Aspirin, NSAID use may reduce ovarian cancer-specific mortality
medwireNews: The risk for death from ovarian cancer is around a third lower among women who regularly use aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis, compared with nonusers, US study data show.
“If these results are confirmed in further studies, further research should explore potential synergistic effects of anti-inflammatory medications used in combination with standard ovarian cancer therapies to improve the prognosis for patients diagnosed with ovarian cancer,” Melissa Merritt (University of Hawaii Cancer Center, Honolulu) and colleagues remark in The Lancet Oncology.
The findings are based on an analysis of 1143 women who were diagnosed with stage I–III epithelial ovarian cancer between 1976 and 2013, while participating in the Nurses' Health Study or Nurses' Health Study II.
The researchers report that, after adjustment for age and year of diagnosis, disease stage, and histology, participants who regularly (≥2 days per week) used aspirin or other NSAIDs in the 2 years after diagnosis had a significantly lower risk for ovarian cancer-specific death than nonusers, at hazard ratios of 0.68 and 0.67, respectively.
This risk was reduced further, to 0.44 and 0.46, among women who only began using aspirin or non-aspirin NSAIDs, respectively, following their ovarian cancer diagnosis, compared with those who remained never users.
The aspirin dose did not appear to impact survival, but the researchers note that the study was insufficiently powered to accurately assess this outcome.
The team also found that there was no significant association between ovarian cancer-specific survival and prediagnosis use of any type of analgesic or postdiagnosis use of acetaminophen.
In an accompanying comment, Penelope Webb, from the QIMR Berghofer Medical Research Institute in Brisbane, Queensland, Australia, describes the magnitude of the benefit seen with postdiagnosis analgesic use as “striking.”
However, she cautions that although the data show promise there is not a clear answer to suggest that women with ovarian cancer should be advised to take aspirin, particularly as its use, as well as that of other NSAIDs, “is not without risks.”
Webb concludes that until randomized trials can provide definitive answers, “further prospective observational studies that can provide reassurance regarding the comparability of analgesic users and non-users might resolve some of the uncertainty” around dose level and timing as well as the mechanisms behind the effect.
By Laura Cowen
medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group