1. Contraceptive use and the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation
- Author
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Yue Yin Xia, Jacek Gronwald, Beth Karlan, Jan Lubinski, Jeanna M. McCuaig, Jennifer Brooks, Pal Moller, Andrea Eisen, Sophie Sun, Leigha Senter, Louise Bordeleau, Susan L. Neuhausen, Christian F. Singer, Nadine Tung, William D. Foulkes, Ping Sun, Steven A. Narod, Joanne Kotsopoulos, Rinat Yerushalmi, Robert Fruscio, Antonella Rastelli, Stefania Zovato, Zerin Hyder, Tomasz Huzarski, Cezary Cybulski, Kevin Sweet, Marie Wood, Wendy McKinnon, Christine Elser, Tuya Pal, Georgia Wiesner, Eitan Friedman, Wendy Meschino, Carrie Snyder, Kelly Metcalfe, Aletta Poll, Nicole Gojska, Ellen Warner, Raymond H. Kim, Barry Rosen, Rochelle Demsky, Peter Ainsworth, Karen Panabaker, Linda Steele, Howard Saal, Kim Serfas, Seema Panchal, Carey A. Cullinane, Robert E. Reilly, Joanne L. Blum, Ava Kwong, Daniel Rayson, Claudine Isaacs, Teresa Ramón y Cajal, Jeffrey Dungan, Stephanie Cohen, Xia, Y, Gronwald, J, Karlan, B, Lubinski, J, Mccuaig, J, Brooks, J, Moller, P, Eisen, A, Sun, S, Senter, L, Bordeleau, L, Neuhausen, S, Singer, C, Tung, N, Foulkes, W, Sun, P, Narod, S, Kotsopoulos, J, Yerushalmi, R, Fruscio, R, Rastelli, A, Zovato, S, Hyder, Z, Huzarski, T, Cybulski, C, Sweet, K, Wood, M, Mckinnon, W, Elser, C, Pal, T, Wiesner, G, Friedman, E, Meschino, W, Snyder, C, Metcalfe, K, Poll, A, Gojska, N, Warner, E, Kim, R, Rosen, B, Demsky, R, Ainsworth, P, Panabaker, K, Steele, L, Saal, H, Serfas, K, Panchal, S, Cullinane, A, Reilly, R, Blum, J, Kwong, A, Rayson, D, Isaacs, C, Ramón y Cajal, T, Dungan, J, and Cohen, S
- Subjects
BRCA2 Protein ,Ovarian Neoplasms ,Heterozygote ,BRCA1 Protein ,BRCA ,Obstetrics and Gynecology ,Breast Neoplasms ,Carcinoma, Ovarian Epithelial ,Case-control ,Contraception ,Oncology ,Risk Factors ,Ovarian cancer ,Case-Control Studies ,Mutation ,Humans ,Intrauterine device ,Female ,Contraceptives, Oral - Abstract
Background BRCA1 and BRCA2 (BRCA) mutation carriers face a high lifetime risk of developing ovarian cancer. Oral contraceptives are protective in this population; however, the impact of other types of contraception (e.g. intrauterine devices, implants, injections) is unknown. We undertook a matched case-control study to evaluate the relationship between type of contraception and risk of ovarian cancer among women with BRCA mutations. Methods A total of 1733 matched pairs were included in this analysis. Women were matched according to year of birth, date of study entry, country of residence, BRCA mutation type and history of breast cancer. Detailed information on hormonal, reproductive and lifestyle exposures were collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) associated with each contraceptive exposure. Results Ever use of any contraceptive was significantly associated with reduced risk of ovarian cancer (OR = 0.62; 95% CI 0.52–0.75; P < 0.0001), which was driven by significant inverse associations with oral contraceptives (OR = 0.66; 95% CI 0.54–0.79; P < 0.0001) and contraceptive implants (OR = 0.30; 95% CI 0.12–0.73; P = 0.008). We observed a similar effect with use of injections (OR = 0.37; 95% CI 0.10–1.38; P = 0.14), but this did not achieve significance. No significant associations were observed between patterns of intrauterine device use and risk of ovarian cancer. Conclusions These findings support a protective effect of oral contraceptives and implants on risk of ovarian cancer among women with BRCA mutations. The possible protective effect of injections requires further evaluation.
- Published
- 2022