Medication use and risk of ovarian carcinoma: A prospective study

Lacey, J.; Sherman, Mark E.; Hartge, Patricia; Schatzkin, Arthur; Schairer, Catherine

doi:10.1002/ijc.11538

Cited by 49 publications

(70 citation statements)

References 24 publications

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“…The full text was read and the reference lists were checked carefully. Finally, we identified 12 studies examining the association between paracetamol use and ovarian cancer [18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Search Resultsmentioning

confidence: 99%

“…The remaining eight studies were included in the meta-analysis [22][23][24][25][26][27][28][29]. Of these, four were case-control studies [25][26][27][28] and the remaining four were cohort studies [22][23][24]29].…”

Section: Search Resultsmentioning

confidence: 99%

“…Of these, four were case-control studies [25][26][27][28] and the remaining four were cohort studies [22][23][24]29]. There were no randomized trials.…”

Section: Search Resultsmentioning

confidence: 99%

“…Seven out of eight studies evaluated consumption of paracetamol and ovarian cancer incidence [22][23][24][25][26][27][28]. One study evaluated consumption of paracetamol and ovarian cancer mortality [29].…”

Section: Search Resultsmentioning

confidence: 99%

“…All studies [22][23][24][25][26][27][28][29] were controlled for potential confounding factors (at least for age), by matching or adjustments.…”

Section: Search Resultsmentioning

confidence: 99%

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Paracetamol use and risk of ovarian cancer: a meta‐analysis

Bonovas

Filioussi

Sitaras

2005

Brit J Clinical Pharma

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AimOvarian cancer remains the most fatal gynaecological malignancy. Several observational studies have examined paracetamol as a potential chemopreventive agent. The nonconclusive nature of the epidemiological evidence prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. MethodsA comprehensive search for articles published up to 2004 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk estimates (RR) and 95% confidence intervals (CIs) were calculated using the random and the fixed-effects models. ResultsEight studies (four case-control and four cohort studies), published between 1998 and 2004, were included. We found no evidence of publication bias or heterogeneity among the studies. The analysis revealed an inverse association between paracetamol use and ovarian cancer risk. This association was marginally significant assuming a random-effects model (RR = 0.84, 95% CI 0.70, 1.00), but not statistically significant assuming a fixed-effects model (RR = 0.90, 95% CI 0.80, 1.01). When the analysis was stratified into subgroups according to study design, the association was inverse in both case-control and cohort studies, but only in the former was it statistically significant. The sensitivity analysis strengthened our confidence in the validity of this association. Furthermore, our results provided evidence for a dose effect; 'regular use' was associated with a statistically significant 30% reduction in the risk of developing ovarian cancer compared with non-use (RR = 0.70, 95% CI 0.51, 0.95). ConclusionsOur meta-analysis supports a protective association between paracetamol use and ovarian cancer, and provides evidence for a dose effect. However, the question of paracetamol's potential association with ovarian cancer deserves fur ther verification, since proof of chemoprevention would represent a major public health advance.

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Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

“…Of these, four were case-control studies [25][26][27][28] and the remaining four were cohort studies [22][23][24]29]. There were no randomized trials.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

“…All studies [22][23][24][25][26][27][28][29] were controlled for potential confounding factors (at least for age), by matching or adjustments.…”

Section: Search Resultsmentioning

confidence: 99%

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Paracetamol use and risk of ovarian cancer: a meta‐analysis

Bonovas

Filioussi

Sitaras

2005

Brit J Clinical Pharma

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Association of Analgesic Use With Risk of Ovarian Cancer in the Nurses’ Health Studies

et al. 2018

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Importance: Ovarian cancer is a highly fatal malignancy with few modifiable risk factors. Results from case-control studies have reported a modest reduced risk of ovarian cancer among women who frequently use aspirin or regularly use low-dose aspirin. We sought to confirm these findings in a large, prospective study with detailed information on NSAID use. Objective: To evaluate whether regular aspirin or non-aspirin NSAID use, and patterns of use, are associated with lower ovarian cancer risk. Design: We included women from two prospective cohorts, the Nurses’ Health Study (NHS) and NHSII. Setting: NHS/NHSII participants were followed 1980–2014 (NHS) and 1989–2015 (NHSII). Participants: Participants in NHS (N=93,664) and NHSII (N=111,834), including 1054 cases of incident epithelial ovarian cancer. Exposures: For each analgesic type, aspirin, low-dose aspirin, non-aspirin NSAIDs and acetaminophen, we evaluated timing, duration, frequency, and number of tablets used; exposure information was updated every 2–4 years. Main Outcome(s) and Measure(s): We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations of aspirin, non-aspirin NSAIDs, and acetaminophen with risk of epithelial ovarian cancer. All statistical tests were two-sided, with a significance level of 0.05. Results: We did not observe significant associations between aspirin and ovarian cancer risk when we evaluated current versus non-use of any aspirin, regardless of dose (HR=0.99, 95%CI=0.83–1.19). However, when we evaluated low-dose (≤100mg) and standard-dose (325mg) aspirin separately, we observed an inverse association for low-dose aspirin (HR=0.77, 95%CI=0.61–0.96), but no association for standard-dose aspirin (HR=1.17, 95%CI=0.92–1.49). Current use of non-aspirin NSAIDs was positively associated with risk of ovarian cancer compared to non-use (HR=1.19, 95%CI=1.00–1.41), and we observed significant positive trends for duration of use (p-trend=0.02) and cumulative average tablets per week (p-trend=0.03). There were no clear associations for acetaminophen. Conclusions and Relevance: Our results were consistent with case-control studies showing a reduced risk of ovarian cancer among regular users of low-dose aspirin. We observed an increased risk of ovarian cancer with long-term high-quantity use of other analgesics, particularly non-aspirin NSAIDs, though this finding requires confirmation.

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Markers of inflammation and risk of ovarian cancer in Los Angeles County

Pearce

Tseng

et al. 2008

Intl Journal of Cancer

102

117

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Factors that increase inflammation have been suggested to influence the development of ovarian cancer, but these factors have not been well studied. To further investigate this question we studied the role of talc use, history of endometrioisis, and use of non-steroidal anti-inflammatory drugs (NSAIDs) and risk of ovarian cancer in a population-based case-control study in Los Angeles County involving 609 women with newly diagnosed epithelial ovarian cancer and 688 population-based control women. Risk of ovarian cancer increased significantly with increasing frequency and duration of talc use; compared to never users risk was highest among longduration (20+ years), frequent (at least daily) talc users (adjusted relative risk (RR) =2.08, 95% confidence interval (CI)=1.34-3.23). A history of physician-diagnosed endometriosis was statistically significantly associated with risk (RR=1.66, 95% CI=1.01-2.75). Women who were talc users and had a history of endometriosis showed a 3-fold increased risk (RR=3.12, 95% CI=1.36-7.22). Contrary to the hypothesis that risk of ovarian cancer may be reduced by use of NSAIDs; risk increased with increasing frequency (per 7 times/week, RR=1.27, 95% CI=1.14-1.43) and years of NSAID use (per 5 years of use, RR=1.25, 95% CI=1.10-1.42); this was consistent across types of NSAIDs. We conclude that risk of ovarian cancer is significantly associated with talc use and with a history of endometriosis, as has been found in previous studies. The NSAID finding was unexpected and suggests that factors associated with inflammation are associated with ovarian cancer risk. This result needs confirmation with careful attention to the reasons for NSAID use.

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Medication use and risk of ovarian carcinoma: A prospective study

Cited by 49 publications

References 24 publications

Paracetamol use and risk of ovarian cancer: a meta‐analysis

Paracetamol use and risk of ovarian cancer: a meta‐analysis

Association of Analgesic Use With Risk of Ovarian Cancer in the Nurses’ Health Studies

Markers of inflammation and risk of ovarian cancer in Los Angeles County

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