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Study To Be Released Wednesday Reports That Long-Term Aspirin Use May Decrease The Risk Of Epithelial Ovarian Cancer

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 previously thought."

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.

Results indicate:

  • * 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 aspirin use.

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Editor: Susan K. Boyer, RN
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