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| |  DG DISPATCH - SGO: Study Suggests Aspirin Offers Protective Benefit Against Ovarian Epithelial Cancer By Cameron Johnston Special to DG News
NASHVILLE, TN -- March 7, 2001 -- The same mechanisms that give aspirin a potentially protective benefit against colorectal cancer could provide protection against ovarian epithelial cancer as well. According to a paper presented here today (March 7) at the 32nd annual meeting of the Society of Gynecologic Oncology, women who use aspirin on a regular basis might run a lower risk of ovarian epithelial cancer than women who do not use it regularly. The study comes from an offshoot of the New York University Women’s Health Study, which has tracked the health of a cohort of more than 14,000 women since 1985. There were 140 cases of ovarian epithelial cancer among the 14,000 women involved in the study, which agrees with other published reports as to the incidence of the disease. Sixty-eight of the 140 were asked to complete a questionnaire asking specifically whether, during 1994-96, they took aspirin three or more times per week, over a six-month period. Data show that women who took aspirin three or more times per week during this period were less likely to develop ovarian epithelial cancer (RR=0.56). The results also show that women who took aspirin within the previous five years were less likely to develop cancer than those women who took aspirin more than five years earlier. This suggests that the presumed protective effect wears off or is reduced over time, and is significantly reduced after five years, said Dr. Arslan Akhmedkhanov, principal investigator and research assistant professor in the division of women’s health at the New York University School of Medicine, New York. In an interview with Doctor’s Guide, Dr. Akhmedkhanov said the study has certain limitations, notably that the women were not asked what dose of aspirin they were using, why they were using it, for exactly how long, or how many days per week they used it. Nonetheless, he suggested three possible mechanisms by which aspirin might reduce the incidence of ovarian epithelial cancer: It might induce apoptosis of the epithelial tumor cells. Aspirin might inhibit angiogenesis, and perhaps most probable, it appears to inhibit the cyclo-oxygenase-1 (COX-1) and COX-2 enzymes, the latter of which has been known to have a causal relationship with colorectal cancer. COX-2 is responsible for the production of prostaglandins, which are known tumor promoters, Dr. Akhmedkhanov said. COX-2 is also over-expressed in other gynecologic malignancies. However, Since aspirin and other non-steroidal anti-inflammatory drugs inhibit COX-2, this might reduce the risk of ovarian epithelial cancer cell proliferation. Aspirin might also act indirectly by reducing pelvic inflammation, and endometriosis, which are known risk factors for ovarian cancer, he added. "I think cyclo-oxygenase reduction is one of the probable mechanisms, but it may be that there are several concurrent mechanisms. We are not excluding the possibility that several mechanism may be involved," Dr. Akhmedkhanov said. "This data suggests that aspirin might have a protective effect. But before any specific recommendations can be made about using aspirin for the prevention of ovarian cancer, larger studies are needed, especially to determine the dose. "We are very cautious in this interpretation because aspirin is not without its risk - primarily the risk of gastrointestinal hemorrhage. Therefore, before any specific recommendations are made, we have to caution that more research is needed to establish the correct dosage, and duration of use," he told Doctor’s Guide.
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