A study to be released Wednesday at the Society of Gynecologic Oncologists annual meeting reported that long-term aspirin use may decrease the risk of epithelial ovarian cancer. The study involved 748 patients in a prospective cohort followed-up for an average of 12 years. Initial results suggest that aspirin use three or more times per week for at least six months could be associated with a 40 percent reduction of the epithelial ovarian cancer risk.
The study was conducted by Arslan Akhmedkhanov M.D., Paolo Toniolo M.D.,
Anne Zeleniuch-Jacquotte M.D., Karen L. Koenig Ph.D. and Roy E. Shore Ph.D.,
DrPH., New York University School of Medicine, New York, New York; and Ikuko
Kato, M. D., Ph.D., Wayne State University in Detroit.
"Evidence suggests that chronic inflammation, similar to the inflammation
seen in endometriosis and pelvic inflammatory disease, could be related to
epithelial ovarian cancer," said the study's lead author, Arslan Akhmedkhanov,
M.D. "One way to evaluate the role of inflammation in ovarian cancer is to
examine the effect of common anti-inflammatory medications, such as aspirin on
epithelial ovarian cancer risk. Our data, combined with other similar
research, indicates aspirin may have broader anticarcinogenic properties than
To assess the relationship between aspirin use and risk of epithelial
ovarian cancer, study subjects were selected from among the participants of
the New York University Women's Health Study, a long-term prospective cohort
involving over 14,000 women. At the enrollment, women answered a
questionnaire covering a variety of topics from demographics to reproductive
data to medical history. After the initial questionnaire, follow-up
questionnaires were sent every two years to update the information on
potential risk factors and to identify newly diagnosed cases of cancer and
other medical conditions.
From 1994 to 1996, detailed data on aspirin use was collected using the
following question: "Have you taken aspirin three or more times per week for
a period of six months or longer?" For women who answered positively,
additional information regarding the dose and duration of aspirin use was
gathered. A total of 140 women with ovarian cancer were identified after the
average follow-up period of 12 years. Of these, 68 responded to questions on
aspirin use in the 1994-1996 follow-up questionnaire and were diagnosed with
common types of epithelial ovarian cancer.
Ten controls per case were selected at random among cancer-free cohort
members, who matched the case on age, menopausal status at enrollment, date of
enrollment and date of response to the 1994-1996 follow-up questionnaire. As
a result, 748 women were available for analyses, including 68 cases of
epithelial ovarian cancer and 680 matched controls.
- * Women taking aspirin three or more times a week for at least a six month
period may experience the reduction in epithelial ovarian cancer risk.
- * The protective effect may be stronger among recent (within previous five
years) users of aspirin.
"If confirmed by a larger prospective studies, these results could have a
considerable impact on the treatment and prevention of gynecologic cancers, as
well as spark greater interest in researching the broader anticancer effects
that aspirin may hold," said the study's lead author, Dr. Akhmedkhanov.
"However, there are risks associated with regular aspirin use and women should
consult with their physicians and gynecologists before starting a long-term
use of aspirin."
"To date, four case-control studies have addressed the role of aspirin and
other non-steroidal anti-inflammatory drugs (NSAIDs) in ovarian cancer. Three
studies suggested a protective benefit of regular aspirin and other NSAID use
in ovarian cancer and one study found no effect. A recent case-control
surveillance study of medication use and cancer, including 780 women with
epithelial ovarian cancer from Baltimore, Boston, New York, and Philadelphia,
found a 50 percent reduction in epithelial ovarian cancer risk using exposure
definition of aspirin use four or more times per week for at least five years.
These results are comparable to the risk estimates observed in our study using
similar exposure definition."
The researchers advise, as in all observational studies, the results
presented here should be interpreted with caution. Because long-term aspirin
use may occasionally result in serious side effects, such as gastrointestinal
bleeding, recommendations regarding chemopreventive use of aspirin against
epithelial ovarian cancer should await confirmation of the effect by larger
prospective studies and clarification of the risk-benefit balance of long-term