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
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
- Alfonso L, Ai G, Spitale RC, Bhat GJ. Molecular targets of aspirin and cancer prevention. Br J Cancer. 2014;111(1):61-67.
- Patrignani P, Patrono C. Aspirin and cancer. J Am Coll Cardiol. 2016;68(9):967-976.
- 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.
- 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.
- 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.
- Simon TG, Ma Y, Ludvigsson JF. Association between aspirin use and risk of hepatocellular carcinoma. JAMA Oncol. 2018;4(12):1683-1690.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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.