HONOLULU and TAMPA, Fla. – Two groundbreaking studies examining the use of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) in connection to ovarian cancer found that women could benefit from daily aspirin consumption to reduce cancer risk and improve survival after diagnosis. The studies, published in Journal of the National Cancer Institute and Lancet Oncology, analyzed data from several very large studies, including the Nurses’ Health Studies and Ovarian Cancer Cohort Consortium. The results showed that daily use of aspirin may reduce ovarian cancer risk by 10 percent and provide as much as a 30 percent improvement in survival.
Ovarian cancer is the most fatal gynecological cancer, largely due to lack of early detection strategies. There is tremendous potential for improvement in both screening and therapy options for this disease. Chemoprevention, or use of a medication to the lower risk or prevent cancer, is one area that could provide new approaches to reduce ovarian cancer burden.
There has been increasing evidence indicating that inflammation plays a role in ovarian cancer development and can worsen patient outcomes. Anti-inflammatory medications, such as aspirin and non-aspirin NSAIDs including ibuprofen (Advil) or naproxen (Aleve), can lower the risk of certain types of cancers.
Reducing Ovarian Cancer Risk
Inflammation is the immune system’s response to infection and injury. It is necessary for the body to heal itself. During an inflammatory response, white blood cells make substances that cause cells to divide and grow to rebuild tissue. However chronic inflammation can trigger the body to initiate an inflammatory response even if there is no injury. Over time, chronic inflammation can cause DNA damage and lead to cancer. Aspirin and non-aspirin NSAIDs contain anti-inflammatory factors that have the ability to block factors that increase the growth and spread of cells.
To determine if aspirin and non-aspirin NSAIDs could reduce ovarian cancer risk, a group of researchers pooled data from 13 studies from around the world that asked women about aspirin and non-aspirin NSAID use at one point in time and followed them to identify those who developed ovarian. The study included more than 750,000 women – of that group, over 3,500 women were diagnosed with ovarian cancer. This study, based on the Ovarian Cancer Cohort Consortium and led by researchers at the National Cancer Institute and Moffitt Cancer Center, was published in the Journal of the National Cancer Institute. It found that daily use of aspirin reduced ovarian cancer risk by 10 percent.
“This study gives us a new perspective on whether aspirin and non-aspirin NSAIDs can impact cancer risk. Not only does it look at ovarian cancer, which hasn’t been studied before, our sample size is three-quarter of a million women who were followed for several decades,” said Shelley S. Tworoger, Ph.D., senior study author and associate center director for Population Science at Moffitt Cancer Center. “The results of the study support that aspirin can reduce ovarian cancer risk, but further studies will need to be performed before a recommendation of daily aspirin can be made. For example, we need to examine the best dose, baby aspirin versus regular aspirin, for women.”
Improving Ovarian Cancer Survival
There is growing research indicating aspirin and non-aspirin NSAIDs can inhibit mechanisms involved in cancer progression. The anti-inflammatory medications can block the creation of prostaglandins, a hormone-like substance that may promote the growth and spread of cancer. The over-the-counter drugs also have an antiplatelet effect. Nearly a third of ovarian cancer patients suffer from thrombocytosis, a disorder in which the body produces too many platelets. Studies suggest an increased platelet count may play a role in ovarian cancer growth.
Using data from the Nurses’ Health Studies based at the Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, researchers at University of Hawai’i and Moffitt Cancer Center analyzed nearly 1,000 ovarian cancer cases to determine if regular use of anti-inflammatory medications provided benefit. Their study, published in Lancet Oncology, found women who used aspirin and non-aspirin NSAIDs after their ovarian cancer diagnosis saw as much as a 30 percent improvement in survival. If results are confirmed, the potential next step would be to determine if the use of anti-inflammatory medications in combination with standard therapies can be used as an intervention to improve the survival rates of women diagnosed with ovarian cancer, as well as determining which specific doses are the most protective.
“To our knowledge, this study contributes the first comprehensive assessment of use of several types of common analgesic medications, such as aspirin and non-aspirin NSAIDs, after diagnosis in relation to ovarian cancer survival,” said Melissa A. Merritt, Ph.D., assistant research professor at University of Hawai’i Cancer Center. “Our work demonstrates the importance of common medication in increasing survival rates of ovarian cancer, and this will encourage more studies to be conducted to confirm the results and broaden the discovery.”
In addition to improved survival and decreasing the risk for ovarian cancer, research has shown daily aspirin also reduces risk for cardiovascular disease and colon cancer. The myriad benefits of low-dose aspirin consumption should compel more women to discuss options with their healthcare providers.
About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. The Tampa-based facility is one of only 49 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s scientific excellence, multidisciplinary research, and robust training and education. Moffitt is a Top 10 cancer hospital and has been nationally ranked by U.S. News & World Report since 1999. Moffitt devotes more than 2 million square feet to research and patient care. Moffitt’s expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet® status, its highest distinction. With more than 5,700 team members, Moffitt has an economic impact in the state of $2.1 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit MOFFITT.org, and follow the momentum on Facebook, Twitter and YouTube.
About University of Hawai’i Cancer Center
The University of Hawai'i Cancer Center through its various activities, cancer trial patients and their guests, and other visitors adds more than $54 million to the O'ahu economy. It is one of only 70 research institutions designated by the National Cancer Institute. Affiliated with the University of Hawai'i at Mānoa, the Center is dedicated to eliminating cancer through research, education, patient care and community outreach with an emphasis on the unique ethnic, cultural, and environmental characteristics of Hawai'i and the Pacific. Learn more at www.uhcancercenter.org. Like us on Facebook at www.facebook.com/UHCancerCenter. Follow us on Twitter @UHCancerCenter.