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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng241er13-lrg.png" alt="Cover of Preventive medicines" /></a><div class="icnblk_cntnt"><h1 id="_NBK604292_"><span itemprop="name">Preventive medicines</span></h1><div class="subtitle">Ovarian cancer: identifying and managing familial and genetic risk</div><p><b>Evidence review M</b></p><p><i>NICE Guideline, No. 241</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2024 Mar</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5833-7</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="niceng241er13.s1"><h2 id="_niceng241er13_s1_">Preventive medicines</h2><div id="niceng241er13.s1.1"><h3>Review question</h3><p>How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</p><div id="niceng241er13.s1.1.1"><h4>Introduction</h4><p>Women with a familial ovarian cancer risk are motivated to take steps to reduce their risk of developing ovarian cancer. These women are offered surgery to remove their tubes and ovaries to mitigate this risk; however, surgery comes with its own inherent risk which may be unacceptable to some. Other women with familial ovarian cancer do not wish to have surgery due to its impact on fertility. Finally, others are not well enough to have the risk reducing surgery. In addition, surgery cannot reduce the risk of developing ovarian cancer completely. Therefore, other ways to reduce an individual’s risk of familial ovarian cancer are a priority to those with an inherited risk and their clinicians. It is known that certain medications can reduce the risk of ovarian cancer in all or specific inherited ovarian cancer syndromes. The evidence review will consider those medications, the evidence that supports them, their side effects and the effective doses needed to reduce ovarian cancer in those with a familial ovarian cancer risk.</p></div><div id="niceng241er13.s1.1.2"><h4>Summary of the protocol</h4><p>See <a href="/books/NBK604292/table/niceng241er13.tab1/?report=objectonly" target="object" rid-ob="figobniceng241er13tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><p>For further details see the review protocol in <a href="#niceng241er13.appa">appendix A</a>.</p></div><div id="niceng241er13.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng241er13.appa">appendix A</a> and the <a href="/books/NBK604292/bin/NG241-Supplement1-Methods.pdf">methods</a> document (supplementary document 1).</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng241er13.s1.1.4"><h4>Effectiveness evidence</h4><div id="niceng241er13.s1.1.4.1"><h5>Included studies</h5><p>Eight studies were included for this review, 1 systematic review of case-control and cohort studies (<a class="bk_pop" href="#niceng241er13.s1.ref7">van Bommel 2023</a>), 3 individual patient data meta-analyses (<a class="bk_pop" href="#niceng241er13.s1.ref2">Hurwitz 2021</a>, <a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a>, <a class="bk_pop" href="#niceng241er13.s1.ref4">Hurwitz 2023</a>), 1 cohort study (<a class="bk_pop" href="#niceng241er13.s1.ref6">Michels 2018</a>) and 3 case-control studies (<a class="bk_pop" href="#niceng241er13.s1.ref1">Gross 1992</a>, <a class="bk_pop" href="#niceng241er13.s1.ref5">McLaughlin 2007</a>, <a class="bk_pop" href="#niceng241er13.s1.ref8">Vicus 2009</a>).</p><p>Three individual patient data meta-analyses (<a class="bk_pop" href="#niceng241er13.s1.ref2">Hurwitz 2021</a>, <a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a>, <a class="bk_pop" href="#niceng241er13.s1.ref4">Hurwitz 2023</a>) compared frequent/daily aspirin use to infrequent/no aspirin use. Although there was some overlap in the study participants included in these studies, the studies focused on, and analysed different populations, namely women with a history of ovarian cancer only (<a class="bk_pop" href="#niceng241er13.s1.ref2">Hurwitz 2021</a>), women with a history of both ovarian cancer or breast cancer (<a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a>) and women with genetic data available (<a class="bk_pop" href="#niceng241er13.s1.ref4">Hurwitz 2023</a>). One systematic review compared oral contraceptive use to no oral contraceptive use among <i>BRCA1/2</i> carriers (<a class="bk_pop" href="#niceng241er13.s1.ref7">van Bommel 2023</a>). One cohort study (<a class="bk_pop" href="#niceng241er13.s1.ref6">Michels 2018</a>) compared oral contraceptive use to no oral contraceptive use. Three case-controls studies compared oral contraceptive use to no oral contraceptive use (<a class="bk_pop" href="#niceng241er13.s1.ref1">Gross 1992</a>, <a class="bk_pop" href="#niceng241er13.s1.ref5">McLaughlin 2007</a>, <a class="bk_pop" href="#niceng241er13.s1.ref8">Vicus 2009</a>).</p><p>The included studies are summarised in <a href="/books/NBK604292/table/niceng241er13.tab2/?report=objectonly" target="object" rid-ob="figobniceng241er13tab2">Table 2</a>.</p><p>See the literature search strategy in <a href="#niceng241er13.appb">appendix B</a> and study selection flow chart in <a href="#niceng241er13.appc">appendix C</a>.</p></div><div id="niceng241er13.s1.1.4.2"><h5>Excluded studies</h5><p>The landmark CAPP2 trial (<a class="bk_pop" href="#niceng241er13.s1.ref9">Burn 2020</a>) comparing aspirin to placebo for cancer prevention in people with Lynch syndrome could not be included as results were not reported separately for women.</p><p>Studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng241er13.appj">appendix J</a>.</p></div></div><div id="niceng241er13.s1.1.5"><h4>Summary of included studies</h4><p>Summaries of the studies that were included in this review are presented in <a href="/books/NBK604292/table/niceng241er13.tab2/?report=objectonly" target="object" rid-ob="figobniceng241er13tab2">Table 2</a>.</p><p>See the full evidence tables in <a href="#niceng241er13.appd">appendix D</a> and the forest plots in <a href="#niceng241er13.appe">appendix E</a>.</p></div><div id="niceng241er13.s1.1.6"><h4>Summary of the evidence</h4><div id="niceng241er13.s1.1.6.1"><h5>Frequent aspirin use versus infrequent or no aspirin use</h5><p>The evidence showed no important differences from frequent aspirin use in terms of ovarian cancer incidence relative to no or non-frequent use in women at all levels of risk, and the evidence also showed no evidence of an important difference in women with a family history of ovarian or breast cancer or in women with a family history of ovarian cancer only. This was also the case for different histological types of ovarian cancer in women with a family history of ovarian or breast cancer. This evidence was of low to moderate quality. Very low quality evidence showed no important difference in non-mucinous epithelial ovarian cancer incidence between frequent and infrequent/no aspirin use in women at all levels of risk.