Date of Award

12-12-2023

Document Type

Dissertation

Degree Name

Doctor of Medical Science (DMSc)

Department

Department of Physician Assistant Medicine

First Advisor

Nicolas Fortes, MPH

Second Advisor

Heather Rollins, DMSc, PA-C

Abstract

The contents of this article are the author’s original unpublished findings.

Background: Each year, approximately 6 million Americans are treated for skin cancer, resulting in a total annual medical expense of $8.9 billion 1. The two most common types of skin cancer are basal cell carcinoma (BCC) followed by squamous cell carcinoma (SCC)2. The metastatic potential of these cancers is minimal; however, their treatment may involve severe scarring and disfigurement2. In contrast, melanoma is an aggressive skin malignancy that grows rapidly and can metastasize in a quick manner2. Risk factors of these skin cancers include UV exposure, fair skin complexions, and family history2. To prevent skin cancer, emphasis is placed on sun protection; however, this approach is suboptimal within the population. To combat this, alternatives such as niacinamide, a form of vitamin B3, may be used to reduce the risk of skin malignancies.

Objectives: To evaluate the mechanisms and effects of oral niacinamide in the risk reduction of skin cancers among individuals with a history of sun exposure.

Methods: A review was conducted by gathering randomized controlled trials and systematic reviews utilizing databases such as ScienceDirect, PubMed, Wiley Online Library, and SpringerLink. Research articles included in this paper have been published within the last eleven years and are inclusive of all races.

Results: Niacinamide was associated with a significant reduction in the occurrence of BCCs and SCCs. However, concerning melanoma, its preventive effects were solely investigated through in vitro and in vivo studies. The lack of clinical trials makes it challenging to evaluate its effectiveness for melanoma.

Conclusion: The research presented found compelling evidence supporting the potential of niacinamide in reducing the incidence of nonmelanoma skin cancers, particularly basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Such results yield to the significance of larger clinical trials aimed at replicating the results obtained from the ONTRAC trial regarding SCCs and BCCs. Despite promising outcomes against nonmelanoma skin cancers, the evidence regarding niacinamide's efficacy in preventing melanoma remains inconclusive. While in vitro and in vivo studies suggest positive effects on melanoma cells, the lack of robust clinical trials specifically evaluating niacinamide's impact on melanoma prevention necessitates further investigation.

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