Aspirin Associated With Reduced Risk of Ovarian Cancer, Especially in Low Daily Doses

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“Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin,” according to an analysis of pooled individual data from the Ovarian Cancer Association Consortium. Analyzing data from 12 population-based case-control studies of ovarian cancer, with 7,776 case patients and 11,843 control subjects, researchers reported that their findings suggest “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.” The results were published in the Journal of the National Cancer Institute.

Regular aspirin use, defined as at least once a week, was reported by 18% of the study population, while 24% reported using nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) regularly and 16% reported using acetaminophen regularly. The 20% risk reduction occurred among daily users of aspirin and the 34% risk reduction among regular users of low-dose aspirin (< 100 mg/d).

“Aspirin use was associated with a reduced risk of ovarian cancer ([odds ratio (OR)] = 0.91; 95% confidence interval [CI] = 0.84 to 0.99),” reported Britton Trabert, PhD, and colleagues representing the National Cancer Institute and cancer centers in the United States, Europe, and Australia. “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).”

The authors acknowledged that “complications associated with aspirin use, including peptic ulcer, upper gastrointestinal bleeding, and hemorrhagic stroke, pose serious threats” and that “current risk–benefit analyses favor aspirin use among high-risk groups but not for large-scale, population-based chemoprevention.” The estimates this study provided on the effect of aspirin on ovarian cancer risk “should be considered in risk–benefit analyses for preventive aspirin use,” the researchers stated. “However, detailed questions about frequency, dose, and duration will need to be evaluated in future studies including pooled data from cohort studies.” ■

Trabert B, et al: J Natl Cancer Inst 106(2):djt431, 2014.