HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE COVER ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a letter to the editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content

NEWS & VIEWS

ACETAMINOPHEN MAY REDUCE RISK OF OVARIAN CANCER

Further studies are needed to determine whether acetaminophen reduces risk of ovarian cancer.

The study, conducted by Kristen B. Moysich, PhD, and colleagues from Roswell Park Cancer Institute in Buffalo, NY, compared 547 women diagnosed with ovarian cancer with 1,094 women who were admitted to the hospital for non-neoplastic conditions in the period between 1982 and 1998. The women in the study were predominantly white and they ranged in age from 20 to 90 years old.

Both groups completed a comprehensive questionnaire pertaining to their reproductive and medical histories, family histories of cancer, occupational and environmental exposures, tobacco and alcohol consumption, and diet.

The questionnaire also assessed analgesic usage—specifically aspirin and acetaminophen use—before the onset of their current illnesses. Those who took either analgesic at least once a week for six consecutive months were considered regular users.

	Experts Remain Unclear on Its Chemopreventive Role

TOP Experts Remain Unclear on... Further Studies Needed

 
The study showed that the ovarian cancer risk for regular acetaminophen users was 44 percent lower than that of nonusers. Furthermore, the risk for women who took seven or more tablets per week was 68 percent lower than that of nonusers. And the longer the use, the more risk was reduced. Compared with nonusers, the ovarian cancer risk for long-term (11 years or more) and shorter-duration users (six months to 10 years) was reduced by 49 percent and 40 percent, respectively.

Although regular aspirin use has previously been associated with a lower risk of colon, esophagus, stomach, and other cancers, this study did not find any difference in ovarian cancer risk between women who regularly used aspirin and those who did not, regardless of frequency and duration of aspirin use.

Should physicians advise their patients to take acetaminophen as a cancer chemopreventive agent? No, says American Cancer Society (ACS) senior epidemiologist Carmen Rodriguez, MD.

Rodriguez is the lead author of an ACS Cancer Prevention II study of over 600,000 women published in Lancet (1998;352:1354-1355) that found a similar reduction of the ovarian cancer mortality rate in women who took daily doses of acetaminophen, and found no association between the ovarian cancer mortality rate and aspirin use.

Other studies support just the opposite conclusion, however. Their findings suggest that aspirin, but not acetaminophen, can protect women against ovarian cancer.

"As a group, these studies, including mine, that do show a decreased risk with the use of acetaminophen did not have a consistent dose response, and that is always a requirement," says Rodriguez. "You need a proven, reproducible temporal relationship and a biological mechanism."

So for now, there is lack of agreement as to whether acetaminophen lowers ovarian cancer risk. And no agreement has been reached as to how much is needed, and how it might work if it is indeed effective as an ovarian cancer chemopreventive agent.

	Further Studies Needed

TOP Experts Remain Unclear on... Further Studies Needed

 
The Roswell Park researchers agree that study results have been inconsistent. Regarding a possible mechanism, some investigators have suggested that acetaminophen may have antigonadotropic activity. This hypothesis is supported by at least one study reporting reduced gonadotropin and estrogen levels in women who were regular acetaminophen users. Whether this is the mechanism by which acetaminophen may reduce ovarian cancer risk is still uncertain.

"Clearly, future research is needed to further explore this association," the researchers write. "Laboratory investigations should be conducted to further define the biological mechanism by which acetaminophen might influence cancer risk."

"The main message is that we really don’t know enough to recommend this for ovarian cancer chemoprevention," says Rodriguez. "It’s an interesting finding that has already been seen in two other studies, but there’s still no understanding of how it works. Because acetaminophen is a nonprescription drug, many patients assume that it is completely safe. However, regular acetaminophen use, or overuse, can cause hepatotoxicity, especially in individuals with pre-existing liver disorders and those exposed to other hepatotoxins."

This Article Full Text (PDF) Submit a letter to the editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content