Date Published: 6 February 2014

USA study finds regular aspirin use may reduce ovarian cancer risk

According to a recent study at the United States' by scientists at the National Cancer Institute (NCI), women who take aspirin daily may reduce their risk of ovarian cancer by 20%. However, the researchers make clear that further research is needed before clinical recommendations can be made.

It has been estimated that over 20,000 women in the United States will be diagnosed with ovarian cancer in 2014, and that more than 14,000 will die from the disease. Although early stage ovarian cancer can be successfully treated, symptoms associated with this disease can mimic other more common conditions, such as digestive and bladder disorders, which can result in delayed diagnosed. There are limited treatment options available for late stage ovarian cancer, which often has poor prognoses. Preventive strategies are therefore particularly important for controlling this ovarian cancer.

Chronic or persistent inflammation has been shown to increase the risk of cancer and other diseases. Previous studies have suggested that the anti-inflammatory properties of aspirin and non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs), may reduce cancer risk overall (for more see also aspirin in the news). However, studies examining whether or not the use of these agents may influence ovarian cancer risk have been largely inconclusive. The recent study is the largest study to date to assess the relationship between these drugs and ovarian cancer risk.

Britton Trabert, Ph.D., and Nicolas Wentzensen, M.D., Ph.D., of NCI's Division of Cancer Epidemiology and Genetics, and their colleagues, analyzed data pooled from 12 large epidemiological studies to investigate whether women who used aspirin, non-aspirin NSAIDs, or acetaminophen have a lower risk of ovarian cancer. These 12 studies (nine from the United States) were part of the Ovarian Cancer Association Consortium. The scientists evaluated the benefit of these drugs in nearly 8,000 women with ovarian cancer and close to 12,000 women who did not have the disease.

Among study participants who reported whether or not they used aspirin regularly:

• 18% used aspirin,
• 24% used non-aspirin NSAIDs, and
• 16 % used acetaminophen.

The researchers determined that participants who reported daily aspirin use had a 20% lower risk of ovarian cancer than those who used aspirin less than once per week. For non-aspirin NSAIDs, which include a wide variety of drugs, the the scientists observed a 10% lower ovarian cancer risk among women who used NSAIDs at least once per week compared with those who used NSAIDs less frequently. However, this finding did not fall in a range that was significant statistically. In contrast to the findings for aspirin and NSAIDs, use of acetaminophen, which is not an anti-inflammatory agent, was not associated with reduced ovarian cancer risk.

This study adds to a growing list of malignancies, such as colorectal (i.e. colon cancer and rectal cancer) and other cancers, that appear to be potentially preventable by the use of aspirin.

" Our study suggests that aspirin regimens, proven to protect against heart attack, may reduce the risk of ovarian cancer as well. However intriguing our results are, they should not influence current clinical practice. Additional studies are needed to explore the delicate balance of risk-benefit for this potential chemopreventive agent, as well as studies to identify the mechanism by which aspirin may reduce ovarian cancer risk," said Trabert.

However, adverse side effects of daily aspirin use include upper gastrointestinal bleeding and hemorrhagic stroke. Due to the risk of such adverse side-effects, the researchers caution that a daily aspirin regimen should only be undertaken with the approval of an appropriate medical practitioner.

Ref. to Paper:
B Trabert, et al. "Aspirin, non-aspirin NSAID, and acetaminophen use and risk of invasive epithelial ovarian cancer: a pooled analysis in the Ovarian Cancer Association Consortium", JNCI . 6 Feb 2014. DOI: 10.1093/jnci/djt431

About NIH:
The National Institutes of Health (NIH), the United States' medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov - statement understood to be correct as of publication date.

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