Back to Search
Start Over
Tretinoin and the Prevention of Keratinocyte Carcinoma (Basal and Squamous Cell Carcinoma of the Skin): A Veterans Affairs Randomized Chemoprevention Trial
- Source :
- Journal of Investigative Dermatology. 132(6):1583-1590
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- Keratinocyte carcinoma (KC) is the most common cancer in the United States, with no proven means for prevention other than systemic retinoids, which have significant toxicity, and sunscreen. Topical tretinoin has been used for KC chemoprevention, although this use is unproven. Hence, we conducted the randomized Veterans Affairs Topical Tretinoin Chemoprevention Trial of high-dose topical tretinoin for KC prevention. We randomized 1,131 patients to topical 0.1% tretinoin or a matching vehicle control for 1.5-5.5 years. The primary outcomes were time to development of new basal cell carcinoma (BCC) and new invasive squamous cell carcinoma (SCC) on the face or ears. The effects were not significant (P=0.3 for BCC and P=0.4 for SCC). The proportions of the tretinoin and control groups who developed a BCC at 5 years were 53 and 54% and an invasive SCC at 5 years were 28 and 31%. These differences (95% confidence intervals) were: for BCC, 1.0% (-6.5, 8.6%); for SCC, 3.6% (-3.1, 10.3%). No differences were observed in any cancer-related end points or in actinic keratosis counts. The only quality of life difference was worse symptoms in the tretinoin group at 12 months after randomization. This trial in high-risk patients demonstrates that high-dose topical tretinoin is ineffective at reducing risk of KCs.
- Subjects :
- Keratinocytes
Male
medicine.medical_specialty
Skin Neoplasms
Randomization
Administration, Topical
Antineoplastic Agents
Tretinoin
Dermatology
Biochemistry
Basal (phylogenetics)
Risk Factors
medicine
Carcinoma
Humans
Basal cell carcinoma
Veterans Affairs
Molecular Biology
Aged
Quality of Health Care
Veterans
Aged, 80 and over
business.industry
Actinic keratosis
Cancer
Cell Biology
Middle Aged
medicine.disease
Carcinoma, Basal Cell
Carcinoma, Squamous Cell
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 0022202X
- Volume :
- 132
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of Investigative Dermatology
- Accession number :
- edsair.doi.dedup.....10f113ce52589fd6c2b4bf4298214ed3
- Full Text :
- https://doi.org/10.1038/jid.2011.483