</p><p>The evidence also showed no evidence of important differences from frequent aspirin use on ovarian cancer risk relative to no or non-frequent use in women with a polygenic risk score for ovarian cancer at or above the median value, below the median value, or in any of the quintiles of polygenic risk score, with the exception of women with a polygenic risk score in the 60 – 80 percentile where an important benefit of frequent aspirin use was observed. However, this is likely to be a spurious finding since the interaction between polygenic score quintile and frequency of aspirin use was not statistically significant. There was also no evidence of important differences for the different histological types of ovarian cancer in women with a polygenic risk score for ovarian cancer at or above the median value. This evidence was of very low to low quality.</p></div><div id="niceng241er13.s1.1.6.2"><h5>Oral contraceptive use versus no oral contraceptive use</h5><p>When comparing oral contraceptive with no oral contraceptive use in women with <i>BRCA1</i> or <i>BRCA2</i> mutations there was an important benefit of oral contraceptive use in terms of reduced ovarian cancer incidence. This evidence was rated as moderate to high quality. However, there was some very low quality evidence that showed no evidence of important difference between oral contraceptive use and no use in terms of ovarian cancer incidence in women with <i>BRCA1</i> mutation only. However, in this study the population was mixed, that is women with ovarian cancer and a history of breast cancer.</p></div><div id="niceng241er13.s1.1.6.3"><h5>Different duration of oral contraceptive use versus no oral contraceptive use</h5><p>When comparing different durations (0 to 1 year, 1.1 to 3 years, 3.1 to 5 years and more than 5 years) of oral contraceptive with no oral contraceptive use in women with <i>BRCA1</i> or <i>BRCA2</i> mutations there was an important benefit of oral contraceptive use in terms of reduced ovarian cancer incidence. This evidence was rated as moderate to high quality. However, other very low to low quality evidence showed no evidence of important differences between short-term (3 to 11 months) or longer term (1 to 4 years, 5 to 9 years, more than 10 years) use and no oral contraceptive use in terms of ovarian cancer incidence in women with a family history of ovarian cancer.</p><p>No evidence was identified for health related quality of life, treatment related adverse effects or overall survival.</p><p>See <a href="#niceng241er13.appf">appendix F</a> for full GRADE tables.</p></div></div><div id="niceng241er13.s1.1.7"><h4>Economic evidence</h4><div id="niceng241er13.s1.1.7.1"><h5>Included studies</h5><p>A systematic review of the economic literature was conducted but no economic studies were identified which were applicable to this review question.</p><p>A single economic search was undertaken for all topics included in the scope of this guideline. See <a href="/books/NBK604292/bin/NG241-Supplement2-Economic-Literature-pdf.pdf">supplementary material 2</a> for details.</p></div><div id="niceng241er13.s1.1.7.2"><h5>Excluded studies</h5><p>Economic studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng241er13.appj">appendix J</a>.</p></div></div><div id="niceng241er13.s1.1.8"><h4>Summary of included economic evidence</h4><p>No economic studies were identified which were applicable to this review question.</p></div><div id="niceng241er13.s1.1.9"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.</p></div><div id="niceng241er13.s1.1.10"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="niceng241er13.s1.1.10.1"><h5>The outcomes that matter most</h5><p>Ovarian cancer incidence was prioritised as a critical outcome by the committee. This is because the aim of the question was to determine whether medicines could prevent ovarian cancer in women at increased risk. Additionally, health related quality of life was also chosen as a critical outcome to capture the impact of medicines on the day-to-day lives of these women, including psychological and emotional factors.</p><p>Treatment related adverse effects was selected as an important outcome because any benefits in terms of incidence of ovarian cancer must be balanced against side effects caused by the medicines themselves. Finally overall survival was an important outcome because both prevention of ovarian cancer and serious adverse effects of treatment could impact overall survival and the balance of these is an important consideration when making treatment decisions.</p></div><div id="niceng241er13.s1.1.10.2"><h5>The quality of the evidence</h5><p>The quality of the evidence was assessed using GRADE and ranged from very low to high quality. Evidence was downgraded mainly due to imprecision in the effect estimates, as well as risk of bias: in some studies aspirin use was determined retrospectively by asking women to recall their usage. The evidence was also downgraded for indirectness in some cases due to the inclusion of women at all risk levels or for unexplained heterogeneity or because of the indirect study population (women with ovarian and breast cancer). Moreover, in 1 case-control study cases and controls were not matched.</p><p>No evidence was identified for health-related quality of life, treatment related adverse effects or overall survival. Due to the lack of evidence on some outcomes the committee also relied on their experience when making recommendations.