Celecoxib for skin cancer prevention
Celecoxib 200 mg twice daily vs. Placebo · for Nonmelanoma skin cancer (high-risk, actinic damage) · real-time analysis of 1 studies · updated 2026-05-29
In a small trial of patients with extensive actinic keratoses, the COX-2 inhibitor celecoxib roughly halved new nonmelanoma skin cancers, including both squamous- and basal-cell carcinomas—but cardiovascular safety concerns limit its use as a preventive.
Efficacy (RCT): Efficacy evidence on clinical outcomes. Effects are risk ratios with number-needed-to-treat where a baseline risk is available. Glossary →
Roughly halved skin cancers in high-risk patients, so NNTs are low. The limit is safety, not efficacy: COX-2 inhibitors carry cardiovascular risk, and this was a small, short trial—so celecoxib is not used routinely for prevention.
Forest plot—Nonmelanoma skin cancer
Study results—Nonmelanoma skin cancer
| Study | Design | Dose / regimen | Treatment | Control | RR [95% CI] | Improvement | NNT | Weight |
|---|---|---|---|---|---|---|---|---|
| Elmets 2010 note | DB-RCT | Celecoxib 200 mg BID | — | — | 0.43 [0.24–0.75] | 57% | 6 | 100% |
RR < 1 favors treatment for outcomes where lower is better. Rows in gray have a confidence interval crossing 1 (individually inconclusive). “~” marks effects reported as OR/HR and treated as RR-approximations. “excl” = excluded from pooling (e.g. reviews).
Notes & interpretation
- Elmets 2010—Nonmelanoma skin cancer rate ratio (P=0.003).
Forest plot—Squamous-cell carcinoma
Study results—Squamous-cell carcinoma
| Study | Design | Dose / regimen | Treatment | Control | RR [95% CI] | Improvement | NNT | Weight |
|---|---|---|---|---|---|---|---|---|
| Elmets 2010 note | DB-RCT | Celecoxib 200 mg BID | — | — | 0.42 [0.19–0.92] | 58% | 10 | 100% |
RR < 1 favors treatment for outcomes where lower is better. Rows in gray have a confidence interval crossing 1 (individually inconclusive). “~” marks effects reported as OR/HR and treated as RR-approximations. “excl” = excluded from pooling (e.g. reviews).
Notes & interpretation
- Elmets 2010—Squamous-cell carcinoma (P=0.03).
Forest plot—Basal-cell carcinoma
Study results—Basal-cell carcinoma
| Study | Design | Dose / regimen | Treatment | Control | RR [95% CI] | Improvement | NNT | Weight |
|---|---|---|---|---|---|---|---|---|
| Elmets 2010 note | DB-RCT | Celecoxib 200 mg BID | — | — | 0.44 [0.19–0.99] | 56% | 12 | 100% |
RR < 1 favors treatment for outcomes where lower is better. Rows in gray have a confidence interval crossing 1 (individually inconclusive). “~” marks effects reported as OR/HR and treated as RR-approximations. “excl” = excluded from pooling (e.g. reviews).
Notes & interpretation
- Elmets 2010—Basal-cell carcinoma (P=0.049).
Background
A randomized, double-blind, placebo-controlled trial of 240 patients with actinic keratoses treated celecoxib 200 mg twice daily for 9 months, with skin cancers counted at 11 months.
Topic methodology & caveats
Studies
- 2010 · DB-RCT Elmets CA, Viner JL, Pentland AP, et al. Chemoprevention of nonmelanoma skin cancer with celecoxib: a randomized, double-blind, placebo-controlled trial. J Natl Cancer Inst. 2010;102:1835-1844.
- 2010 · DB-RCT Elmets CA, Viner JL, Pentland AP, et al. Chemoprevention of nonmelanoma skin cancer with celecoxib: a randomized, double-blind, placebo-controlled trial. J Natl Cancer Inst. 2010;102:1835-1844.
- 2010 · DB-RCT Elmets CA, Viner JL, Pentland AP, et al. Chemoprevention of nonmelanoma skin cancer with celecoxib: a randomized, double-blind, placebo-controlled trial. J Natl Cancer Inst. 2010;102:1835-1844.