Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (BT, LAB, NW); University of Texas School of Public Health, Houston, TX (RBN); Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (WL); Channing Division of Network Medicine (MAM, EMP) and Obstetrics and Gynecology Epidemiology Center (DWC, KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA (MAM, EMP, DWC, KLT); Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN (ELG); Queensland Institute of Medical Research, Brisbane, Australia (PMW, CMN, SJJ, Australian Ovarian Cancer Study Group, the Australian Cancer Study (Ovarian Cancer); Peter MacCallum Cancer Centre, East Melbourne, Australia (Australian Ovarian Cancer Study Group); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (HAR); Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA (MAR, JAD); Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, Dartmouth Medical School, Lebanon, NH (JAD); Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA (MTG); Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI (GL); Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (SKK, EH, AJ); Gynaecologic Clinic, Copenhagen University Hospital, Copenhagen, Denmark (SKK); The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ (EVB, MGK, UC); Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (SO); Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, CA (HA, AZ); Department of Women's Cancer, University College London, EGA Institute for Wo
J Natl Cancer Inst. 2014 Feb;106(2):djt431. doi: 10.1093/jnci/djt431.
Regular aspirin use is associated with reduced risk of several malignancies. Epidemiologic studies analyzing aspirin, nonaspirin nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen use and ovarian cancer risk have been inconclusive.
We analyzed pooled data from 12 population-based case-control studies of ovarian cancer, including 7776 case patients and 11843 control subjects accrued between 1992 and 2007. Odds ratios (ORs) for associations of medication use with invasive epithelial ovarian cancer were estimated in individual studies using logistic regression and combined using random effects meta-analysis. Associations between frequency, dose, and duration of analgesic use and risk of ovarian cancer were also assessed. All statistical tests were two-sided.
Aspirin use was associated with a reduced risk of ovarian cancer (OR = 0.91; 95% confidence interval [CI] = 0.84 to 0.99). Results were similar but not statistically significant for nonaspirin NSAIDs, and there was no association with acetaminophen. In seven studies with frequency data, the reduced risk was strongest among daily aspirin users (OR = 0.80; 95% CI = 0.67 to 0.96). In three studies with dose information, the reduced risk was strongest among users of low dose (<100 mg) aspirin (OR = 0.66; 95% CI = 0.53 to 0.83), whereas for nonaspirin NSAIDs, the reduced risk was strongest for high dose (≥500 mg) usage (OR = 0.76; 95% CI = 0.64 to 0.91).
Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin. These findings suggest that the same aspirin regimen proven to protect against cardiovascular events and several cancers could reduce the risk of ovarian cancer 20% to 34% depending on frequency and dose of use.
常规使用阿司匹林与降低多种恶性肿瘤的风险有关。分析阿司匹林、非阿司匹林非甾体抗炎药（NSAID）和对乙酰氨基酚使用与卵巢癌风险的流行病学研究尚无定论。
我们分析了 1992 年至 2007 年间纳入的 12 项基于人群的卵巢癌病例对照研究的汇总数据，包括 7776 例病例患者和 11843 例对照。使用逻辑回归在个体研究中估计药物使用与侵袭性上皮性卵巢癌的比值比（OR），并使用随机效应荟萃分析进行合并。还评估了镇痛剂使用频率、剂量和持续时间与卵巢癌风险之间的关系。所有统计检验均为双侧检验。
阿司匹林的使用与卵巢癌风险降低相关（OR = 0.91；95%置信区间 [CI] = 0.84 至 0.99）。非阿司匹林 NSAID 的结果相似但无统计学意义，与对乙酰氨基酚无关。在 7 项具有频率数据的研究中，在每日使用阿司匹林的患者中风险降低最为明显（OR = 0.80；95% CI = 0.67 至 0.96）。在 3 项具有剂量信息的研究中，低剂量（<100mg）阿司匹林使用者的风险降低最为明显（OR = 0.66；95% CI = 0.53 至 0.83），而非阿司匹林 NSAID 中，高剂量（≥500mg）使用者的风险降低最为明显（OR = 0.76；95% CI = 0.64 至 0.91）。
阿司匹林的使用与卵巢癌风险降低相关，尤其是在每日使用低剂量阿司匹林的患者中。这些发现表明，同样的阿司匹林方案被证明可以预防心血管事件和多种癌症，根据使用频率和剂量，可使卵巢癌风险降低 20%至 34%。