</p></div><div id="niceng241er13.s1.1.10.3"><h5>Benefits and harms</h5><div id="niceng241er13.s1.1.10.3.1"><h5>Aspirin</h5><p>The committee noted that there was some overlap in the study participants included in the studies comprising this evidence but also that the studies focused on and analysed different populations. They discussed the evidence that showed no important difference in terms of ovarian cancer incidence when comparing frequent aspirin use to no or non-frequent use in women at all levels of risk and the evidence that showed no evidence of an important difference either in women with a family history of ovarian or breast cancer, in women with a family history of ovarian cancer only and in women with all levels of polygenic risk score values. They noted that this was also the case for different histological types of ovarian cancer. They therefore concluded that aspirin did not show a protective effect in terms of ovarian cancer and agreed that there was insufficient evidence to recommend the general use of aspirin for women with high risk of familial ovarian cancer. So, the committee did not recommend it for the sole purpose of reducing ovarian cancer risk. They discussed the quality of the evidence and noted that it was very low to moderate, despite the evidence not being of the highest quality rating it was consistent with their experience in expertise and so they did not recommend it for general protective use for ovarian cancer. The committee noted that there was existing NICE guidance on the use of aspirin to reduce the risk of colorectal cancer in people with Lynch syndrome. As people with Lynch syndrome were included in the scope of this guideline, the committee felt it was important to make cross reference to the NICE colorectal cancer guideline to ensure they were aware of this recommendation.</p></div><div id="niceng241er13.s1.1.10.3.2"><h5>Combined oral contraceptives</h5><p>The committee discussed the evidence for both comparisons (oral contraceptive use versus no use and different durations of use versus no use) that showed that there was an important benefit in reducing the risk of ovarian cancer associated with oral contraceptive. Whilst this was moderate to high quality evidence the committee drew on their knowledge that long-term use of oral contraceptives increased risk of breast cancer. They noted that this rather than the evidence quality was the important factor in clinical decision making and the strength of the recommendation that can be made because it is the balance between the protective benefit in relation to ovarian cancer and the risk of breast cancer that needs to be weight up. Although breast cancer was not an outcome in this evidence review, the committee agreed that this increased risk of breast cancer needs to be taken into account when thinking about oral contraceptives to prevent ovarian cancer. They agreed that the balance of risks and benefits will depend on the individual (for example how strong the family history is, which pathogenic variant the person may have and other potential risk factors). They therefore decided to only recommend oral contraceptives as a preventive medicine in particular circumstances: when the reduction in ovarian cancer risk (based on for example age, family history) may outweigh an increased breast cancer risk, and after taking into account whether the timing of risk-reducing surgery is appropriate or not (for example, it may not be appropriate because of age and planned pregnancy).</p><p>In the committee’s experience people are not always fully informed about the potential risks (increased risk of developing breast cancer) and benefits (reduced risk of developing ovarian cancer) of combined oral contraceptives which is necessary for informed decision making.</p></div><div id="niceng241er13.s1.1.10.3.3"><h5>Research recommendation</h5><p>The committee noted a lack of relevant evidence on preventive medicines and its inconsistency in women at increased risk of ovarian cancer to support decision making. They thought that some women may not want to undergo risk-reducing surgery and preventative medicine would then be a good option. Therefore they agreed to make a research recommendation on the effectiveness on preventive medicines.</p></div></div><div id="niceng241er13.s1.1.10.4"><h5>Cost effectiveness and resource use</h5><p>No existing economic evidence was identified for this review. The recommendations in this area reinforce current practice and implementing them will not require additional resources. Furthermore, the recommendations regarding oral contraceptives to prevent ovarian cancer will only apply to a small number of people since risk-reducing surgery is the preferred first-line treatment option for the majority of people.</p></div></div><div id="niceng241er13.s1.1.11"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports one cross reference and recommendations 1.7.1 to 1.7.43 and research recommendation 6 (on primary preventive medicines) in the NICE guideline.</p></div></div><div id="niceng241er13.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><div id="niceng241er13.s1.rl.r1.1"><h4>Effectiveness</h4><ul class="simple-list"><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref1"><p id="p-119">
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<strong>Gross 1992</strong>
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</p>Gross, T P, Schlesselman, J J, Stadel, B V
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et al. The risk of epithelial ovarian cancer in short-term users of oral contraceptives. American journal of epidemiology
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136(1): 46–53, 1992
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[<a href="https://pubmed.ncbi.nlm.nih.gov/1415131" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1415131</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref2"><p id="p-120">
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<strong>Hurwitz 2021</strong>
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</p>Hurwitz, Lauren M; Michels, Kara A; Cook, Michael B
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et al. Associations between daily aspirin use and cancer risk across strata of major cancer risk factors in two large U.S. cohorts. Cancer causes & control: CCC; vol. 32 (no. 1); 57–65, 2021
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[<a href="/pmc/articles/PMC7855934/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7855934</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33104910" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33104910</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref3"><p id="p-121">
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<strong>Hurwitz 2022</strong>
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</p>Hurwitz, Lauren M, Townsend, Mary K, Jordan, Susan J
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et al. Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia. Journal of clinical oncology: official journal of the American Society of Clinical Oncology
