Skin cancer associated with commonly prescribed drugs: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and statins -weighing the evidence

ABSTRACT

Introduction: Skin cancers, including both malignant melanoma (MM) and nonmelanoma skin cancer (NMSC), are the most commonly diagnosed cancers in the US. The incidence of both MM and NMSC continues to rise.

Areas covered: Current evidence for an association between four of the most commonly prescribed classes of drugs in the U.S. and risk for MM and NMSC is reported. Medline was searched (January 2000 to May 2017) for each drug in the classes and for ‘basal cell carcinoma’, ‘squamous cell carcinoma’, ‘non-melanoma skin cancer’, ‘skin cancer’ and ‘melanoma’. Skin cancer risk information was reported for: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)-reductase inhibitors (statins).

Expert opinion: Since skin cancer risk is associated with all four classes of these commonly prescribed drugs that represent nearly 20% of the Top 100 drugs in the U.S., these important findings warrant enhanced education, especially for prescribers and those patients at high risk for skin cancer.

KEYWORDS:

• Tumor necrosis factor alpha inhibitors
• angiotensin-receptor blockers
• phosphodiesterase type 5 inhibitors
• HMG-CoA-reductase inhibitors
• statins
• basal cell carcinoma
• squamous cell carcinoma
• non-melanoma skin cancer
• skin cancer
• melanoma

Article highlights

• Skin cancers, including both malignant melanoma (MM) and nonmelanoma skin cancer (NMSC), among the most commonly diagnosed cancers in the US, may occur with exposure to some of the most commonly prescribed drugs.

• Well-known risk factors for MM and NMSC have been validated, while skin cancer risk associated with drug exposure has not been well-delineated.

• Concerns have been raised about skin cancer risks subsequent to exposure to commonly prescribed drugs.

• This review of four classes of commonly prescribed drugs in the U.S. finds that skin cancer risk is associated with all four classes of drugs.

• These findings warrant enhanced education, especially for prescribers and those patients at high risk for skin cancer.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper has not been funded.