TY - JOUR
T1 - Analgesic Use and Ovarian Cancer Risk
T2 - An Analysis in the Ovarian Cancer Cohort Consortium
AU - Trabert, Britton
AU - Poole, Elizabeth M.
AU - White, Emily
AU - Visvanathan, Kala
AU - Adami, Hans-Olov
AU - Anderson, Garnet L.
AU - Brasky, Theodore M.
AU - Brinton, Louise A.
AU - Fortner, Renee T.
AU - Gaudet, Mia
AU - Hartge, Patricia
AU - Hoffman-Bolton, Judith
AU - Jones, Michael
AU - Lacey, James V.
AU - Larsson, Susanna C.
AU - Mackenzie, Gerardo G.
AU - Schouten, Leo J.
AU - Sandler, Dale P.
AU - O'Brien, Katie
AU - Patel, Alpa V.
AU - Peters, Ulrike
AU - Prizment, Anna
AU - Robien, Kim
AU - Setiawan, V. Wendy
AU - Swerdlow, Anthony
AU - van den Brandt, Piet A.
AU - Weiderpass, Elisabete
AU - Wilkens, Lynne R.
AU - Wolk, Alicja
AU - Wentzensen, Nicolas
AU - Tworoger, Shelley S.
AU - Ovarian Cancer Cohort Consortium OC3
N1 - Funding Information:
This work was supported by Department of Defense Ovarian Cancer Research Program grant W81XWH-12-1-0561. The UKBGS thanks Breast Cancer Now and the Institute of Cancer Research (ICR) for support and funding. The ICR acknowledges National Health Service funding to the National Institute for Health Research Biomedical Research Centre. K05CA154337 from the National Cancer Institute (NCI) and Office of Dietary Supplements (VITAL); R01 CA39742 (Iowa Women's Health Study); research grants from the Swedish Research Council and Swedish Cancer Foundation (SMC, WLHS); UM1 CA164973 (Multiethnic Cohort Study [MEC]); NIH/NCI UM1 CA182876 (SCHS); UM1 CA186107, P01 CA87969, UM1 CA176726, R01 CA67262 (Nurses' Health Study, Nurses' Health Study II); and NIEHS Intramural Research Program (Project Z01-ES044005 to DPS). The Womens Health Initiative (WHI) program is funded by the National Heart, Lung, and Blood Institute, NIH/DHHS, through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. NCI Intramural Research Program.
Funding Information:
This work was supported by Department of Defense Ovarian Cancer Research Program grant W81XWH-12-1-0561. The UKBGS thanks Breast Cancer Now and the Institute of Cancer Research (ICR) for support and funding. The ICR acknowledges National Health Service funding to the National Institute for Health Research Biomedical Research Centre. K05CA154337 from the National Cancer Institute (NCI) and Office of Dietary Supplements (VITAL); R01 CA39742 (Iowa Women’s Health Study); research grants from the Swedish Research Council and Swedish Cancer Foundation (SMC, WLHS); UM1 CA164973 (Multiethnic Cohort Study [MEC]); NIH/NCI UM1 CA182876 (SCHS); UM1 CA186107, P01 CA87969, UM1 CA176726, R01 CA67262 (Nurses’ Health Study, Nurses’ Health Study II); and NIEHS Intramural Research Program (Project Z01-ES044005 to DPS). The Womens Health Initiative (WHI) program is funded by the National Heart, Lung, and Blood Institute, NIH/DHHS, through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. NCI Intramural Research Program.
