Melanoma is one of the most aggressive and dangerous types of skin cancer. Although it is not the most common, it is responsible for the majority of skin cancer deaths due to its ability to grow rapidly and spread to other organs. In recent years, scientists have tried to identify factors that could prevent its appearance or reduce its aggressiveness. Among these possibilities, a surprising medication has begun to draw attention: aspirin. A recent study published in Archives of Dermatological Research by Pulumati and collaborators (2024), rigorously evaluated whether aspirin could be associated with a lower risk of developing melanoma.
Aspirin, or acetylsalicylic acid, is one of the most widely used drugs in the world. It is commonly used to relieve pain, reduce inflammation, and prevent cardiovascular events. However, for years it has been observed that it may have beneficial effects in certain types of cancer, particularly colorectal cancer. These observations led researchers to ask whether this low-cost, easily accessible medication could also help reduce the risk of developing melanoma.
To answer this question, Chong and his team conducted a systematic review of all available literature, followed by a meta-analysis to obtain global and reliable conclusions. The researchers compiled studies published up to 2023 that evaluated the use of aspirin and the subsequent incidence of melanoma. In total, they analyzed data from hundreds of thousands of people from prospective studies, cohorts, case-control studies, and population databases from the United States and Europe. This allowed them to integrate information on the frequency of aspirin use, dosage, duration of treatment, age and sex of participants, and reported incidence of melanoma. Subsequently, the team applied rigorous statistical methods to determine whether there was truly an association between aspirin use and a lower risk of melanoma.
The results of the meta-analysis were particularly interesting, there is a possible association between regular aspirin use and a lower risk of melanoma, especially in women. The included studies showed that women who used aspirin had a significantly lower risk of developing melanoma compared to those who did not. In men, however, the effect did not appear to be as strong, which could be due to biological, hormonal, or behavioral differences. The protective effect also appeared to be more evident in people who used aspirin for a prolonged period, generally five years or more. Although the results were not completely consistent across all studies, the overall trend suggests a potential preventive benefit.
However, how could a medication as old and common as aspirin exert this possible protective effect?
Researchers do not have a definitive answer, but several biologically plausible explanations have been proposed. One of them relates to chronic inflammation. Aspirin acts by inhibiting the COX-1 and COX-2 enzymes, which participate in the production of prostaglandins—molecules that promote inflammation. Although inflammation is a normal response of the body, when it is persistent it can promote DNA changes, increase oxidative stress, and alter the cellular microenvironment, creating conditions that facilitate the development of cancer. By reducing this inflammation, aspirin could help skin cells be less exposed to pro-tumor signals.
Another possible explanation has to do with sun exposure. Ultraviolet (UV) light directly damages DNA and generates free radicals—highly reactive molecules that stress cells and hinder proper DNA repair. This accumulated damage is one of the main triggers of melanoma. Some studies suggest that aspirin could reduce the inflammatory response induced by UV radiation and lessen the impact of this oxidative damage. Although it does not replace sunscreen, aspirin could act as an additional modulator against the consequences of UV light on the skin.
Finally, researchers propose a third mechanism related to the action of platelets. In addition to their role in blood clotting, platelets can “protect” incipient tumor cells by forming a kind of shield that makes it more difficult for the immune system to detect them. Aspirin, by inhibiting platelet activation, could prevent this effect and allow immune cells to identify and eliminate abnormal cells more easily before they develop into melanoma. This theory is consistent with previous studies linking aspirin to benefits in other types of cancer.
Figure 1. potential ways aspirin may help create a skin environment less favorable for malignant transformation, including lowering harmful inflammation, reducing UV-related cellular stress, and supporting immune recognition of abnormal cells.
Despite these promising findings, the study’s authors warn that it is still not appropriate to recommend the use of aspirin exclusively to prevent melanoma. More studies (especially controlled clinical trials) are needed to confirm these effects and determine appropriate doses, treatment duration, and possible differences between population groups. Additionally, it is important to remember that aspirin is not without risks. Prolonged use can cause adverse effects such as gastrointestinal bleeding, ulcers, or internal hemorrhages. For this reason, its use should never be initiated for preventive purposes without the supervision of a healthcare professional.
Beyond its immediate conclusions, the study by Chong et al. represents an important step forward in understanding melanoma prevention. Its results suggest that a common medication could have additional benefits in cancer prevention. This could, in the future, make it possible to identify specific groups of people who may benefit from preventive aspirin use. Moreover, the study reinforces the relevance of inflammation as a central factor in the development of melanoma and opens new research paths regarding the use of anti-inflammatory drugs in skin cancer prevention.
However, it is essential to remember that melanoma prevention remains largely in our own hands. The most effective strategies remain the same: wearing sunscreen daily, avoiding tanning beds, reducing sun exposure between 10 a.m. and 4 p.m., monitoring changes in moles, and visiting a dermatologist regularly. Aspirin could be a complement in the future, but it does not replace traditional sun protection measures or medical monitoring.
In conclusion, the study conducted by Chong and collaborators in 2024 provides initial but promising evidence that aspirin may be associated with a lower risk of melanoma, particularly in women. Although it is still too early to recommend its widespread use as a preventive measure, this research opens an interesting path in the fight against one of the most aggressive skin cancers. As science continues to advance, prevention, education, and vigilance remain our main tools to reduce melanoma incidence and improve population health.
Main reference:
Pulumati, A., Algarin, Y. A., Jaalouk, D., Kim, S., Latta, S., & Nouri, K. (2024). Aspirin as a chemopreventive agent for cutaneous melanoma: A literature review. Archives of Dermatological Research, 316, 367. https://doi.org/10.1007/s00403-024-03056-3
Other references:
Rothwell, P. M., Wilson, M., Elwin, C. E., Norrving, B., Algra, A., Warlow, C. P., & Meade, T. W. (2010). Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet (London, England), 376(9754), 1741–1750. https://doi.org/10.1016/S0140-6736(10)61543-7
Tian, W., Zhao, Y., Liu, S., & Li, X. (2010). Meta-analysis on the relationship between nonsteroidal anti-inflammatory drug use and gastric cancer. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP), 19(4), 288–298. https://doi.org/10.1097/CEJ.0b013e328339648c
Bordeaux, J. S., Lu, K. Q., & Cooper, K. D. (2007). Melanoma: prevention and early detection. Seminars in oncology, 34(6), 460–466. https://doi.org/10.1053/j.seminoncol.2007.09.012