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40(36): 4207–4217, 2022
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[<a href="/pmc/articles/PMC9916035/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9916035</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35867953" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35867953</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref4"><p id="p-122">
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<strong>Hurwitz 2023</strong>
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</p>Hurwitz, Lauren M, Webb, Penelope M, Jordan, Susan J
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et al. Association of Frequent Aspirin Use With Ovarian Cancer Risk According to Genetic Susceptibility. JAMA network open
|
|
6(2): e230666, 2023
|
|
[<a href="/pmc/articles/PMC9958519/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9958519</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36826816" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36826816</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref5"><p id="p-123">
|
|
<strong>McLaughlin 2007</strong>
|
|
</p>McLaughlin
|
|
John R, Risch, Harwey A, Lubinski, Jan
|
|
et al. Reproductive risk factors for ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study. The Lancet. Oncology; 2007; vol. 8 (no. 1); 26–34, 2007
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17196508" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17196508</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref6"><p id="p-124">
|
|
<strong>Michels 2018</strong>
|
|
</p>Michels, Kara A, Pfeiffer, Ruth M, Brinton, Louise A
|
|
et al. Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers. JAMA oncology
|
|
4(4): 516–521, 2018
|
|
[<a href="/pmc/articles/PMC5885214/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5885214</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29346467" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29346467</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref7"><p id="p-125">
|
|
<strong>Van Bommel 2023</strong>
|
|
</p>van Bommel, Majke H D, IntHout, Joanna, Veldmate, Guus
|
|
et al. Contraceptives and cancer risks in BRCA1/2 pathogenic variant carriers: a systematic review and meta-analysis. Human reproduction update
|
|
29(2): 197–217, 2023
|
|
[<a href="/pmc/articles/PMC9976973/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9976973</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36383189" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36383189</span></a>]</div></li><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref8"><p id="p-126">
|
|
<strong>Vicus 2009</strong>
|
|
</p>Vicus
|
|
D, Rosen
|
|
B, Lubinski
|
|
J, et al. Tamoxifen and the risk of ovarian cancer in BRCA1 mutation carriers. Gynecol Oncol.115(1):135–137, 2009
|
|
[<a href="/pmc/articles/PMC3756313/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3756313</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19577280" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19577280</span></a>]</div></li></ul></div><div id="niceng241er13.s1.rl.r1.2"><h4>Economic</h4><ul class="simple-list"><p>No economic studies were identified which were applicable to this review question.</p></ul></div><div id="niceng241er13.s1.rl.r1.3"><h4>Other</h4><ul class="simple-list"><li class="half_rhythm"><div class="bk_ref" id="niceng241er13.s1.ref9"><p id="p-128">
|
|
<strong>Burn 2020</strong>
|
|
</p>Burn
|
|
J, Sheth
|
|
H, Elliott
|
|
F
|
|
et al. Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial. Lancet (London, England)
|
|
395(10240): 1855–1863, 2020
|
|
[<a href="/pmc/articles/PMC7294238/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7294238</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32534647" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32534647</span></a>]</div></li></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng241er13.appa"><h3>Appendix A. Review protocols</h3><p id="niceng241er13.appa.et1"><a href="/books/NBK604292/bin/niceng241er13-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 233K)</span></p></div><div id="niceng241er13.appb"><h3>Appendix B. Literature search strategies</h3><p id="niceng241er13.appb.et1"><a href="/books/NBK604292/bin/niceng241er13-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Literature search strategies for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 283K)</span></p></div><div id="niceng241er13.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng241er13.appc.et1"><a href="/books/NBK604292/bin/niceng241er13-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 237K)</span></p></div><div id="niceng241er13.appd"><h3>Appendix D. Evidence tables</h3><p id="niceng241er13.appd.et1"><a href="/books/NBK604292/bin/niceng241er13-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Evidence tables for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 452K)</span></p></div><div id="niceng241er13.appe"><h3>Appendix E. Forest plots</h3><div id="niceng241er13.appe.s1"><h4>Forest plots for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</h4><p>No meta-analysis was conducted for this review question and so there are no forest plots.</p></div></div><div id="niceng241er13.appf"><h3>Appendix F. GRADE tables</h3><p id="niceng241er13.appf.et1"><a href="/books/NBK604292/bin/niceng241er13-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">GRADE tables for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 390K)</span></p></div><div id="niceng241er13.appg"><h3>Appendix G. Economic evidence study selection</h3><div id="niceng241er13.appg.s1"><h4>Study selection for: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="niceng241er13.apph"><h3>Appendix H. Economic evidence tables</h3><div id="niceng241er13.apph.s1"><h4>Economic evidence tables for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="niceng241er13.appi"><h3>Appendix I. Economic model</h3><div id="niceng241er13.appi.s1"><h4>Economic model for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="niceng241er13.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng241er13.appj.s1"><h4>Excluded studies for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</h4></div><div id="niceng241er13.appj.s2"><h4>Excluded effectiveness studies</h4><div id="niceng241er13.appj.tab1" class="table"><h3><span class="label">Table 9</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604292/table/niceng241er13.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng241er13.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Code [Reason]</th></tr></thead><tbody><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Baandrup, Louise, Faber, Mette T, Christensen, Jane
