Meta-analysis on the association between non-steroidal anti-inflammatory drug use and ovarian cancer

Aim: Animal and in vitro studies suggest that the use of non-steroidal anti-inflammatory drugs (NSAIDs) may be associated with reduced risk for ovarian cancer. However, results from these studies have been inconsistent. The aim of our study was to review and summarize the evidence provided by longitudinal studies on the association between NSAID use and ovarian cancer risk.

Methods: A comprehensive literature search for articles published up to December 2011 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risk (RR) or odds ratios (OR) were calculated.

Results: Seventeen reports (13 case-control studies, one clinical trial and three cohort studies), published between 1998 and 2011 were identified. There was no evidence of an association between aspirin use and ovarian cancer risk based on a random-effects model (RR = 0.91, 95% confidence interval (CI) 0.82, 1.01) or a fixed-effects model (RR = 0.94, 95% CI 0.87, 1.01). Similarly, we did not find strong evidence of an association between non-aspirin NSAID use and ovarian cancer using a random-effects model (RR = 0.89, 95% CI 0.74, 1.08) or a fixed-effects model (RR = 0.86, 95% CI 0.76, 0.98). Furthermore, our analysis did not show a strong association between frequency or duration of non-aspirin-NSAID use and ovarian cancer.

Conclusions: Our findings indicate that there is no strong evidence of an association between aspirin/NA-NSAID use and ovarian cancer. However, this subject deserves further investigation.