Use of non-prescription analgesic medications and survival among Black women with ovarian cancer

Abstract

Background: Chronic inflammation and inflammatory-related exposures have been implicated in epithelial ovarian cancer (EOC) prognosis. However, no studies have evaluated whether analgesic medication use impacts survival in Black women with EOC, an understudied population with poor survival. Methods: Leveraging data from the African American Cancer Epidemiology Study, we examined the association of pre-diagnostic analgesic medication use (aspirin, non-aspirin non-steroidal anti-inflammatory drugs [naNSAIDs], and acetaminophen) with survival among self-identified Black women diagnosed with EOC (N = 541) using multivariable Cox proportional hazards regression. Stratified analyses were conducted by comorbidities and histotype. Results: Acetaminophen use was associated with a higher risk of mortality overall (HR = 1.40; 95% CI = 1.00-1.97) and for frequent and chronic use (≥30 days per month: HR = 1.62; 95% CI = 1.12-2.34; >5 years: HR = 1.57; 95% CI = 1.03-2.39). These associations were more pronounced among women with high-grade serous carcinoma (HGSC)/carcinosarcoma and those with comorbidities. Among women with comorbidities, naNSAID use was associated with a decreased risk of mortality (HR = 0.71; 95% CI = 0.51-0.99), but no association was observed among women without comorbidities (HR = 0.99; 95% CI = 0.56-1.75). No associations with survival were observed for aspirin. Conclusion: Chronic use of acetaminophen negatively impacted survival among Black women with EOC, while naNSAID use conferred a survival advantage only among women with comorbidities.