Regular aspirin use lowers risk of ovarian cancer development: Study

USA: Despite the existence of the majority of other ovarian cancer risk factors, frequent aspirin use is linked to a decreased risk of ovarian cancer, states a research study published in the Journal of Clinical Oncology.

The most lethal gynecologic malignancy is ovarian cancer. The majority of recognized risk factors for ovarian cancer, including endometriosis, mutations in the BRCA 1 and 2 genes, and family history, cannot be altered. Regular aspirin use has been linked to a lower risk of ovarian cancer, but no study has thoroughly examined impact modification.

The correlation between frequent aspirin usage and risk of ovarian cancer was examined broadly and in subgroups of women with additional ovarian cancer risk factors by the authors using validated, individual-level data from 17 studies.

According to the analysis of the data from two ovarian cancer consortia, taking aspirin frequently was linked to a 13% lower chance of developing the disease. High-grade serous ovarian cancer, the most prevalent and lethal histological form, saw a similar risk drop.

For the research, the Ovarian Cancer Cohort Consortium contributed nine cohort studies with 2,600 cases, while the Ovarian Cancer Association Consortium contributed eight case-control studies with 5,726 cases. The authors pooled study-specific estimates using random-effects meta-analysis to examine relationships between frequent aspirin usage, defined as the use of at least 6 days per week, and ovarian cancer risk by using Cox regression and logistic regression. They carried out analyses within subgroups delineated by the number of risk factors (endometriosis, obesity, family history of breast/ovarian cancer, nulliparity, use of oral contraceptives, and tubal ligation) as well as by the potential confounders (0, 1, 2 or more).

Key findings of the study:

• With no discernible heterogeneity by research design or histotype, frequent aspirin usage was linked to a 13% decline in ovarian cancer risk. 
• All additional categories classified by ovarian cancer risk factors showed consistent risk decreases (relative risks ranging from 0.79 to 0.93), including women with fewer than two risk factors (relative risk, 0.81).

"Future research should examine how aspirin-based chemotherapy programs could supplement currently used preventive measures, which are presently only directed at women who pose the greatest risk (for example, prophylactic salpingo-oophorectomy for carriers of the BRCA1/2 mutation), and identify additional high-risk subgroups to maximize population-level impact and reduce risks", added the authors.

The researchers concluded that routine aspirin use has an additional advantage of primary prevention of ovarian cancer, which could be considered in composite risk-benefit analyses.

REFERENCE

Hurwitz LM, Townsend MK, Jordan SJ, et al. Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia. JCO; Published online 22 July 2022. DOI: 10.1200/JCO.21.01900