Merritt MA, et al. - In patients with ovarian cancer, researchers determined the impact of modifiable exposures to common analgesics outside of standard treatment on prognosis. According to findings, ovarian cancer-specific survival appeared to improve in association with recent use of aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), defined as current use in the past 2 years.

Methods

• Researchers retrieved information from medical records, death certificates, or linkage to a state or Surveillance, Epidemiology, and End Results (SEER) cancer registry on ovarian cancer cases, using the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII), which are ongoing prospective studies of 121,700 and 116,429 US nurses who have completed biennial questionnaires since 1976 and 1989, respectively.
• Patients with confirmed invasive, stage I–III epithelial ovarian cancer, and having data available on analgesic use were considered eligible.
• The association of self-reported regular use (≥ 2 days per week) of aspirin, non-aspirin NSAIDs, or paracetamol before and after ovarian cancer diagnosis, with ovarian cancer-specific survival was investigated as the primary objective.
• They used Cox proportional hazards regression to calculate hazard ratios (HRs) and 95% CIs for these links, adjusting for age and year of diagnosis, disease stage, and histology.

Results

• Between June 1, 1976 and May 31, 2012 for the NHS, and between June 1, 1989 and May 31, 2013 for NHSII, an epithelial ovarian cancer diagnosis was made for 1,789 participants of the NHS and NHSII studies and 1,143 (64%) were eligible to be included in this study; pre-diagnosis exposure analysis and post-diagnosis exposure analysis included 1,031 (90%) and 964 cases (84%) of these, respectively.
• They observed an improved ovarian cancer-specific survival among participants who reported recent (current use in the past 2 years) post-diagnosis use of aspirin (HR 0·68 [95% CI 0·52–0·89]) and non-aspirin NSAIDs (HR 0·67 [95% CI 0·51–0·87]), vs never-users.
• Findings demonstrated no positive association of any type of analgesic use pre-diagnosis, and of post-diagnosis use of paracetamol, with ovarian cancer-specific survival.
• Compared with never-users, a lower risk of ovarian cancer-specific death was observed in participants who became recent users of aspirin (HR 0·44 [95% CI 0·26–0·74]) or became recent users of non-aspirin NSAIDs (HR 0·46 [95% CI 0·29–0·73]) post-diagnosis in analyses of change in analgesic use from pre-diagnosis to post-diagnosis.