Nicotinamide’s ability to protect against skin cancer has been strengthened by a large US study, with one local expert impressed by the results.
Taking a vitamin B3 supplement soon after developing skin cancer could reduce your risk of developing additional cancers, new research suggests.
Nicotinamide, a vitamin B derivative, has long been suspected to prevent the development of skin cancer.
Studies exploring this association have yielded mixed results due to issues with sample sizes and capturing prescriptions. Now, a new study published in JAMA Dermatology suggests that nicotinamide use is associated with a reduced risk of developing skin cancer.
“These results reinforce what many dermatologists have long suspected, nicotinamide is an underutilised, low-risk intervention that can make a difference in reducing skin cancer burden, especially for patients with an early history of disease,” said Associate Professor Yousuf Mohammed, a senior research fellow and research leader from the School of Pharmacy and Pharmaceutical Sciences at The University of Queensland.
US researchers undertook a retrospective cohort study of 33,822 veterans – 12,287 of whom had been exposed to 500mg nicotinamide twice a day for at least 30 days – to determine whether nicotinamide could prevent skin cancer.
Propensity score matching was used to pair exposed and unexposed veterans on factors such as the number of skin cancers each patient had, previous acitretin use and history of solid organ transplant or chronic lymphocytic leukaemia before comparing the time to the first skin cancer diagnosis.
Nicotinamide use was associated with a 14% reduction in the rate of new skin cancers compared to non-users (hazard ratio 0.86, 95% confidence interval 0.82-0.89).
There was a 22% reduction in the rate of new cutaneous squamous cell carcinomas in nicotinamide users compared to non-users (HR 0.78, 0.75-0.82), but there was no association between nicotinamide use and the rate of basal cell carcinomas (1.00, 0.96-1.05).
However, when all skin cancer diagnoses were considered, there was roughly a 50% decrease in the rate of new skin cancer diagnoses if patients started taking nicotinamide after being diagnosed with their first skin cancer.
“The benefit was greatest for cSCC, but also was seen for BCC when initiated after the first or second skin cancer,” the researchers noted.
Furthermore, patients with 30-90 or 91-364 days of nicotinamide use had lower rates of skin cancer compared to patients who had used nicotinamide for at least a year (0.81, 0.71-0.88 and 0.84, 0.80-0.89, respectively).
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Professor Mohammed said nicotinamide showed “real promise as a practical tool for skin cancer prevention”, particularly relating to the data for patients who began taking nicotinamide at a very early stage of their cancer journey.
“These findings highlight that timing matters; starting earlier may be the key to stronger protection,” he said in a statement.
The researchers felt the benefits of starting nicotinamide at an early stage came from its chemopreventative effects.
“While there is some evidence suggesting that nicotinamide could potentiate cancer growth and metastasis, our data did not support this concern,” they wrote.
Professor Mohammed said he believed the accessibility, safety and tolerability of nicotinamide would appeal to clinicians.
“Unlike systemic retinoids or invasive field therapies, nicotinamide is inexpensive, over-the-counter and free from significant side effects,” he said.
The findings of the study are potentially limited by the generalisability of the findings, with a vast majority of the included patients being white and male.
“However, this is a population that is at greater risk for skin cancer than the general population, so any risk reduction among this group would likely be similar to those with lesser baseline risks,” the researchers concluded.
