eprintid: 10152789 rev_number: 10 eprint_status: archive userid: 699 dir: disk0/10/15/27/89 datestamp: 2022-07-28 07:36:39 lastmod: 2023-08-08 12:59:04 status_changed: 2022-07-28 07:36:39 type: article metadata_visibility: show sword_depositor: 699 creators_name: Hurwitz, Lauren M creators_name: Townsend, Mary K creators_name: Jordan, Susan J creators_name: Patel, Alpa V creators_name: Teras, Lauren R creators_name: Lacey, James V creators_name: Doherty, Jennifer A creators_name: Harris, Holly R creators_name: Goodman, Marc T creators_name: Shvetsov, Yurii B creators_name: Modugno, Francesmary creators_name: Moysich, Kirsten B creators_name: Robien, Kim creators_name: Prizment, Anna creators_name: Schildkraut, Joellen M creators_name: Berchuck, Andrew creators_name: Fortner, Renée T creators_name: Chan, Andrew T creators_name: Wentzensen, Nicolas creators_name: Hartge, Patricia creators_name: Sandler, Dale P creators_name: O'Brien, Katie M creators_name: Anton-Culver, Hoda creators_name: Ziogas, Argyrios creators_name: Menon, Usha creators_name: Ramus, Susan J creators_name: Pearce, Celeste Leigh creators_name: Wu, Anna H creators_name: White, Emily creators_name: Peters, Ulrike creators_name: Webb, Penelope M creators_name: Tworoger, Shelley S creators_name: Trabert, Britton title: Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia ispublished: pub divisions: UCL divisions: J38 divisions: D65 divisions: B02 note: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. abstract: PURPOSE: Frequent aspirin use has been associated with reduced ovarian cancer risk, but no study has comprehensively assessed for effect modification. We leveraged harmonized, individual-level data from 17 studies to examine the association between frequent aspirin use and ovarian cancer risk, overall and across subgroups of women with other ovarian cancer risk factors. METHODS: Nine cohort studies from the Ovarian Cancer Cohort Consortium (n = 2,600 cases) and eight case-control studies from the Ovarian Cancer Association Consortium (n = 5,726 cases) were included. We used Cox regression and logistic regression to assess study-specific associations between frequent aspirin use (≥ 6 days/week) and ovarian cancer risk and combined study-specific estimates using random-effects meta-analysis. We conducted analyses within subgroups defined by individual ovarian cancer risk factors (endometriosis, obesity, family history of breast/ovarian cancer, nulliparity, oral contraceptive use, and tubal ligation) and by number of risk factors (0, 1, and ≥ 2). RESULTS: Overall, frequent aspirin use was associated with a 13% reduction in ovarian cancer risk (95% CI, 6 to 20), with no significant heterogeneity by study design (P = .48) or histotype (P = .60). Although no association was observed among women with endometriosis, consistent risk reductions were observed among all other subgroups defined by ovarian cancer risk factors (relative risks ranging from 0.79 to 0.93, all P-heterogeneity > .05), including women with ≥ 2 risk factors (relative risk, 0.81; 95% CI, 0.73 to 0.90). CONCLUSION: This study, the largest to-date on aspirin use and ovarian cancer, provides evidence that frequent aspirin use is associated with lower ovarian cancer risk regardless of the presence of most other ovarian cancer risk factors. Risk reductions were also observed among women with multiple risk factors, providing proof of principle that chemoprevention programs with frequent aspirin use could target higher-risk subgroups. date: 2022-12-20 date_type: published publisher: American Society of Clinical Oncology (ASCO) official_url: https://doi.org/10.1200/JCO.21.01900 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1967085 doi: 10.1200/JCO.21.01900 medium: Print-Electronic lyricists_name: Menon, Usha lyricists_id: UMENO29 actors_name: Payne, Roxanne actors_id: RPAYN74 actors_role: owner full_text_status: public publication: Journal of Clinical Oncology volume: 40 number: 36 pagerange: 4207-4217 event_location: United States issn: 0732-183X citation: Hurwitz, Lauren M; Townsend, Mary K; Jordan, Susan J; Patel, Alpa V; Teras, Lauren R; Lacey, James V; Doherty, Jennifer A; ... Trabert, Britton; + view all <#> Hurwitz, Lauren M; Townsend, Mary K; Jordan, Susan J; Patel, Alpa V; Teras, Lauren R; Lacey, James V; Doherty, Jennifer A; Harris, Holly R; Goodman, Marc T; Shvetsov, Yurii B; Modugno, Francesmary; Moysich, Kirsten B; Robien, Kim; Prizment, Anna; Schildkraut, Joellen M; Berchuck, Andrew; Fortner, Renée T; Chan, Andrew T; Wentzensen, Nicolas; Hartge, Patricia; Sandler, Dale P; O'Brien, Katie M; Anton-Culver, Hoda; Ziogas, Argyrios; Menon, Usha; Ramus, Susan J; Pearce, Celeste Leigh; Wu, Anna H; White, Emily; Peters, Ulrike; Webb, Penelope M; Tworoger, Shelley S; Trabert, Britton; - view fewer <#> (2022) Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia. Journal of Clinical Oncology , 40 (36) pp. 4207-4217. 10.1200/JCO.21.01900 <https://doi.org/10.1200/JCO.21.01900>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10152789/1/jco.21.01900.pdf