitor use and risk of skin cancer based on three prospective cohorts–the Nurses' Health Study (NHS, 2000-2012), NHS II (2001-2011), and the Health Professionals Follow-up Study (HPFS, 2002-2012). COX-2 inhibitor use and duration were assessed by biennial questionnaires, with cSCC and melanoma cases verified by pathological records. Over 1.54 million person-years of follow-up, 16,098 BCC, 1,973 cSCC, and 625 invasive melanoma cases were documented. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of COX-2 inhibitor use with risk of BCC, cSCC, and melanoma were estimated using Cox proportional hazards models. We pooled the results between the three cohorts using a fixed effects model. For ever vs. never users, COX-2 inhibitor use was associated with a modestly increased risk of BCC (multivariable HR 1.10, 95% CI 1.06–1.15) and cSCC (multivariable HR 1.12, 95% CI 1.00–1.27). The effect estimate was similar for melanoma, but was non-significant (multivariable HR 1.10, 95% CI 0.89–1.38). In conclusion, COX-2 inhibitor use was not associated with decreased skin cancer risk and instead was associated with modestly increased risk of BCC and cSCC. Further investigation is necessary to replicate these results. Citation Format: Hsuan Yen, Hsi Yen, Aaron Drucker, Jiali Han, Wen-Qing Li, Tricia Li, Abrar Qureshi, Eunyoung Cho. COX-2 inhibitor use and risk of skin cancer: three prospective cohort studies [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3491.