NASHVILLELong-term aspirin use may decrease the risk
of epithelial ovarian cancer, Arslan Akhmedkhanov, MD, reported at the 32nd
Annual Meeting of the Society of Gynecologic Oncologists (SGO). The study
involved 748 patients from a prospective cohort followed for an average of 12
Initial results suggest that aspirin use three or more times a
week for at least 6 months could be associated with a 40% reduction in the risk
epithelial ovarian cancer, said Dr. Akhmedkhanov, research assistant professor,
Division of Women’s Health Epidemiology, Department of Obstetrics and
Gynecology, New York University (NYU) School of Medicine.
"Evidence suggests that chronic inflammation, similar to
the inflammation seen in endometriosis and pelvic inflammatory disease, could
be related to epithelial ovarian cancer," he said. "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, indicate that
aspirin may have broader anticarcinogenic properties than previously
The subjects came from NYU’s Women’s Health Study, a
long-term prospective cohort involving more than 14,000 women who completed a
health questionnaire at enrollment (between 1985 and 1991) and every 2 years
Of this cohort, 12,239 women responded to baseline and
1994-1996 follow-up questionnaires. The 1994-1996 follow-up collected data on
aspirin use via the following question: "Have you taken aspirin three or
more times per week for a period of 6 months or longer?" For women who
answered yes, information regarding the dose and duration of aspirin use was
A total of 140 women with ovarian cancer were identified in the
cohort after an average follow-up of 12 years. Of these, 55 were excluded
because the cancer diagnosis preceded enrollment in the study. Of the remaining
85 cases, 73 responded to questions on aspirin use in the 1994-1996
questionnaire. Among the confirmed cases, 5 were excluded because they were
nonepithelial ovarian cancer.
The remaining 68 cases of epithelial ovarian cancer were
included in this nested case-control study. For each case, 10 matched controls
were selected at random from cancer-free cohort members.
Within each matched set, aspirin exposure was discounted for
both cases and corresponding controls if it occurred after, or within 1 year
before, the date of case diagnosis. A lag period of 1 year was chosen, Dr.
Akhmedkhanov said, to prevent the possibility that aspirin use among the cases
might have been the result of early symptoms of an undiagnosed disease
"and therefore might be a consequence of, rather than a risk factor for,
Results showed that taking aspirin three or more times a week
for at least 6 months appeared to be inversely associated with the risk of
epithelial ovarian cancer, with an odds ratio of .60 (adjusted for potential
risk factors). This corresponds to a 40% reduction in risk, Dr. Akhmedkhanov
The protective effect may be stronger among recent users of
aspirin (use within the previous 5 years). For this group the adjusted odds
radio was .36, he said.
He noted that the results should be interpreted with caution,
because of the study limitations. Among them, the study was based on a limited
number of cases, "and we did not have information on the exact dosage and
indications for aspirin use, which should be taken into account," he said.
Therefore, at this time, Dr. Akhmedkhanov said, "we cannot recommend that
women start taking aspirin to prevent ovarian cancer based on the results of
this study alone. Larger studies are needed to confirm this effect and clarify
the effective dose and duration."