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Aspirin, Nonaspirin Nonsteroidal Anti-inflammatory Drugs, or Acetaminophen and Risk of Ovarian Cancer

Lo-Ciganic, Wei-Hsuana; Zgibor, Janice C.a; Bunker, Clareann H.a; Moysich, Kirsten B.b; Edwards, Robert P.c; Ness, Roberta B.d

doi: 10.1097/EDE.0b013e3182456ad3

Background: Aspirin, nonaspirin nonsteroidal anti-inflammatory drugs (NA-NSAIDs) and acetaminophen all have biologic effects that might reduce the risk of ovarian cancer. However, epidemiologic data on this question are mixed.

Methods: A population-based, case-control study in western Pennsylvania, eastern Ohio, and western New York State included 902 women with incident epithelial ovarian cancer who were diagnosed between February 2003 and November 2008 as well as 1802 matched controls. Regular use (at least 2 tablets per week for 6 months or more) of aspirin, NA-NSAIDs, and acetaminophen before the reference date (9 months before interview date) was assessed by in-person interview. We used logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

Results: The OR for aspirin use was 0.81 (95% CI = 0.63–1.03). Decreased risks were found among women who used aspirin continuously (0.71 [0.54–0.94]) or at a low-standardized daily dose (0.72 [0.53–0.97]), who used aspirin for the prevention of cardiovascular disease (0.72 [0.57–0.97]), who used aspirin more recently, or who used selective cyclooxygenase-2 inhibitors (0.60 [0.39–0.94]). No associations were observed among women using nonselective NA-NSAIDs or acetaminophen.

Conclusions: Risk reductions of ovarian cancer were observed with use of aspirin or selective cyclooxygenase-2 inhibitors. However, the results should be interpreted with caution due to the inherent study limitations and biases.

Supplemental Digital Content is available in the text.

From the aDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA; bDepartment of Cancer Prevention and Control, Division of Cancer Prevention and Population Science, and Department of Cancer Pathology and Prevention, Roswell Park Cancer Institute, Buffalo, NY; cDepartment of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Hospital of UPMC, University of Pittsburgh, Pittsburgh, PA; and dSchool of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.

Submitted 28 March 2011; accepted 1 November 2011; posted online 17 January 2012.

Supported by National Cancer Institute (Grant No: R01CA095023). The authors reported no other financial interests related to this research.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Correspondence: Wei-Hsuan Lo-Ciganic, University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, 130 N. Bellefield Avenue, Pittsburgh, PA 15213. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.