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Epidemiology

Low-dose aspirin use and risk of ovarian cancer: a combined analysis from two nationwide studies in Denmark and Sweden

British Journal of Cancer volume 130, pages 1279–1285 (2024)Cite this article

Subjects

Abstract

Background

Studies on association between low-dose aspirin use and ovarian cancer risk were mostly based on self-reported medication use and few had large enough sample size to investigate the potential modification effect by ovarian cancer risk factors.

Methods

In these two nationwide nested case-control studies among the Danish and Swedish female population, 11,874 women with ovarian cancer (30–84 years old) (Denmark: 7328 diagnosed in 2000–2019, Sweden: 4546 diagnosed in 2010–2018) were randomly age- matched with 473,960 female controls (293,120 from Denmark, and 181,840 from Sweden). We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) and combined the estimates based the fixed-effect assumption. Effect modification by inflammation-related risk factors and by indication (cardiovascular disease, CVD) were also investigated.

Results

Ever use of low-dose aspirin was not strongly associated with the overall risk of ovarian cancer (OR = 0.97; 95%CI: 0.92–1.03). However, the association differed according to parity (nulliparous: OR = 0.80, 95%CI: 0.70–0.92; parous: OR = 1.00, 95%CI: 0.94–1.07; p-interaction = 0.0024), and according to history of CVD (no CVD: OR = 0.91, 95%CI: 0.82–1.00; ever CVD: OR = 1.05, 95%CI: 0.97–1.13; p-interaction =0.0204).

Conclusions

Low-dose aspirin use was associated with a decreased ovarian cancer risk especially in nulliparous women and in women without CVD diagnosis.

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Fig. 1: Modification effect of ovarian cancer risk factors and cardiovascular diseases on the association between low-dose aspirin use and ovarian cancer risk.

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Data availability

The Danish data is based on pseudonymized registry data located on a secure platform at Statistics Denmark, which can be accessed given the relevant data permissions. The Swedish data is located on an encrypted server at Karolinska Institutet and is available from the study authors given all relevant data permissions.

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Acknowledgements

We express our gratitude to Senior Researcher Søren Friis for providing his expert opinion on the correlation between low-dose aspirin and ovarian cancer.

Funding

This work was funded by the Mermaid project (Mermaid III).

Author information

Authors and Affiliations

  1. Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark

    Guoqiao Zheng, Mette Tuxen Faber, Louise Baandrup, Rasmus Hertzum-Larsen & Susanne K. Kjær

  2. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Jiangrong Wang & Karin Sundström

  3. Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Susanne K. Kjær

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Contributions

G.Z.: Conceptualization, Methodology, Investigation, Data management, Formal analysis, Writing—original draft. M.T.F.: Conceptualization, Methodology, Writing—review & editing, Project administration. J.W.: Investigation, Writing—review & editing, Project administration. L.B.: Conceptualization, Methodology, Writing—review & editing. R.H.L.: Data management, Investigation, Writing—review & editing. K.S.: Investigation, Writing—review & editing, Project administration. S.K.K.: Conceptualization, Methodology, Investigation, Writing—review & editing, Project administration, Supervision, Funding.

Corresponding author

Correspondence to Guoqiao Zheng.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study is based on data from Danish and Swedish health registries with no direct involvement of study participants and thus no ethical approval was needed. For the data from Denmark, the relevant approvals for use of the included register data, which are placed in a project database at Statistics Denmark (project number 704327), were obtained. The Danish Cancer Society is responsible for the data stored at the Danish Cancer Society Research Center’s project database at Statistics Denmark. In agreement with the General Data Protection Regulation, the project is registered in the Danish Cancer Society’s internal list of projects that are dealing with personalized data (Journal numbers 2018-DCRC-0050 and 2019-DCRC-0054). The study was performed in accordance with the Declaration of Helsinki. For the data from Sweden, ethical approval for the study was obtained from the Ethical Review Authority of Sweden. Karolinska Institutet is responsible for the data stored for use in the project.

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Zheng, G., Faber, M.T., Wang, J. et al. Low-dose aspirin use and risk of ovarian cancer: a combined analysis from two nationwide studies in Denmark and Sweden. Br J Cancer 130, 1279–1285 (2024). https://doi.org/10.1038/s41416-024-02609-7

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