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Ann Oncol. 2018 Dec 19. doi: 10.1093/annonc/mdy541. [Epub ahead of print]

Use of aspirin, other nonsteroidal anti-inflammatory drugs and acetaminophen and risk of endometrial cancer: the Epidemiology of Endometrial Cancer Consortium.

Author information

1
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
2
University of Queensland, School of Public Health, Brisbane, Australia.
3
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
4
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
5
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
6
Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, Helsinki, Finland.
7
Department of Epidemiology, Harvard School of Public Health, Boston, USA.
8
School of Public Health, University of Minnesota, Minneapolis, USA.
9
Slone Epidemiology Center, Boston University, Boston, USA.
10
Women and Children's Division, Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway.
11
Department of Bowel Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
12
Ohio State University Comprehensive Cancer Center, Columbus, USA.
13
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA.
14
Fred Hutchinson Cancer Research Center, Seattle, USA.
15
Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, USA.
16
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA.
17
Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, USA.
18
Memorial Sloan Kettering Cancer Center, New York, USA.
19
University of Southern California, Los Angeles, USA.
20
University of Hawaii Cancer Center, Honolulu, USA.
21
Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA.

Abstract

Background:

Regular use of aspirin has been associated with a reduced risk of cancer at several sites but the data for endometrial cancer are conflicting. Evidence regarding use of other analgesics is limited.

Patients and methods:

We pooled individual-level data from seven cohort and five case-control studies participating in the Epidemiology of Endometrial Cancer Consortium including 7,120 women with endometrial cancer and 16,069 controls. For overall analyses, study-specific odds ratios (ORs) and 95% confidence intervals (CI) were estimated using logistic regression and combined using random-effects meta-analysis; for stratified analyses we used mixed-effects logistic regression with study as a random effect.

Results:

At least weekly use of aspirin and non-aspirin (NA) NSAIDs was associated with an approximately 15% reduced risk of endometrial cancer among both overweight and obese women (OR = 0.86 [95%CI 0.76-0.98] and 0.86 [0.76-0.97], respectively, for aspirin; 0.87 [0.76-1.00] and 0.84 [0.74-0.96], respectively, for NA-NSAIDs). There was no association among women of normal weight (BMI <25 kg/m2, PHeterogeneity=0.04 for aspirin, PHeterogeneity=0.003 for NSAIDs). Among overweight and obese women, the inverse association with aspirin was stronger for use 2-6 times/week (OR = 0.81, 95%CI 0.68-0.96) than for daily use (0.91, 0.80-1.03), possibly because a high proportion of daily users use low-dose formulations. There was no clear association with use of acetaminophen.

Conclusion:

Our pooled analysis provides further evidence that use of standard-dose aspirin or other NSAIDs may reduce risk of endometrial cancer among overweight and obese women.

PMID:
30566587
DOI:
10.1093/annonc/mdy541

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