|
|
et al. (2013) Nonsteroidal anti-inflammatory drugs and risk of ovarian cancer: systematic review and meta-analysis of observational studies. Acta obstetricia et gynecologica Scandinavica
|
|
92(3): 245–55
|
|
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23240575" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23240575</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beral, Valerie, Bull, Diana, Green, Jane
|
|
et al. (2007) Ovarian cancer and hormone replacement therapy in the Million Women Study. Lancet (London, England)
|
|
369(9574): 1703–10
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17512855" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17512855</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Intervention in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Burn
|
|
J, Gerdes
|
|
AM, Macrae
|
|
F
|
|
et al. (2011) Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet (London, England)
|
|
378(9809): 2081–2087
|
|
[<a href="/pmc/articles/PMC3243929/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3243929</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22036019" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22036019</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Results not reported separately for women (% of women not reported)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Burn
|
|
J, Sheth
|
|
H, Elliott
|
|
F
|
|
et al. (2020) Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial. Lancet (London, England)
|
|
395(10240): 1855–1863
|
|
[<a href="/pmc/articles/PMC7294238/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7294238</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32534647" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32534647</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Results not reported separately for women (55.3% women)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cook, Nancy R, Lee, I-Min, Gaziano, J Michael
|
|
et al. (2005) Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. JAMA
|
|
294(1): 47–55
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/15998890" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15998890</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
D’Alessandro, G., Frigerio, M., Barra, F.
|
|
et al. (2021) Systematic review and meta-analysis on the impact of the levonorgestrel-releasing intrauterine system in reducing risk of ovarian cancer. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [<a href="/pmc/articles/PMC9290617/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9290617</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33969485" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33969485</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Intervention in study does not match that specified in this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dixon, Suzanne C, Nagle, Christina M, Wentzensen, Nicolas
|
|
et al. (2017) Use of common analgesic medications and ovarian cancer survival: results from a pooled analysis in the Ovarian Cancer Association Consortium. British journal of cancer
|
|
116(9): 1223–1228
|
|
[<a href="/pmc/articles/PMC5418444/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5418444</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28350790" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28350790</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dorjgochoo, Tsogzolmaa, Shu, Xiao-Ou, Li, Hong-Lan
|
|
et al. (2009) Use of oral contraceptives, intrauterine devices and tubal sterilization and cancer risk in a large prospective study, from 1996 to 2006. International journal of cancer
|
|
124(10): 2442–9
|
|
[<a href="/pmc/articles/PMC2666967/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2666967</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19170208" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19170208</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fairfield, Kathleen M, Hunter, David J, Fuchs, Charles S
|
|
et al. (2002) Aspirin, other NSAIDs, and ovarian cancer risk (United States). Cancer causes & control : CCC
|
|
13(6): 535–42
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12195643" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12195643</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ferris, J.S., Daly, M.B., Buys, S.S.
|
|
et al. (2014) Oral contraceptive and reproductive risk factors for ovarian cancer within sisters in the breast cancer family registry. British Journal of Cancer
|
|
110(4): 1074–1080
|
|
[<a href="/pmc/articles/PMC3929882/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3929882</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24398512" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24398512</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Included in <a class="bk_pop" href="#niceng241er13.s1.ref7">van Bommel 2023</a></td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Friebel, Tara M; Domchek, Susan M; Rebbeck, Timothy R (2014) Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis. Journal of the National Cancer Institute
|
|
106(6): dju091
|
|
[<a href="/pmc/articles/PMC4081625/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4081625</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24824314" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24824314</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review, included studies checked for relevance</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gross, T P and Schlesselman, J J (1994) The estimated effect of oral contraceptive use on the cumulative risk of epithelial ovarian cancer. Obstetrics and gynecology
|
|
83(3): 419–24
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8127536" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8127536</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>All estimates appear to be unadjusted</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang, Wen-Yi, Daugherty, Sarah E, Shiels, Meredith S
|
|
et al. (2018) Aspirin Use and Mortality in Two Contemporary US Cohorts. Epidemiology (Cambridge, Mass.)
