Chemoprevention of Keratinocyte Cancers: Could Aspirin Be the Solution?

Keratinocyte cancer burden is escalating, particularly in older Australian adults, where the incidence was > 6,000/100,000 in persons aged 80 to 84 per year, compared with 26/100,000 in persons aged 20 to 24 per year, in Queensland between 2011 to 2014. Keratinocyte cancers are estimated to account for 25% of all cancer-related hospitalisations and > $1 billion in treatment costs per year in Australlia. This undoubtedly leads to a large strain on the medical system, as well as amplifying patient morbidity and mortality. Those who are immunosuppressed, or with haematological malignancy or a solid organ transplant, are typically at highest risk of developing a keratinocyte cancer; however, older adults, and especially UV exposed Caucasian populations are increasingly requiring treatment for several keratinocyte cancers every year. This has resulted in an acute, urgent need for efficacious, tolerable, safe chemoprevention agents that could decrease keratinocyte cancer burden. Aspirin has been investigated as a chemopreventive agent for many years in other cancers. In this narrative review, the role for aspirin in the chemoprevention of keratinocyte cancers is discussed.