Aspirin, nonaspirin nonsteroidal anti-inflammatory drug, and acetaminophen use and risk of invasive epithelial ovarian cancer: a pooled analysis in the Ovarian Cancer Association Consortium. 

Overview

Aspirin prevents the development of some types of cancer, particularly of the colon and rectum. The authors examined the effects of different pain relief drugs on the risk of ovarian cancer. They compared whether taking aspirin, other non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen affected the risk of ovarian cancer.

Methodology

This study combined information on 19,619 participants from 12 previous studies on ovarian cancer. Each of these studies compared characteristics of ovarian cancer cases to selected control groups without ovarian cancer. By combining these past studies, the authors were able to compare 7,776 ovarian cancer cases to 11,843 control cases in terms of their self-reported regular use of aspirin, NSAIDs, and acetaminophen. The study also looked at different doses of medicines reported by participants and their risk of ovarian cancer.

Results

  • Aspirin use of at least once per month was linked to a 9% lower risk of ovarian cancer compared to non-users and those with less regular use. From a subset of 7 past studies with more precise information on the frequency of aspirin use, daily aspirin use was associated with a 20% lower risk of ovarian cancer compared to no regular use. Low-dose aspirin (< 100 mg) appeared to have greater benefits than higher doses.

  • The effect of aspirin was similar across different subtypes of ovarian cancer (serous, endometrioid, and mucinous).

  • Overall, reported regular use of other NSAIDs was associated with 10% less risk of ovarian cancer (although this finding could have been due to random chance). From a subset of three past studies with information on dosage there was a 24% reduction in ovarian cancer from high dose NSAIDs (≥ 500 mg) and a 4% reduction from lower dose NSAIDs compared to no regular use.

  • Acetaminophen did not appear to affect the risk of ovarian cancer.

  • Conclusions

    • Daily aspirin use appears to lower the risk of ovarian cancer. There appeared to be a greater effect of taking aspirin on a daily basis compared to less frequently. The type of studies being combined do not allow a clear judgment of whether another behavior linked to pain medicine consumption could be the actual cause of the reduced risk. Nonetheless, this study identifies ovarian cancer as another type of cancer where aspirin may have a preventive benefit.

    • Although NSAIDs appear to lower the risk of ovarian cancer, they are effective only when taken at higher doses (which may have greater side-effects).