Can Aspirin Help Prevent Ovarian Cancer?
"We did not set out to look at ovarian cancer prevention," Akhmedkhanov says. "Conditions that reduce inflammation, such as pregnancy and oral contraceptive use, have been shown to be associated with reduced risk of ovarian cancer. That is why we studied the association between inflammation and ovarian cancer by evaluating the use of aspirin, which is the most widely used anti-inflammatory [drug]."
Women who reported taking aspirin three times a week or more for a period of six months or longer had significantly lower risk of epithelial ovarian cancer than those who did not, and the protective effect appeared to be strongest among women who reported recent regular aspirin use.
In his presentation Wednesday at the Society for Gynecologic Oncologists meeting, Akhmedkhanov cited four other recent studies evaluating the use of aspirin for the prevention of ovarian cancer. Three of the studies found that aspirin appears to be protective, and the fourth found no protective effect.
Setsuko K. Chambers, MD, of Yale University School of Medicine, questioned the design of the NYU study and concluded that the findings were, at best, inconclusive.
"There is good biologic plausibility for the hypothesis being tested in this study, but concerns remain about the accuracy of this data," she said in a rebuttal presentation. "This one-time questionnaire on aspirin usage reported nine years after the start of trial enrollment could easily lead to errors in recall. ... The interpretation of the data in this study does not allow an association -- either positive or negative -- between aspirin usage and ovarian cancer."
So what can be done to protect against ovarian cancer? While aspirin and other anti-inflammatory agents may one day be shown to have a role in prevention, hormonal therapy, in the form of oral contraceptives, already has a proven role. Recent studies suggest that during her childbearing years, a woman can cut her risk of ovarian cancer in half by taking birth control pills for as little as three years.
"I don't think we can leave this meeting with a clinical recommendation that aspirin decreases the incidence of ovarian cancer," Beth Y. Karlan, MD, of Cedars-Sinai Medical Center in Los Angeles tells WebMD. "I think the significance of these findings is that they generate a hypothesis for further study, and they highlight the importance of prevention. We now know that hormonal therapy with oral contraceptives protects against ovarian cancer. This shows that nonhormonal modalities may be an alternative and potentially additive approach to prevention."