Can aspirin help reduce risk of developing ovarian cancer?

Posted in ovarian cancer; Posted 14 days ago by Andreas Obermair

The potential role of aspirin in preventing ovarian cancer is an area of intense, ongoing research. Strong evidence indicates that regular and frequent use of aspirin, particularly on a daily or near-daily basis, may have a protective effect against the occurrence of ovarian cancer.

In a recent study in JAMA Network Open, researchers aimed to investigate if taking aspirin frequently can reduce the risk of ovarian cancer, and if this effect is influenced by a person's genetic makeup.

The researchers combined information from eight different studies conducted in the US, UK and Australia combining 4,476 ovarian cancer patients and looked at how often people took aspirin and their genetic information. Frequent use of aspirin was defined across the studies as daily or most days of the week for six months or longer. They then used this information to see if there was a connection between taking aspirin frequently and the risk of developing ovarian cancer, and if this connection was influenced by a person's genes.

The researchers found that taking aspirin regularly lowered the risk of ovarian cancer by 13%. This was found for most types of ovarian cancer, including the more aggressive subtypes. The researchers also found that a person's genes do not seem to affect the protective effect of aspirin.

Aspirin and its use after diagnosis

I was a Chief Investigator in the Ovarian cancer Prognosis And Lifestyle (OPAL) study, and part of its findings have been recently published in the Journal of The National Cancer Institute. The study aimed to see if nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin, have any influence on the recurrence of ovarian cancer disease and overall patient survival. The study included more than 900 Australian women diagnosed with ovarian cancer from 2012 to 2015. We asked them how often they used NSAIDs. Participants were followed for up to five years postdiagnosis.

In our study frequent use (defined as 4 days per week or more) of NSAIDs, including aspirin, after a diagnosis of ovarian cancer was associated with improved survival, particularly in women with stage III or IV disease. The findings suggest an average additional survival of 2.5 months during the five years following diagnosis. While this may not seem substantial, it holds significance in the context of ovarian cancer. About 75% of patients are detected in advanced stages with limited treatment options, making any extension in survival noteworthy.

While these results sound promising, introducing aspirin is not straight forward. Aspirin, like any medication, comes with potential risks, including gastrointestinal bleeding and haemorrhagic stroke. These risks need to be carefully weighed against the potential benefits when considering
aspirin for cancer prevention. Future studies should determine specifically the benefits and harms of aspirin maintenance treatment.

I often recommend low-dose aspirin after any gynaecological cancer type if patients tolerate it well. It is cheap, mostly well tolerated and an increasing number of studies detect a survival benefit.

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