Analgesic Use and Ovarian Cancer Risk

An Analysis in the Ovarian Cancer Cohort Consortium

Ovarian Cancer Cohort Consortium (OC3)

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 (∼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.

Original languageEnglish (US)
Pages (from-to)137-145
Number of pages9
JournalJournal of the National Cancer Institute
Volume111
Issue number2
DOIs
StatePublished - Feb 1 2019

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Ovarian Neoplasms
Analgesics
Aspirin
Confidence Intervals
Non-Steroidal Anti-Inflammatory Agents
Acetaminophen
Risk Reduction Behavior
Pharmaceutical Preparations
Case-Control Studies
Anti-Inflammatory Agents
Odds Ratio
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Analgesic Use and Ovarian Cancer Risk : An Analysis in the Ovarian Cancer Cohort Consortium. / Ovarian Cancer Cohort Consortium (OC3).

In: Journal of the National Cancer Institute, Vol. 111, No. 2, 01.02.2019, p. 137-145.

Research output: Contribution to journalArticle

@article{6c5783682166470e87e869fb694815fb,
title = "Analgesic Use and Ovarian Cancer Risk: An Analysis in the Ovarian Cancer Cohort Consortium",
abstract = "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 (∼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.",
author = "{Ovarian Cancer Cohort Consortium (OC3)} and Britton Trabert and Poole, {Elizabeth M.} and Emily White and Kala Visvanathan and Adami, {Hans Olov} and Anderson, {Garnet L.} and Brasky, {Theodore M.} and Brinton, {Louise A.} and Fortner, {Renee T.} and Mia Gaudet and Patricia Hartge and Judith Hoffman-Bolton and Michael Jones and Lacey, {James V.} and Larsson, {Susanna C.} and Gerardo Mackenzie and Schouten, {Leo J.} and Sandler, {Dale P.} and Katie O'Brien and Patel, {Alpa V.} and Ulrike Peters and Anna Prizment and Kim Robien and Setiawan, {V. Wendy} and Anthony Swerdlow and {van den Brandt}, {Piet A.} and Elisabete Weiderpass and Wilkens, {Lynne R.} and Alicja Wolk and Nicolas Wentzensen and Tworoger, {Shelley S.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1093/jnci/djy100",
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TY - JOUR

T1 - Analgesic Use and Ovarian Cancer Risk

T2 - An Analysis in the Ovarian Cancer Cohort Consortium

AU - Ovarian Cancer Cohort Consortium (OC3)

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

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.

PY - 2019/2/1

Y1 - 2019/2/1

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 (∼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 (∼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.

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DO - 10.1093/jnci/djy100

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JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

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