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
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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.
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Successful, field-altering risk-factor and subphenotype investigations among many centers have been demonstrated by large consortia across an array of health outcomes.
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- Authors
- Trabert, B., Ness, R. B., Lo-Ciganic, W.-H., Murphy, M. A., Goode, E. L., Poole, E. M., Brinton, L. A., Webb, P. M., Nagle, C. M., Jordan, S. J., Australian Ovarian Cancer Study Group, T. A. C. S. (. C., Risch, H. A., Rossing, M. A., Doherty, J. A., Goodman, M. T., Lurie, G., Kjaer, S. K., Hogdall, E., Jensen, A., Cramer, D. W., Terry, K. L., Vitonis, A., Bandera, E. V., Olson, S., King, M. G., Chandran, U., Anton-Culver, H., Ziogas, A., Menon, U., Gayther, S. A., Ramus, S. J., Gentry-Maharaj, A., Wu, A. H., Pearce, C. L., Pike, M. C., Berchuck, A., Schildkraut, J. M., Wentzensen, N., & on behalf of the Ovarian Cancer Association Consortium
- Affiliations
- University of Southern California (US)
- Division of Cancer Epidemiology and Genetics (US)
- ORCID
- Trabert, B.
- Murphy, M. A.
- Goode, E. L.
- Poole, E. M.
- Brinton, L. A.
- Webb, P. M.
- Nagle, C. M.
- Jordan, S. J.
- Risch, H. A.
- Doherty, J. A.
- Goodman, M. T.
- Jensen, A.
- Cramer, D. W.
- Terry, K. L.
- Bandera, E. V.
- Olson, S.
- Chandran, U.
- Ziogas, A.
- Menon, U.
- Gayther, S. A.
- Ramus, S. J.
- Wu, A. H.
- Pearce, C. L.
- Pike, M. C.
- Berchuck, A.
- Schildkraut, J. M.
- Wentzensen, N.
- Venue
- JNCI Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02-06
- Volume
- 106
- Issue
- 2
- Pages
- djt431-djt431
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- PMC
- PMC3924755
- OpenAlex
- W2156778593
- Cited by
- 243
- References
- 61
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 19 · 2023: 17 · 2022: 20 · 2021: 16 · 2020: 15 · 2019: 23 · 2018: 29 · 2017: 32 · 2016: 21 · 2015: 20 · 2014: 11 · 2013: 1
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JNCI Journal of the National Cancer Institute (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Ovarian Cancer Research Fund (P50-CA136393)
- Cancer Research UK
- National Institutes of Health (n01pc067010-004, n01cn025403-006, n01pc067001-013, 5r01ca083918-05, n01cn055424-010, CA136393)
- U.S. Public Health Service (PSA 042205)
- Medical Research Council
- National Health and Medical Research Council (199600, 400413)
- National Cancer Institute (P01CA017054, N01-PC-67010, K07CA095666, N01 PC67001, R01-CA14089, R01CA061107, N01 CN 55424, N01-CN-25403, R01CA112523, R03CA115195, R01-CA17054, K22CA138563, R01 CA83918, R01CA058860, R01CA076016, R01CA054419, R01 CA92044, P50CA105009, R01CA074850, R01CA058598, R01CA080742, R01CA061132, R03CA113148, R01CA087538, R01CA095023, R01CA122443, P30CA023108, P30CA015083, T32CA009001, P50CA136393)
- Topics
- Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- aspirin, paracetamol, invasive epithelial ovarian cancer, ovarian cancer risk, analgesic use, low-dose aspirin, chemoprevention
- MeSH terms
- Carcinoma, Ovarian Epithelial, Acetaminophen, Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Australia, Data Collection, Denmark, Drug Administration Schedule, Female, United Kingdom, Humans, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Risk, United States, Incidence, Logistic Models, Odds Ratio, Case-Control Studies, Anticarcinogenic Agents, Protective Agents
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