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Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia.

Publication ,  Journal Article
Hurwitz, LM; Townsend, MK; Jordan, SJ; Patel, AV; Teras, LR; Lacey, JV; Doherty, JA; Harris, HR; Goodman, MT; Shvetsov, YB; Modugno, F; Wu, AH ...
Published in: J Clin Oncol
December 20, 2022

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. METHODS: Nine 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). RESULTS: Overall, 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). CONCLUSION: This 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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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 20, 2022

Volume

40

Issue

36

Start / End Page

4207 / 4217

Location

United States

Related Subject Headings

  • Risk Factors
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Endometriosis
  • Case-Control Studies
  • Aspirin
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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Hurwitz, L. M., Townsend, M. K., Jordan, S. J., Patel, A. V., Teras, L. R., Lacey, J. V., … Trabert, B. (2022). Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia. J Clin Oncol, 40(36), 4207–4217. https://doi.org/10.1200/JCO.21.01900
Hurwitz, Lauren M., Mary K. Townsend, Susan J. Jordan, Alpa V. Patel, Lauren R. Teras, James V. Lacey, Jennifer A. Doherty, 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.J Clin Oncol 40, no. 36 (December 20, 2022): 4207–17. https://doi.org/10.1200/JCO.21.01900.
Hurwitz LM, Townsend MK, Jordan SJ, Patel AV, Teras LR, Lacey JV, 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. J Clin Oncol. 2022 Dec 20;40(36):4207–17.
Hurwitz, Lauren M., 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.J Clin Oncol, vol. 40, no. 36, Dec. 2022, pp. 4207–17. Pubmed, doi:10.1200/JCO.21.01900.
Hurwitz LM, Townsend MK, Jordan SJ, Patel AV, Teras LR, Lacey JV, Doherty JA, Harris HR, Goodman MT, Shvetsov YB, Modugno F, Moysich KB, Robien K, Prizment A, Schildkraut JM, Berchuck A, Fortner RT, Chan AT, Wentzensen N, Hartge P, Sandler DP, O’Brien KM, Anton-Culver H, Ziogas A, Menon U, Ramus SJ, Pearce CL, Wu AH, White E, Peters U, Webb PM, Tworoger SS, Trabert B. Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia. J Clin Oncol. 2022 Dec 20;40(36):4207–4217.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 20, 2022

Volume

40

Issue

36

Start / End Page

4207 / 4217

Location

United States

Related Subject Headings

  • Risk Factors
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Endometriosis
  • Case-Control Studies
  • Aspirin
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis