title: Non-steroidal anti-inflammatory drug use and ovarian cancer risk: findings from the NIH-AARP Diet and Health Study and systematic review.
abstract: BACKGROUND
  Chronic inflammation has been proposed as a risk factor for ovarian cancer. Some data suggest that anti-inflammatory medications may be protective against ovarian cancer; however, results have been inconsistent.
  
  
  METHODS
  We evaluated the risk of epithelial ovarian cancer with regular use of NSAIDs prospectively in the NIH-AARP Diet and Health Study, using Cox proportional hazard models. We also examined the risk of common subtypes of epithelial ovarian cancer (serous, mucinous, endometrioid, clear cell, and other epithelial) with regular use of NSAIDs. In addition, we performed meta-analyses summarizing the risk of ovarian cancer with "regular use" of NSAIDs in previously published studies.
  
  
  RESULTS
  We did not observe a significant association between regular use of NSAIDs with ovarian cancer risk in the AARP cohort (aspirin: RR 1.06, 95 % CI 0.87-1.29; non-aspirin NSAIDs: RR 0.93, 95 % CI 0.74-1.15); however, summary estimates from prospective cohort studies demonstrated that use of non-aspirin NSAIDs may reduce the risk of ovarian cancer (RR 0.88, 95 % CI 0.77-1.01). Although not significant, we found that mucinous tumors were inversely associated with non-aspirin NSAID use (RR 0.69, 95 % CI 0.23-2.10) in the AARP cohort, which was supported by the meta-analysis (RR 0.69, CI 0.50-0.94.)
  
  
  CONCLUSIONS
  Although results from the NIH-AARP cohort study were not statistically significant, our meta-analysis suggests that non-aspirin NSAIDs may be protective against ovarian cancer. Additional analyses, focusing on dose, duration, and frequency of NSAID use and accounting for ovarian cancer heterogeneity are necessary to further elucidate the association between NSAID use and ovarian cancer risk.
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Murphy
authors.forename: Britton
authors.initials: B
authors.lastname: Trabert
authors.forename: Hannah P
authors.initials: HP
authors.lastname: Yang
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Albert
authors.initials: A
authors.lastname: Hollenbeck
authors.forename: Nicolas
authors.initials: N
authors.lastname: Wentzensen
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D010051:Ovarian Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal