title: Non-steroidal anti-inflammatory drug use and risk of endometrial cancer: A systematic review and meta-analysis of observational studies.
abstract: OBJECTIVE
  Non-steroidal anti-inflammatory drug (NSAID) use has been linked to a reduction in the risk of several cancer types. For endometrial cancer, however, results have been inconsistent. To summarize the available evidence on the risk of endometrial cancer associated with use of aspirin or non-aspirin (NA-) NSAIDs, we performed a systematic review and meta-analysis of observational studies.
  
  
  METHODS
  We conducted a bibliographic database search in PubMed, Embase and Cochrane Library. Relative risk estimates were extracted from eligible case-control and cohort studies and pooled using a random effects model.
  
  
  RESULTS
  Six case-control and seven cohort studies were found eligible for our meta-analysis. We observed risk reductions in endometrial cancer associated with regular use of aspirin (case-control: 11%, cohort: 8%) and NA-NSAIDs (case-control: 9%, cohort: 6%), compared to non-use. However, the pooled risk ratios were not statistically significant. Higher risk reductions were seen with high frequency of notably aspirin use (case-control: 37%, cohort: 20%). The inverse association between regular aspirin use and endometrial cancer risk was strongest among women with a body mass index above 30 (case-control: 44%, cohort: 20%).
  
  
  CONCLUSIONS
  Regular use of aspirin or NA-NSAIDs was associated with a marginally reduced risk of endometrial cancer. Larger risk reductions were linked with high frequency of NSAID use and high BMI.
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Freija
authors.initials: F
authors.lastname: Verdoodt
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, and Department of Clinical Epidemiology, Faculty of Health, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Friis
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Dehlendorff
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Vanna
authors.initials: V
authors.lastname: Albieri
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: susanne@cancer.dk.
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D064887:Observational Studies as Topic
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Aspirin; Cancer prevention; Endometrial cancer; Non-steroidal anti-inflammatory drugs; Pharmacoepidemiology