OBJECTIVE: Several observational studies have investigated the association between nonsteroidal anti-inflammatory drug (NSAID) use and ovarian cancer risk, but with conflicting results. We performed a systematic review and meta-analysis of the association between NSAID use and ovarian cancer risk. DESIGN: Systematic review and meta-analysis of observational studies published until September 2012. SETTING: Studies were identified from the PubMed database. POPULATION: Fourteen case-control and seven cohort studies were included. METHODS: Pooled relative risks (RRs) with corresponding 95% confidence intervals (CI) for aspirin and non-aspirin NSAIDs, separately, were calculated. Both fixed and random effect models were applied, but only random effect pooled RRs are presented. Risk estimates for invasive and borderline ovarian tumors combined and for invasive ovarian tumors only were calculated. Furthermore, heterogeneity and publication bias were evaluated. MAIN OUTCOME MEASURES: Ovarian cancer. RESULTS: In the combined analysis, a slight inverse association between use of aspirin (RR 0.93; 95% CI 0.84-1.02) and non-aspirin NSAIDs (RR 0.94; 95% CI 0.84-1.06) and ovarian cancer risk was found, although it was not statistically significant. However, the risk of invasive ovarian cancer was significantly reduced with use of aspirin (RR 0.88; 95% CI 0.79-0.98). A similar tendency was observed for non-aspirin NSAIDs, but the results were not significant. CONCLUSIONS: This meta-analysis showed a slight inverse association between NSAIDs and risk of ovarian cancer. However, data suggest that a chemopreventive effect of NSAIDs may be restricted to invasive ovarian tumors. Further research on NSAIDs and ovarian cancer is needed before definite conclusions can be drawn.
OBJECTIVE: Several observational studies have investigated the association between nonsteroidal anti-inflammatory drug (NSAID) use and ovarian cancer risk, but with conflicting results. We performed a systematic review and meta-analysis of the association between NSAID use and ovarian cancer risk. DESIGN: Systematic review and meta-analysis of observational studies published until September 2012. SETTING: Studies were identified from the PubMed database. POPULATION: Fourteen case-control and seven cohort studies were included. METHODS: Pooled relative risks (RRs) with corresponding 95% confidence intervals (CI) for aspirin and non-aspirin NSAIDs, separately, were calculated. Both fixed and random effect models were applied, but only random effect pooled RRs are presented. Risk estimates for invasive and borderline ovarian tumors combined and for invasive ovarian tumors only were calculated. Furthermore, heterogeneity and publication bias were evaluated. MAIN OUTCOME MEASURES: Ovarian cancer. RESULTS: In the combined analysis, a slight inverse association between use of aspirin (RR 0.93; 95% CI 0.84-1.02) and non-aspirin NSAIDs (RR 0.94; 95% CI 0.84-1.06) and ovarian cancer risk was found, although it was not statistically significant. However, the risk of invasive ovarian cancer was significantly reduced with use of aspirin (RR 0.88; 95% CI 0.79-0.98). A similar tendency was observed for non-aspirin NSAIDs, but the results were not significant. CONCLUSIONS: This meta-analysis showed a slight inverse association between NSAIDs and risk of ovarian cancer. However, data suggest that a chemopreventive effect of NSAIDs may be restricted to invasive ovarian tumors. Further research on NSAIDs and ovarian cancer is needed before definite conclusions can be drawn.
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Authors: Bridget Charbonneau; Matthew S Block; William R Bamlet; Robert A Vierkant; Kimberly R Kalli; Zachary Fogarty; David N Rider; Thomas A Sellers; Shelley S Tworoger; Elizabeth Poole; Harvey A Risch; Helga B Salvesen; Lambertus A Kiemeney; Laura Baglietto; Graham G Giles; Gianluca Severi; Britton Trabert; Nicolas Wentzensen; Georgia Chenevix-Trench; Alice S Whittemore; Weiva Sieh; Jenny Chang-Claude; Elisa V Bandera; Irene Orlow; Kathryn Terry; Marc T Goodman; Pamela J Thompson; Linda S Cook; Mary Anne Rossing; Roberta B Ness; Steven A Narod; Jolanta Kupryjanczyk; Karen Lu; Ralf Butzow; Thilo Dörk; Tanja Pejovic; Ian Campbell; Nhu D Le; Clareann H Bunker; Natalia Bogdanova; Ingo B Runnebaum; Diana Eccles; James Paul; Anna H Wu; Simon A Gayther; Estrid Hogdall; Florian Heitz; Stanley B Kaye; Beth Y Karlan; Hoda Anton-Culver; Jacek Gronwald; Claus K Hogdall; Diether Lambrechts; Peter A Fasching; Usha Menon; Joellen Schildkraut; Celeste Leigh Pearce; Douglas A Levine; Susanne Kruger Kjaer; Daniel Cramer; James M Flanagan; Catherine M Phelan; Robert Brown; Leon F A G Massuger; Honglin Song; Jennifer A Doherty; Camilla Krakstad; Dong Liang; Kunle Odunsi; Andrew Berchuck; Allan Jensen; Jan Lubinski; Heli Nevanlinna; Yukie T Bean; Galina Lurie; Argyrios Ziogas; Christine Walsh; Evelyn Despierre; Louise Brinton; Alexander Hein; Anja Rudolph; Agnieszka Dansonka-Mieszkowska; Sara H Olson; Philipp Harter; Jonathan Tyrer; Allison F Vitonis; Angela Brooks-Wilson; Katja K Aben; Malcolm C Pike; Susan J Ramus; Elisabeth Wik; Cezary Cybulski; Jie Lin; Lara Sucheston; Robert Edwards; Valerie McGuire; Jenny Lester; Andreas du Bois; Lene Lundvall; Shan Wang-Gohrke; Lukasz M Szafron; Sandrina Lambrechts; Hannah Yang; Matthias W Beckmann; Liisa M Pelttari; Anne M Van Altena; David van den Berg; Mari K Halle; Aleksandra Gentry-Maharaj; Ira Schwaab; Urmila Chandran; Janusz Menkiszak; Arif B Ekici; Lynne R Wilkens; Arto Leminen; Francesmary Modugno; Grace Friel; Joseph H Rothstein; Ignace Vergote; Montserrat Garcia-Closas; Michelle A T Hildebrandt; Piotr Sobiczewski; Linda E Kelemen; Paul D P Pharoah; Kirsten Moysich; Keith L Knutson; Julie M Cunningham; Brooke L Fridley; Ellen L Goode Journal: Cancer Res Date: 2013-11-22 Impact factor: 12.701