Overview

• Analyzing 33,822 VA patients, nicotinamide use at 500 mg twice daily for more than 30 days was associated with a 14% overall reduction in subsequent skin cancers.
• When started after a patient’s first skin cancer, the observed risk reduction rose to 54%, with diminishing benefit when initiated after later cancers.
• Risk reduction was seen across cancer types, with the strongest association for cutaneous squamous cell carcinoma.
• Among solid organ transplant recipients, no overall benefit was detected, though early use was linked to fewer cutaneous squamous cell carcinomas.
• Nicotinamide, a vitamin B3 derivative available over the counter and on the VA formulary, is described by authors and experts as a promising, accessible chemoprevention candidate pending prospective validation.