|
|
29(1): 126–133
|
|
[<a href="/pmc/articles/PMC5718934/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5718934</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28863047" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28863047</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No ovarian cancer-specific analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang, Zhezhou, Gao, Yutang, Wen, Wanqing
|
|
et al. (2015) Contraceptive methods and ovarian cancer risk among Chinese women: A report from the Shanghai Women’s Health Study. International journal of cancer
|
|
137(3): 607–14
|
|
[<a href="/pmc/articles/PMC4437849/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4437849</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25556333" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25556333</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huber, D, Seitz, S, Kast, K
|
|
et al. (2020) Use of oral contraceptives in BRCA mutation carriers and risk for ovarian and breast cancer: a systematic review. Archives of gynecology and obstetrics
|
|
301(4): 875–884
|
|
[<a href="/pmc/articles/PMC8494665/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8494665</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32140806" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32140806</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review, included studies checked for relevance</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Iodice, S, Barile, M, Rotmensz, N
|
|
et al. (2010) Oral contraceptive use and breast or ovarian cancer risk in BRCA1/2 carriers: a meta-analysis. European journal of cancer (Oxford, England : 1990)
|
|
46(12): 2275–84
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20537530" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20537530</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review, included studies checked for relevance</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Iversen, Lisa, Sivasubramaniam, Selvaraj, Lee, Amanda J
|
|
et al. (2017) Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners’ Oral Contraception Study. American journal of obstetrics and gynecology
|
|
216(6): 580e1–580e9 [<a href="https://pubmed.ncbi.nlm.nih.gov/28188769" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28188769</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moorman, Patricia G, Havrilesky, Laura J, Gierisch, Jennifer M
|
|
et al. (2013) Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology
|
|
31(33): 4188–98
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24145348" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24145348</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review, included studies checked for relevance</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Movahedi, Mohammad, Bishop, D Timothy, Macrae, Finlay
|
|
et al. (2015) Obesity, Aspirin, and Risk of Colorectal Cancer in Carriers of Hereditary Colorectal Cancer: A Prospective Investigation in the CAPP2 Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology
|
|
33(31): 3591–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26282643" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26282643</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Outcomes in study do not match those specified in this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Murphy, Megan A, Trabert, Britton, Yang, Hannah P
|
|
et al. (2012) Non-steroidal anti-inflammatory drug use and ovarian cancer risk: findings from the NIH-AARP Diet and Health Study and systematic review. Cancer causes & control : CCC
|
|
23(11): 1839–52
|
|
[<a href="/pmc/articles/PMC3469773/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3469773</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22972000" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22972000</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ness, Roberta B, Dodge, Rhiannon C, Edwards, Robert P
|
|
et al. (2011) Contraception methods, beyond oral contraceptives and tubal ligation, and risk of ovarian cancer. Annals of epidemiology
|
|
21(3): 188–96
|
|
[<a href="/pmc/articles/PMC3052991/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3052991</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21109450" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21109450</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Included in <a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a></td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Park, Boyoung, Park, Sohee, Shin, Hai-Rim
|
|
et al. (2016) Population attributable risks of modifiable reproductive factors for breast and ovarian cancers in Korea. BMC cancer
|
|
16: 5
|
|
[<a href="/pmc/articles/PMC4702325/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4702325</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26732868" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26732868</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses of in high-risk women, instead family history was one of the factors adjusted for in the analyses, but with no results reported for that</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pinheiro, Simone P, Tworoger, Shelley S, Cramer, Daniel W
|
|
et al. (2009) Use of nonsteroidal antiinflammatory agents and incidence of ovarian cancer in 2 large prospective cohorts. American journal of epidemiology
|
|
169(11): 1378–87
|
|
[<a href="/pmc/articles/PMC2727251/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2727251</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19342401" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19342401</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Included in <a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a></td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Piver, M S, Baker, T R, Jishi, M F
|
|
et al. (1993) Familial ovarian cancer. A report of 658 families from the Gilda Radner Familial Ovarian Cancer Registry 1981-1991. Cancer
|
|
71(2suppl): 582–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8420680" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8420680</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Information on intervention (birth control pills) not reported in sufficient detail to analyse (e.g., extent/definition of use unclear)</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pragout, D., Laurence, V., Baffet, H.
|
|
et al. (2018) Contraception and cancer: CNGOF Contraception Guidelines. Gynecologie Obstetrique Fertilite et Senologie
|
|
46(12): 834–844 [<a href="https://pubmed.ncbi.nlm.nih.gov/30385358" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30385358</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Santucci, C., Gallus, S., Martinetti, M.
