Aspirin use and ovarian cancer risk using extended follow-up of the PLCO Cancer Screening Trial

Hurwitz, Lauren M.; Pinsky, Paul F.; Huang, Wen‐Yi; Freedman, Neal D.; Trabert, Britton

doi:10.1016/j.ygyno.2020.08.038

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Recent investigations in the PLCO population have demonstrated several associations between aspirin use and the risk of cancer incidence and survival. Among cancers screened as part of the trial protocol, aspirin use has been associated with significant reductions in risk of colorectal polyps and colorectal cancer; in contrast, there was modest to no association between aspirin use and prostate and ovarian incidence and survival . To our knowledge, no investigations into aspirin use and risk of bladder, breast, esophageal, gastric, pancreatic, or uterine cancers have been conducted in PLCO.…”

Section: Introductionmentioning

confidence: 99%

“…Among cancers screened as part of the trial protocol, aspirin use has been associated with significant reductions in risk of colorectal polyps and colorectal cancer; in contrast, there was modest to no association between aspirin use and prostate and ovarian incidence and survival. 33 , 34 , 35 , 36 , 37 To our knowledge, no investigations into aspirin use and risk of bladder, breast, esophageal, gastric, pancreatic, or uterine cancers have been conducted in PLCO. With the high frequency of aspirin use, the substantial annual incidence of breast, bladder, and uterine cancers in the United States, and the noted association between aspirin use and gastrointestinal cancers (eg, esophageal, gastric, pancreatic), we chose to perform a thorough investigation of the association between aspirin use and cancer risk and survival of these cancers in PLCO.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

2021

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IMPORTANCE Many studies have evaluated the long-term benefits of aspirin use; however, the association of aspirin use with cancer incidence and survival in older individuals remains uncertain.Additional population-based evidence of this association is necessary to better understand any possible protective effects of aspirin in older adults. OBJECTIVE To investigate the association of aspirin use with risk of developing new cancers and site-specific cancer-associated survival in bladder, breast, esophageal, gastric, pancreatic, and uterine cancers. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Participants were aged 65 years or older at baseline (1993-2001) or reached age 65 during follow-up. Data analysis was conducted from January to June 2020. MAIN OUTCOMES AND MEASURES Incidence of and survival from the investigated cancer types.Univariable and multivariable hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards regression modeling, adjusting for covariates. Multivariable models for incidence included time-varying covariates. RESULTSA total of 139 896 individuals (mean [SD] age at baseline, 66.4 [2.4] years; 71 884 [51.4%] women; 123 824 [88.5%] non-Hispanic White individuals) were included in the analysis. During the study period, 32 580 incident cancers (1751 [5.4%] bladder, 4552 [14.0%] breast, 332 [1.0%] esophageal, 397 [1.2%] gastric, 878 [2.7%] pancreatic, and 716 [2.2%] uterine cancers) werereported. Aspirin use was not associated with incidence of any of the investigated cancer types among individuals aged 65 years or older. Multivariable regression analysis demonstrated that aspirin use at least 3 times/week was associated with increased survival among patients with bladder (HR, 0.67; 95% CI, 0.51-0.88) and breast (HR, 0.75; 95% CI, 0.59-0.96) cancers but not among those with esophageal, gastric, pancreatic, or uterine cancer. A similar association of any aspirin use with bladder (HR, 0.75; 95% CI, 0.58-0.98) and breast (HR, 0.79; 95% CI, 0.63-0.99) cancer survival was observed. CONCLUSIONS AND RELEVANCEIn the current study, any aspirin use and aspirin use at least 3 times/week was associated with improved bladder and breast cancer survival. Associations between aspirin use and incidence of any of the investigated cancers or between aspirin use and esophageal, gastric, pancreatic, or uterine cancer survival were not observed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

2021

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“…Pooled secondary analyses of randomized controlled trials of aspirin for cardiovascular disease prevention have noted a decreased risk of female reproductive cancers with $ 3 years of aspirin use, although too few ovarian cancer cases were diagnosed in these trial populations to draw inferences for ovarian cancer specifically. 11 In the observational setting, individual study results have been mixed, [12][13][14][15][16][17][18][19][20][21][22][23] but metaanalyses 24 and pooled analyses of cohort 25 and casecontrol 26 studies have found that aspirin may reduce ovarian cancer risk by 10%-20%, particularly when used frequently (ie, daily or almost daily).…”

Section: Introductionmentioning

confidence: 99%

Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia

Hurwitz

Townsend

Jordan

et al. 2022

Obstetrical &Amp; Gynecological Survey

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“…Data from numerous studies have shown that prolonged intake of aspirin reduces the risk of and improves survival in patients with several cancers, including colon, breast, lung, prostate, and endometrial cancers ( Bardia et al, 2011 ; Lim et al, 2012 ; Huang et al, 2014 ; Cao et al, 2016 ; Chen & Holmes, 2017 ; Takiuchi et al, 2018 ; Gan et al, 2019 ; Loomans-Kropp et al, 2019 ). Regular aspirin use is related to a reduction in the ovarian cancer risk ( Trabert et al, 2014 ; Trabert et al, 2019 ; Hurwitz et al, 2020 ). Furthermore, Merritt, Rice & Barnard (2018) recently assessed the relations between aspirin, other NSAIDs, paracetamol, and ovarian cancer-specific survival after an ovarian cancer diagnosis in approximately 1,000 cases.…”

Section: Introductionmentioning

confidence: 99%

Aspirin inhibits tumor progression and enhances cisplatin sensitivity in epithelial ovarian cancer

Guo

Zhu

et al. 2021

PeerJ

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Background Ovarian cancer is the most common gynecological malignancy and is difficult to manage due to the emergence of resistance to various chemotherapeutic drugs. New efforts are urgently awaited. Aspirin, which is traditionally considered a nonsteroidal anti-inflammatory drug (NSAID), has been reported to exert potential chemopreventive effects. Therefore, we aimed to investigate the anticancer effect and explore the underlying molecular mechanisms of aspirin on epithelial ovarian cancer (EOC) cells. Methods We conducted wound healing, transwell migration, EdU cell proliferation, colony formation and apoptosis detection assays to observe the effects of aspirin on the migration, proliferation and apoptosis of EOC cells (A2870, Caov-3, and SK-OV-3). EOC cells were treated with a combination of aspirin and cisplatin (CDDP) to observe the effect of aspirin on enhancing CDDP sensitivity. Orthotopic xenograft models of ovarian cancer established with A2780-Luciferase-GFP cells were applied to compare tumor growth inhibition in the control, CDDP and CDDP plus aspirin groups through in vivo imaging, which can be used to continuously monitor tumor growth. The expression and acetylation levels of p53 in EOC cells treated with aspirin were determined using western blotting, and p53 acetylation levels were examined in tumors harvested from the transplanted mice. Quantitative real-time PCR was used to assess the mRNA expression of p53 target genes. Results Aspirin inhibited migration and proliferation and induced apoptosis in EOC cell lines in a concentration-dependent manner. In vitro, aspirin enhanced the sensitivity of EOC cells to CDDP by increasing its inhibitory effect on proliferation and its effect on inducing apoptosis. In vivo, the differences in the tumor growth inhibition rates among the different CDDP experimental groups were statistically significant (p < 0.05). Aspirin did not affect p53 protein expression but increased the p53 acetylation level in a concentration-dependent manner. In addition, the mRNA levels of CDKN1A, BAX, FOXF1, PUMA, and RRAD in EOC cells were significantly increased by the aspirin treatment. Conclusions Aspirin inhibits tumor progression and enhances the CDDP sensitivity of EOC cells. These antitumor effects of aspirin might be mediated by p53 acetylation and subsequent activation of p53 target genes.

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Aspirin use and ovarian cancer risk using extended follow-up of the PLCO Cancer Screening Trial

Cited by 14 publications

References 16 publications

Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Evaluation of Aspirin Use With Cancer Incidence and Survival Among Older Adults in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia

Aspirin inhibits tumor progression and enhances cisplatin sensitivity in epithelial ovarian cancer

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