Aspirin and Liver, Ovarian Cancers

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This fact sheet evaluates the data that suggest that aspirin can reduce the risk of liver and ovarian cancers.
This fact sheet evaluates the data that suggest that aspirin can reduce the risk of liver and ovarian cancers.

Ovarian Cancer

Several cohort studies suggest that aspirin use decreases the risk of ovarian cancer. In a study of 205,498 women from the Nurses' Health Study and Nurses' Health Study II, current aspirin use was not associated with risk of ovarian cancer, but low-dose aspirin significantly decreased the risk of developing ovarian cancer by 23% (HR, 0.77; 95% CI, 0.61-0.96).8 There was no association between standard-dose aspirin and risk of ovarian cancer. In another cohort study of 758,829 women, daily use of aspirin (≥6 per week) significantly decreased the risk of ovarian cancer by 10% compared with infrequent/nonuse (RR, 0.90; 95% CI, 0.82-1.00).9 Lower levels of aspirin use were not associated with ovarian cancer risk.

These data were similar to the findings of a pooled analysis of 12 case-control studies that included 7776 cases and 11,843 controls.10 Aspirin use decreased the risk of ovarian cancer (OR, 0.91; 95% CI, 0.84-0.99), particularly with daily use (OR, 0.80; 95% CI, 0.67-0.96) and with low-dose aspirin (OR, 0.66; 95% CI, 0.53-0.83).

Among women with ovarian cancer, an analysis of the Nurses' Health Studies that included 1143 women found that postdiagnosis (within 2 years) use of aspirin significantly improved ovarian cancer–specific survival compared with nonuse (HR, 0.68; 95% CI, 0.52-0.89).11 Prediagnosis use was not associated with survival outcomes after ovarian cancer diagnosis. Similarly, a retrospective study of 77 patients diagnosed with clear cell ovarian cancer demonstrated that aspirin use was significantly associated with prolonged disease-free survival compared with nonuse (HR, 0.13; P =.018) and lower recurrence at 24 months, with a rate of 8% compared with 28% among nonusers.12 Women who took aspirin demonstrated a longer overall survival (HR, 0.13; P =.015) with a median not yet reached compared with 166 months among nonusers. However, another study of a nationwide Danish cohort, found no association between low-dose aspirin use and ovarian cancer–specific mortality or all-cause mortality.13

Conclusions

Most epidemiologic data suggest that aspirin use, particularly low-dose, may have a chemopreventive effect against HCC and ovarian cancer. However, given that many studies do not provide dose or frequency information — and that there is a need for additional controlled studies — aspirin is not yet recommended to be taken specifically to prevent these cancers.2

References

  1. Alfonso L, Ai G, Spitale RC, Bhat GJ. Molecular targets of aspirin and cancer prevention. Br J Cancer. 2014;111(1):61-67.
  2. Patrignani P, Patrono C. Aspirin and cancer. J Am Coll Cardiol. 2016;68(9):967-976.
  3. Qiao Y, Yang T, Gan Y, et al. Associations between aspirin use and the risk of cancers: a meta-analysis of observational studies. BMC Cancer. 2018;18(1):288.
  4. Tao Y, Li Y, Liu X, Deng Q, Yu Y, Yang Z. Nonsteroidal anti-inflammatory drugs, especially aspirin, are linked to lower risk and better survival of hepatocellular carcinoma: a meta-analysis. Cancer Manag Res. 2018;10:2695-2709.
  5. Pang Q, Jin H, Qu K, et al. The effects of nonsteroidal anti-inflammatory drugs in the incident and recurrent risk of hepatocellular carcinoma: a meta-analysis. Onco Targets Ther. 2017;10:4645-4656.
  6. Simon TG, Ma Y, Ludvigsson JF. Association between aspirin use and risk of hepatocellular carcinoma. JAMA Oncol. 2018;4(12):1683-1690.
  7. Hwang IC, Chang J, Kim K, Park SM. Aspirin use and risk of hepatocellular carcinoma in a national cohort study of Korean adults. Sci Rep. 2018;8:4968.
  8. Barnard ME, Poole EM, Curhan GC, et al. Association of analgesic use with risk of ovarian cancer in the Nurses' Health Studies. JAMA Oncol. 2018;4(12):1675-1682.
  9. Trabert B, Poole EM, White E, et al. Analgesic use and ovarian cancer risk: an analysis in the Ovarian Cancer Cohort Consortium [published online May 31, 2018]. J Natl Cancer Inst. Epub 2018 May 31. doi: 10.1093/jnci/djy100
  10. Trabert B, Ness RB, Lo-Ciganic W-H, et al. Aspirin, nonaspirin nonsteroidal anti-inflammatory drug, and acetaminophen use and risk of invasive epithelial ovarian cancer: a pooled analysis in the Ovarian Cancer Association Consortium. J Natl Cancer Inst. 2014;106(2):djt431.
  11. Merritt MA, Rice MS, Barnard ME, et al. Pre-diagnosis and post-diagnosis use of common analgesics and ovarian cancer prognosis (NHS/NHSII): a cohort study. Lancet Oncol. 2018;19:1107-1116.
  12. Wield AM, Walsh CS, Rimel BJ, et al. Aspirin use correlates with survival in women with clear cell ovarian cancer. Gynecol Oncol Rep. 2018;25:78-81.
  13. Verdoodt F, Kjaer SK, Dehlendorff C, Friis S. Aspirin use and ovarian cancer mortality in a Danish nationwide cohort study. Br J Cancer. 2018;118(4):611-615.
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