|
|
et al. (2021) Aspirin and the risk of nondigestive tract cancers: An updated meta-analysis to 2019. International Journal of Cancer
|
|
148(6): 1372–1382
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32984948" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32984948</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schlesselman, J J (1995) Net effect of oral contraceptive use on the risk of cancer in women in the United States. Obstetrics and gynecology
|
|
85(5pt1): 793–801
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/7724116" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7724116</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuler, Susanne, Ponnath, Marvin, Engel, Jorg
|
|
et al. (2013) Ovarian epithelial tumors and reproductive factors: a systematic review. Archives of gynecology and obstetrics
|
|
287(6): 1187–204
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23503972" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23503972</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Even though the study calls itself a systematic review, it is not reported accordingly, e.g., no inclusion/exclusion criteria reported, no analysis method reported</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Soegaard, Marie, Jensen, Allan, Hogdall, Estrid
|
|
et al. (2007) Different risk factor profiles for mucinous and nonmucinous ovarian cancer: results from the Danish MALOVA study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
|
|
16(6): 1160–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/17548679" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17548679</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sorensen, H T, Friis, S, Norgard, B
|
|
et al. (2003) Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study. British journal of cancer
|
|
88(11): 1687–92
|
|
[<a href="/pmc/articles/PMC2377131/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2377131</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12771981" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12771981</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No ovarian cancer-specific analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tworoger, Shelley S, Fairfield, Kathleen M, Colditz, Graham A
|
|
et al. (2007) Association of oral contraceptive use, other contraceptive methods, and infertility with ovarian cancer risk. American journal of epidemiology
|
|
166(8): 894–901
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17656616" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17656616</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Analyses not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No analyses in high-risk women</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Whelan, Eilbhe, Kalliala, Ilkka, Semertzidou, Anysia
|
|
et al. (2022) Risk Factors for Ovarian Cancer: An Umbrella Review of the Literature. Cancers
|
|
14(11) [<a href="/pmc/articles/PMC9179274/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9179274</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35681688" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35681688</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not relevant to this review protocol</td></tr><tr><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Whittemore, A S, Balise, R R, Pharoah, P D P
|
|
et al. (2004) Oral contraceptive use and ovarian cancer risk among carriers of BRCA1 or BRCA2 mutations. British journal of cancer
|
|
91(11): 1911–5
|
|
[<a href="/pmc/articles/PMC2410144/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2410144</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15545966" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15545966</span></a>]
|
|
</td><td headers="hd_h_niceng241er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Included in <a class="bk_pop" href="#niceng241er13.s1.ref7">van Bommel 2023</a></td></tr></tbody></table></div></div></div><div id="niceng241er13.appj.s3"><h4>Excluded economic studies</h4><p>No economic evidence was identified for this review. See <a href="/books/NBK604292/bin/NG241-Supplement2-Economic-Literature-pdf.pdf">supplementary material 2</a> for further information.</p></div></div><div id="niceng241er13.appk"><h3>Appendix K. Research recommendations – full details</h3><p id="niceng241er13.appk.et1"><a href="/books/NBK604292/bin/niceng241er13-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Research recommendations for review question: How effective are preventive medicines for reducing the incidence of ovarian cancer for women at increased risk of familial ovarian cancer?</a><span class="small"> (PDF, 151K)</span></p></div></div><div class="bk_prnt_sctn"><h2>Tables</h2><div class="whole_rhythm bk_prnt_obj bk_first_prnt_obj"><div id="niceng241er13.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604292/table/niceng241er13.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng241er13.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_niceng241er13.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng241er13.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women at increased risk of familial ovarian cancer</td></tr><tr><th id="hd_b_niceng241er13.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng241er13.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medicines:
|
|
<ul><li class="half_rhythm"><div>oral contraceptives</div></li><li class="half_rhythm"><div>NSAIDs</div></li></ul></td></tr><tr><th id="hd_b_niceng241er13.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng241er13.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">In comparison with:
|
|
<ul><li class="half_rhythm"><div>each other</div></li><li class="half_rhythm"><div>placebo</div></li></ul></td></tr><tr><th id="hd_b_niceng241er13.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_niceng241er13.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
|
|
<ul><li class="half_rhythm"><div>ovarian cancer incidence</div></li><li class="half_rhythm"><div>health related quality of life (measured using a validated scale)</div></li></ul>
|
|
<b>Important</b>
|
|
<ul><li class="half_rhythm"><div>treatment related adverse effects</div></li><li class="half_rhythm"><div>overall survival</div></li></ul></td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin">NSAIDS: non-steroidal anti-inflammatory drugs</p></div></dd></dl></div></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="niceng241er13.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604292/table/niceng241er13.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng241er13.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref1">Gross 1992</a>
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</p>
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<p>Case-control</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N total=130 women with a family history of ovarian cancer</p>
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<p>n=31 women with epithelial ovarian cancer, n=16 used oral contraceptive and n=15 did not use it</p>
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<p>Age reported for all cases of ovarian cancer in the cohort (n=283): age mean (SD): not reported. Age by category (years): 20-29=7%, 30-39=11%, 40-49=40%, 50-54=42%</p>
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<p>n=99 controls, n=52 used oral contraceptive and n=47did not use it</p>
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<p>Age reported for all controls in the cohort (n=1929): age mean (SD): not reported. Age by category (years): 20-29=5%, 30-39=12%, 40-49=43%, 50-54=40%</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Epithelian ovarian cancer incidence</div></li></ul>
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref2">Hurwitz 2021</a>
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</p>
