Nonsteroidal anti-inflammatory drugs and risk of ovarian cancer: systematic review and meta-analysis of observational studies

被引:51
作者
Baandrup, Louise [1 ]
Faber, Mette T. [1 ]
Christensen, Jane [1 ]
Jensen, Allan [1 ]
Andersen, Klaus K. [1 ]
Friis, Soren [1 ,2 ]
Kjaer, Susanne K. [1 ,3 ]
机构
[1] Danish Canc Soc, Res Ctr, DK-2100 Copenhagen, Denmark
[2] Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark
[3] Univ Copenhagen, Rigshosp, Gynecol Clin, Juliane Marie Ctr, DK-2100 Copenhagen, Denmark
关键词
Analgesics; gyne-oncology; inflammation; meta-analysis; ovarian neoplasms; review; ANALGESIC DRUGS; NSAID USE; ASPIRIN; INFLAMMATION; MORTALITY; ASSOCIATION; CARCINOMA; CYCLOOXYGENASE-2; ACETAMINOPHEN; PREVENTION;
D O I
10.1111/aogs.12069
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 0.841.02) and non-aspirin NSAIDs (RR 0.94; 95% CI 0.841.06) 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 0.790.98). 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.
引用
收藏
页码:245 / 255
页数:11
相关论文
共 54 条
[1]   Aspirin and epithelial ovarian cancer [J].
Akhmedkhanov, A ;
Toniolo, P ;
Zeleniuch-Jacquotte, A ;
Kato, I ;
Koenig, KL ;
Shore, RE .
PREVENTIVE MEDICINE, 2001, 33 (06) :682-687
[2]   Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials [J].
Algra, Annemijn M. ;
Rothwell, Peter M. .
LANCET ONCOLOGY, 2012, 13 (05) :518-527
[3]   Use of analgesic drugs and risk of ovarian cancer: results from a Danish case-control study [J].
Ammundsen, Henriette B. ;
Faber, Mette T. ;
Jensen, Allan ;
Hogdall, Estrid ;
Blaakaer, Jan ;
Hogdall, Claus ;
Kjaer, Susanne K. .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2012, 91 (09) :1094-1102
[4]  
[Anonymous], BR J CLIN PHARM
[5]  
[Anonymous], PHARMACOEPIDEMIOLOGY
[6]   Traditional reviews, meta-analyses and pooled analyses in epidemiology [J].
Blettner, M ;
Sauerbrei, W ;
Schlehofer, B ;
Scheuchenpflug, T ;
Friedenreich, C .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1999, 28 (01) :1-9
[7]   Do nonsteroidal anti-inflammatory drugs affect the risk of developing ovarian cancer? A meta-analysis [J].
Bonovas, S ;
Filioussi, K ;
Sitaras, NM .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2005, 60 (02) :194-203
[8]   Aspirin and cancer risk: an updated quantitative review to 2005 [J].
Bosetti, Cristina ;
Gallus, Silvano ;
La Vecchia, Carlo .
CANCER CAUSES & CONTROL, 2006, 17 (07) :871-888
[9]   Over-the-counter analgesics and risk of ovarian cancer [J].
Cramer, DW ;
Harlow, BL ;
Titus-Ernstoff, L ;
Bohlke, K ;
Welch, WR ;
Greenberg, ER .
LANCET, 1998, 351 (9096) :104-107
[10]   Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement [J].
Cuzick, Jack ;
Otto, Florian ;
Baron, John A. ;
Brown, Powel H. ;
Burn, John ;
Greenwald, Peter ;
Jankowski, Janusz ;
La Vecchia, Carlo ;
Meyskens, Frank ;
Senn, Hans Joerg ;
Thun, Michael .
LANCET ONCOLOGY, 2009, 10 (05) :501-507