Aspirin and NSAID Use Reduce Risk of Invasive Epithelial Ovarian Cancer
In a study reported in Journal of the National Cancer Institute, Trabert et al in the Ovarian Cancer Association Consortium found that aspirin use and high-dose nonsteroidal anti-inflammatory drug (NSAID) use were associated with significant reductions in risk for ovarian cancer, with the greatest magnitude of risk reduction occurring with daily low-dose aspirin use.
Study Details
The study involved analysis of pooled data from 12 population-based case-control studies of ovarian cancer, including 7,776 case patients and 11,843 control subjects accrued between 1992 and 2007. Odds ratios (ORs) for associations of aspirin, nonaspirin NSAIDs, and acetaminophen use with invasive epithelial ovarian cancer were estimated in individual studies using logistic regression and combined using random effects meta-analysis. The multivariate logistic regression model adjusted for age, race, body mass index, oral contraceptive use, parity, menopausal status, and family history of breast or ovarian cancer in a first-degree relative.
Regular medication use was defined as use at least once per week. Overall, 18% of the study population reported regular use of aspirin, 24% reported regular use of nonaspirin NSAIDs, and 16% reported regular use of acetaminophen.
Aspirin Use
Regular vs nonregular aspirin use was associated with a significantly reduced risk of ovarian cancer (OR = 0.91, 95% confidence interval [CI] = 0.84–0.99). Daily aspirin use was associated with significantly reduced risk vs no regular use in the seven studies reporting frequency of use (OR = 0.80, 95% CI = 0.67–0.96), as was daily low-dose (< 100 mg/d) aspirin use in the three studies reporting dose (OR = 0.66, 95% CI = 0.53–0.83).
In analysis by combined categories of frequency and dose, both low-dose daily use (OR = 0.64, 95% CI = 0.50–0.81) and high-dose daily use (OR = 0.78, 95% CI = 0.62–0.97) significantly reduced cancer risk. Regular aspirin use was associated with reduced risk of serous, endometrioid, and mucinous ovarian cancers, but the effect was statistically significant only for serous cancer (OR = 0.89, 95% CI = 0.80–0.99).
NSAID Use
Overall, neither regular nonaspirin NSAID use (OR = 0.90, 95% CI = 0.77–1.05) nor daily use (OR = 0.97, 95% CI = 0.83–1.12) was associated with a significant reduction in risk. However, among the three studies that reported dose, high-dose regular NSAID use (≥ 500 mg/d) was associated with a significant risk reduction (OR = 0.76, 95% CI = 0.64–0.91). In analysis of combined categories of frequency and dose, daily high-dose use was associated with significantly reduced risk (OR = 0.75, 95% CI = 0.60–0.94).The association between NSAID use and risk was strongest for serous cancers but was not significant for any cancer subtype.
Acetaminophen Use
Overall, acetaminophen use was not associated with ovarian cancer risk (OR = 0.99, 95% CI = 0.88–1.12) and no associations were observed according to dose, duration, or frequency or according to cancer subtypes.
The investigators concluded, “Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin. These findings suggest that the same aspirin regimen proven to protect against cardiovascular events and several cancers could reduce the risk of ovarian cancer 20% to 34% depending on frequency and dose of use.”
Britton Trabert, PhD, of the National Cancer Institute, is the corresponding author for the Journal of the National Cancer Institute article.
The study was supported in part by the Intramural Research Program of the National Institutes of Health.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
