Effect of non-steroidal anti-inflammatory drugs on the histology of basal cell carcinomas.

Background: Aggressive histology is not rare in BCC. Large studies from referral centers report incidences of aggressive histology BCC ranging from 2.5- 44%. These aggressive BCC are characterized by subclinical extension, invasive behavior, local recurrence and challenging treatment.
Objectives: To examine the association between non-steroidal anti-inflammatory drug (NSAID) use and the different histological subtypes of basal cell carcinoma (BCC).
Methods: The design was a nested case-control study. The two population-based cohorts were of patients with a primary BCC diagnosis during January and May 2010 (n=136) and NSAID use in the 15 years prior to baseline. All the lesions were excised and analyzed to determinate the histological subtype of BCC as aggressive or non-aggressive. Odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression, were calculated with the SPSS software to estimate the association of aggressive histological subtypes of BCC and use of NSAID. We controlled the potential confounding factors.
Results: The rate of non-aggressive BCC associated with exposure to NSAID was increased (OD: 0.34; 95% CI: 0.14-0.84) after adjusting for covariants.
Limitations: our sample is small. We collected data regarding use of NSAID over a wide time ranges, so that we are unable to propose when the potential benefits of NSAID on the histology of BCC would happen.
Conclusion: According to our data, NSAID exposure is associated with a decreased risk of aggressive BCC.