Trabert, Britton2; Ness, Roberta B2; Lo-Ciganic, Wei-Hsuan2; Murphy, Megan A2; Goode, Ellen L2; Poole, Elizabeth M2; Brinton, Louise A2; Webb, Penelope M2; Nagle, Christina M2; Jordan, Susan J2; Risch, Harvey A2; Rossing, Mary Anne2; Doherty, Jennifer A2; Goodman, Marc T2; Lurie, Galina2; Kjær, Susanne K2; Hogdall, Estrid1; Jensen, Allan2; Cramer, Daniel W2; Terry, Kathryn L2; Vitonis, Allison2; Bandera, Elisa V2; Olson, Sara2; King, Melony G2; Chandran, Urmila2; Anton-Culver, Hoda2; Ziogas, Argyrios2; Menon, Usha2; Gayther, Simon A2; Ramus, Susan J2; Gentry-Maharaj, Aleksandra2; Wu, Anna H2; Pearce, Celeste Leigh2; Pike, Malcolm C2; Berchuck, Andrew2; Schildkraut, Joellen M2; Wentzensen, Nicolas2
1 Pathology, Herlev and Gentofte Hospital, The Capital Region of Denmark2 unknown
a pooled analysis in the Ovarian Cancer Association Consortium
BACKGROUND: Regular aspirin use is associated with reduced risk of several malignancies. Epidemiologic studies analyzing aspirin, nonaspirin nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen use and ovarian cancer risk have been inconclusive. METHODS: We analyzed pooled data from 12 population-based case-control studies of ovarian cancer, including 7776 case patients and 11843 control subjects accrued between 1992 and 2007. Odds ratios (ORs) for associations of medication use with invasive epithelial ovarian cancer were estimated in individual studies using logistic regression and combined using random effects meta-analysis. Associations between frequency, dose, and duration of analgesic use and risk of ovarian cancer were also assessed. All statistical tests were two-sided. RESULTS: Aspirin use was associated with a reduced risk of ovarian cancer (OR = 0.91; 95% confidence interval [CI] = 0.84 to 0.99). Results were similar but not statistically significant for nonaspirin NSAIDs, and there was no association with acetaminophen. In seven studies with frequency data, the reduced risk was strongest among daily aspirin users (OR = 0.80; 95% CI = 0.67 to 0.96). In three studies with dose information, the reduced risk was strongest among users of low dose (<100 mg) aspirin (OR = 0.66; 95% CI = 0.53 to 0.83), whereas for nonaspirin NSAIDs, the reduced risk was strongest for high dose (≥500 mg) usage (OR = 0.76; 95% CI = 0.64 to 0.91). CONCLUSIONS: 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.
National Cancer Institute. Journal (print), 2014, Vol 106, Issue 2
Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Acetaminophen; Anti-Inflammatory Agents, Non-Steroidal; Anticarcinogenic Agents; Aspirin; Australia; Case-Control Studies; Data Collection; Denmark; Drug Administration Schedule; Female; Great Britain; Humans; Incidence; Logistic Models; Neoplasms, Glandular and Epithelial; Odds Ratio; Ovarian Neoplasms; Protective Agents; Risk; United States