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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A causal relationship has been demonstrated between UV radiation and cutaneous squamous cell carcinoma &#40;SCC&#41; due to&#44; among other factors&#44; the induction of the cyclooxygenase 2 &#40;COX-2&#41; enzyme&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> which stimulates the production of prostaglandin E2&#44; which in turn promotes carcinogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> The same also occurs in other organs &#40;colon&#44; breast&#44; and prostate&#41; in association with various stimuli that induce COX-2&#44; and research has demonstrated the potential of nonsteroidal anti-inflammatory drugs &#40;NSAIDs&#41; to prevent carcinogenesis in those organs&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> The prevention of cutaneous SCC is of great importance because the incidence of this disease has continued to increase&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> Because COX-2 is overexpressed in cutaneous SCC&#44; NSAIDs are thought to be useful in preventing the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">On the basis of this evidence&#44; several epidemiologic studies are currently being carried out to determine the true utility of NSAID use in the prevention of nonmelanoma skin cancer&#44; with variable results&#46; Muranushi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> carried out a meta-analysis with the aim of unifying and evaluating all current evidence on the relationship between NSAID use and cutaneous SCC&#46; This study found&#44; with statistical significance&#44; that NSAID use reduces the risk of cutaneous SCC by 18&#37; and that the use of nonaspirin NSAIDs reduces the same risk by 15&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> The use of aspirin alone yielded similar percentages&#44; but with borderline statistical significance&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> The decrease in risk is thought to be caused by the inhibition of COX-2 activity in promoting cutaneous carcinogenesis&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The meta-analysis has multiple limitations&#44; including the heterogeneity of the NSAID dosage measurements &#40;which makes it impossible to analyze the relationship between dose and effect&#41; and the failure to consider the confounding effect of sun exposure&#46; Dosage is especially important in the study of aspirin because at low doses it would inhibit COX-1 and the preventive effect would be negligible but at high doses it would inhibit COX-2 and have an antitumor effect&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> In addition&#44; the study considered NSAIDs as a group&#44; despite the differences between their mechanisms of action&#44; which are quite probably related to their preventive effects&#46; The variability of the prevalence of NSAID use among the studies could reflect differences in the health status of the patients and&#44; therefore&#44; in their immune function&#46; Collecting data on NSAID use is complex because patient interviews lead to greater memory bias in sporadic users&#44; whereas prescription database searches do not detect people who use NSAIDs without a prescription&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The synthesis of the data published to date therefore provides evidence for a significant inverse association between oral NSAID use and the incidence of cutaneous SCC&#44; especially in patients with a high prevalence of actinic keratoses or a personal history of other keratinocytic tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> However&#44; further studies that consider other confounding factors besides sun exposure&#8212;such as type of NSAID&#44; dose&#44; reason for use&#44; etc&#46;&#8212;are needed&#46; Despite its limitations&#44; this study provides a basis for conducting further research into effective new lines of prevention&#46;</p></span>"
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Residents Forum
RF-Oral Nonsteroidal Anti-inflammatory Drug Use May Reduce the Risk of Cutaneous Squamous Cell Carcinoma
FR-El consumo oral de antiinflamatorios no esteroideos podría disminuir el riesgo de aparición de carcinoma espinocelular cutáneo
C. Bernárdez
Autor para correspondencia
, E. Macías del Toro, J.L. Ramírez Bellver, F. Feltes
Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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