TY - JOUR
T1 - Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk
T2 - A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia
AU - Hurwitz, Lauren M.
AU - Townsend, Mary K.
AU - Jordan, Susan J.
AU - Patel, Alpa V.
AU - Teras, Lauren R.
AU - Lacey, James V.
AU - Doherty, Jennifer A.
AU - Harris, Holly R.
AU - Goodman, Marc T.
AU - Shvetsov, Yurii B.
AU - Modugno, Francesmary
AU - Moysich, Kirsten B.
AU - Robien, Kim
AU - Prizment, Anna
AU - Schildkraut, Joellen M.
AU - Berchuck, Andrew
AU - Fortner, Renée T.
AU - Chan, Andrew T.
AU - Wentzensen, Nicolas
AU - Hartge, Patricia
AU - Sandler, Dale P.
AU - O'Brien, Katie M.
AU - Anton-Culver, Hoda
AU - Ziogas, Argyrios
AU - Menon, Usha
AU - Ramus, Susan J.
AU - Pearce, Celeste Leigh
AU - Wu, Anna H.
AU - White, Emily
AU - Peters, Ulrike
AU - Webb, Penelope M.
AU - Tworoger, Shelley S.
AU - Trabert, Britton
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2022/12/20
Y1 - 2022/12/20
N2 - PURPOSE Frequent aspirin use has been associated with reduced ovarian cancer risk, but no study has comprehensively assessed for effect modification. We leveraged harmonized, individual-level data from 17 studies to examine the association between frequent aspirin use and ovarian cancer risk, overall and across subgroups of women with other ovarian cancer risk factors.METHODSNine cohort studies from the Ovarian Cancer Cohort Consortium (n = 2,600 cases) and eight case-control studies from the Ovarian Cancer Association Consortium (n = 5,726 cases) were included. We used Cox regression and logistic regression to assess study-specific associations between frequent aspirin use (≥ 6 days/week) and ovarian cancer risk and combined study-specific estimates using random-effects meta-analysis. We conducted analyses within subgroups defined by individual ovarian cancer risk factors (endometriosis, obesity, family history of breast/ovarian cancer, nulliparity, oral contraceptive use, and tubal ligation) and by number of risk factors (0, 1, and ≥ 2).RESULTSOverall, frequent aspirin use was associated with a 13% reduction in ovarian cancer risk (95% CI, 6 to 20), with no significant heterogeneity by study design (P =.48) or histotype (P =.60). Although no association was observed among women with endometriosis, consistent risk reductions were observed among all other subgroups defined by ovarian cancer risk factors (relative risks ranging from 0.79 to 0.93, all P-heterogeneity >.05), including women with ≥ 2 risk factors (relative risk, 0.81; 95% CI, 0.73 to 0.90).CONCLUSIONThis study, the largest to-date on aspirin use and ovarian cancer, provides evidence that frequent aspirin use is associated with lower ovarian cancer risk regardless of the presence of most other ovarian cancer risk factors. Risk reductions were also observed among women with multiple risk factors, providing proof of principle that chemoprevention programs with frequent aspirin use could target higher-risk subgroups.
AB - PURPOSE Frequent aspirin use has been associated with reduced ovarian cancer risk, but no study has comprehensively assessed for effect modification. We leveraged harmonized, individual-level data from 17 studies to examine the association between frequent aspirin use and ovarian cancer risk, overall and across subgroups of women with other ovarian cancer risk factors.METHODSNine cohort studies from the Ovarian Cancer Cohort Consortium (n = 2,600 cases) and eight case-control studies from the Ovarian Cancer Association Consortium (n = 5,726 cases) were included. We used Cox regression and logistic regression to assess study-specific associations between frequent aspirin use (≥ 6 days/week) and ovarian cancer risk and combined study-specific estimates using random-effects meta-analysis. We conducted analyses within subgroups defined by individual ovarian cancer risk factors (endometriosis, obesity, family history of breast/ovarian cancer, nulliparity, oral contraceptive use, and tubal ligation) and by number of risk factors (0, 1, and ≥ 2).RESULTSOverall, frequent aspirin use was associated with a 13% reduction in ovarian cancer risk (95% CI, 6 to 20), with no significant heterogeneity by study design (P =.48) or histotype (P =.60). Although no association was observed among women with endometriosis, consistent risk reductions were observed among all other subgroups defined by ovarian cancer risk factors (relative risks ranging from 0.79 to 0.93, all P-heterogeneity >.05), including women with ≥ 2 risk factors (relative risk, 0.81; 95% CI, 0.73 to 0.90).CONCLUSIONThis study, the largest to-date on aspirin use and ovarian cancer, provides evidence that frequent aspirin use is associated with lower ovarian cancer risk regardless of the presence of most other ovarian cancer risk factors. Risk reductions were also observed among women with multiple risk factors, providing proof of principle that chemoprevention programs with frequent aspirin use could target higher-risk subgroups.
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U2 - 10.1200/JCO.21.01900
DO - 10.1200/JCO.21.01900
M3 - Article
C2 - 35867953
AN - SCOPUS:85144235458
SN - 0732-183X
VL - 40
SP - 4207
EP - 4217
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 36
ER -