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<p>IPD meta-analysis</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=7074 women with a family history of ovarian cancer</p>
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<p>n=1446 daily aspirin use</p>
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<p>n=5628 no daily aspirin use</p>
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<p>Age by category of aspirin use for the whole cohort reported (mean (SD), years): aspirin use = 63.4 (5.3), no aspirin use = 62.21 (5.39)</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Daily aspirin use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No daily aspirin use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Ovarian cancer incidence</div></li></ul>
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref3">Hurwitz 2022</a>
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</p>
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<p>IPD meta-analysis</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=505404</p>
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<p>Participants identified from 9 cohort studies and 8 case-control studies.</p>
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<p>Age mean (SD): ranged from 46 to 68.2 years in the cohort studies (SD not reported) and the median ranged from 56.2 to 60.7 years in the cases in the case-control studies. Not reported for the controls.</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Frequent aspirin use (aspirin use for ≥6 days/week or ≥28 days/month and for a duration of ≥6 months)</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-frequent aspirin use (no less frequent use than intervention group)</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Ovarian cancer incidence</div></li></ul>
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref4">Hurwitz 2023</a>
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</p>
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<p>IPD meta-analysis</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=11135</p>
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<p>Participants identified from 8 case-control studies</p>
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<p>Age mean (SD): not reported.</p>
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<p>Age, median (IQR): 58 (50-66) years for cases and 57 (49-65) years for controls</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Frequent aspirin use (daily or almost daily use of aspirin for ≥6 months)</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-frequent aspirin use (less frequent use than intervention group)</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Ovarian cancer incidence</div></li></ul>
|
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref5">McLaughlin 2007</a>
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</p>
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<p>Case-control</p>
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<p>Multinational, Canada</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N total=3223 women with <i>BRCA1</i>/2 mutation</p>
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<p>n=799 women with invasive ovarian cancer</p>
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<p>Age at questionnaire* (median (range), years): 53 (27-81)</p>
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<p>n=2424 controls</p>
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<p>Age at questionnaire* (median (range), years): 53 (33-82)</p>
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<p>*age at questionnaire and not cancer diagnosis because the latter is not applicable here for the control group</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<ul><li class="half_rhythm"><div>Ovarian cancer risk</div></li></ul>
|
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bk_pop" href="#niceng241er13.s1.ref6">Michels 2018</a>
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</p>
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<p>Cohort</p>
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<p>USA</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N total=5062 women with a family history of ovarian cancer</p>
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<p>n=51 women with ovarian cancer</p>
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<p>n=5011 controls</p>
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<p>Age by category of oral contraceptive use duration for the whole cohort reported (median (range), years): 1-4 years=59 (55-64), 5-9 years=59 (55-64), >=10 years=60 (56-64)</p>
|
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No or <1 year oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<ul><li class="half_rhythm"><div>Ovarian cancer incidence</div></li></ul>
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</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<a class="bk_pop" href="#niceng241er13.s1.ref7">Van Bommel 2023</a>
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</p>
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<p>Systematic review of observational studies</p>
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<p>Netherlands</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=21,425 in 10 studies</p>
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<p>Women with <i>BRCA1</i> or <i>BRCA2</i> pathogenic mutations</p>
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<p>Age mean (SD): not reported.</p>
|
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<p>Age range: 20 to 93 years</p>
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral contraception pill</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No oral contraception</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Ovarian cancer incidence</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng241er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<a class="bk_pop" href="#niceng241er13.s1.ref8">Vicus 2009</a>
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</p>
|
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<p>Case-control</p>
|
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<p>Multinational</p>
|
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</td><td headers="hd_h_niceng241er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N total=714 women with <i>BRCA1</i> mutation</p>
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<p>n=154 women with ovarian cancer and a previous history of breast cancer</p>
|
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<p>Age at diagnosis of ovarian cancer (mean (range), years): 51.4 (35-75)</p>
|
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<p>n=560 controls (women with a history of breast cancer)</p>
|
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<p>Age at diagnosis of ovarian cancer (mean (range), years): not applicable; age at diagnosis of breast cancer (mean (range), years):43 (26-68)</p>
|
|
</td><td headers="hd_h_niceng241er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No oral contraceptive use</td><td headers="hd_h_niceng241er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Ovarian cancer risk</div></li></ul>
|
|
</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin">IPD: individual patient data; SD: standard deviation.</p></div></dd></dl></div></div></div></div></div><div><p>Final</p></div><div><p>Evidence review underpinning recommendations 1.7.1 to 1.7.4 and research recommendation 6 in the NICE guideline</p><p>These evidence reviews were developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="https://www.gov.wales/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div><div class="small"><span class="label">Bookshelf ID: NBK604292</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/38889262" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">38889262</a></span></div></div></div>
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