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/2
Y1 - 2019/2
N2 - Background Aspirin use is associated with reduced risk of several cancers. A pooled analysis of 12 case-control studies showed a 10% decrease in ovarian cancer risk with regular aspirin use, which was stronger for daily and low-dose users. To prospectively investigate associations of analgesic use with ovarian cancer, we analyzed data from 13 studies in the Ovarian Cancer Cohort Consortium (OC3).Methods The current study included 758 829 women who at study enrollment self-reported analgesic use, among whom 3514 developed ovarian cancer. Using Cox regression, we assessed associations between frequent medication use and risk of ovarian cancer. Dose and duration were also evaluated. All statistical tests were two-sided.Results Women who used aspirin almost daily (6 days/wk) vs infrequent/nonuse experienced a 10% reduction in ovarian cancer risk (rate ratio [RR] = 0.90, 95% confidence interval [CI] = 0.82 to 1.00, P = .05). Frequent use (4 days/wk) of aspirin (RR = 0.95, 95% CI = 0.88 to 1.03), nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs; RR = 1.00, 95% CI = 0.90 to 1.11), or acetaminophen (RR = 1.05, 95% CI = 0.88 to 1.24) was not associated with risk. Daily acetaminophen use (RR = 1.28, 95% CI = 1.00 to 1.65, P = .05) was associated with elevated ovarian cancer risk. Risk estimates for frequent, long-term (10+ years) use of aspirin (RR = 1.15, 95% CI = 0.98 to 1.34) or nonaspirin NSAIDs (RR = 1.19, 95% CI = 0.84 to 1.68) were modestly elevated, although not statistically significantly so.Conclusions This large, prospective analysis suggests that women who use aspirin daily have a slightly lower risk of developing ovarian cancer (approximate to 10% lower than infrequent/nonuse)similar to the risk reduction observed in case-control analyses. The observed potential elevated risks for 10+ years of frequent aspirin and NSAID use require further study but could be due to confounding by medical indications for use or variation in drug dosing.
AB - Background Aspirin use is associated with reduced risk of several cancers. A pooled analysis of 12 case-control studies showed a 10% decrease in ovarian cancer risk with regular aspirin use, which was stronger for daily and low-dose users. To prospectively investigate associations of analgesic use with ovarian cancer, we analyzed data from 13 studies in the Ovarian Cancer Cohort Consortium (OC3).Methods The current study included 758 829 women who at study enrollment self-reported analgesic use, among whom 3514 developed ovarian cancer. Using Cox regression, we assessed associations between frequent medication use and risk of ovarian cancer. Dose and duration were also evaluated. All statistical tests were two-sided.Results Women who used aspirin almost daily (6 days/wk) vs infrequent/nonuse experienced a 10% reduction in ovarian cancer risk (rate ratio [RR] = 0.90, 95% confidence interval [CI] = 0.82 to 1.00, P = .05). Frequent use (4 days/wk) of aspirin (RR = 0.95, 95% CI = 0.88 to 1.03), nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs; RR = 1.00, 95% CI = 0.90 to 1.11), or acetaminophen (RR = 1.05, 95% CI = 0.88 to 1.24) was not associated with risk. Daily acetaminophen use (RR = 1.28, 95% CI = 1.00 to 1.65, P = .05) was associated with elevated ovarian cancer risk. Risk estimates for frequent, long-term (10+ years) use of aspirin (RR = 1.15, 95% CI = 0.98 to 1.34) or nonaspirin NSAIDs (RR = 1.19, 95% CI = 0.84 to 1.68) were modestly elevated, although not statistically significantly so.Conclusions This large, prospective analysis suggests that women who use aspirin daily have a slightly lower risk of developing ovarian cancer (approximate to 10% lower than infrequent/nonuse)similar to the risk reduction observed in case-control analyses. The observed potential elevated risks for 10+ years of frequent aspirin and NSAID use require further study but could be due to confounding by medical indications for use or variation in drug dosing.
KW - NONSTEROIDAL ANTIINFLAMMATORY DRUGS
KW - LIFETIME OVULATORY CYCLES
KW - LOW-DOSE ASPIRIN
KW - BREAST-CANCER
KW - PRIMARY PREVENTION
KW - WOMENS HEALTH
KW - ACETAMINOPHEN
KW - INFLAMMATION
KW - ASSOCIATION
KW - DISEASE
U2 - 10.1093/jnci/djy100
DO - 10.1093/jnci/djy100
M3 - Article
C2 - 29860330
SN - 0027-8874
VL - 111
SP - 137
EP - 145
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 2
ER -