Repository logo
 

Oral Contraceptive Use in BRCA1 and BRCA2 Mutation Carriers: Absolute Cancer Risks and Benefits

Simple item page
cam.depositDate2022-01-13
cam.issuedOnline2022-01-20
cam.oa.sapoa_rrs_na
cam.orpheus.successTue Feb 01 19:02:44 GMT 2022 - Embargo updated
dc.contributor.authorEaston, Douglas
dc.contributor.authorAntoniou, antonis
dc.contributor.orcidSchrijver, Lieske H [0000-0003-2580-2096]
dc.contributor.orcidSonke, Gabe S [0000-0001-8088-9628]
dc.contributor.orcidMourits, Marian JE [0000-0003-2385-2639]
dc.contributor.orcidAndrieu, Nadine [0000-0001-8820-5550]
dc.contributor.orcidAntoniou, Antonis C [0000-0001-9223-3116]
dc.contributor.orcidEaston, Douglas F [0000-0003-2444-3247]
dc.contributor.orcidEngel, Christoph [0000-0002-7247-282X]
dc.contributor.orcidJohn, Esther M [0000-0003-3259-8003]
dc.contributor.orcidKast, Karin [0000-0001-6531-755X]
dc.contributor.orcidMilne, Roger L [0000-0001-5764-7268]
dc.contributor.orcidPhillips, Kelly-Anne [0000-0002-0475-1771]
dc.date.accessioned2022-01-14T00:31:25Z
dc.date.available2022-01-14T00:31:25Z
dc.date.issued2022-04-11
dc.date.updated2022-01-13T10:34:20Z
dc.description.abstractBackground: To help BRCA1/2 mutation carriers make informed decisions regarding use of combined-type oral contraceptive preparation (COCP), absolute risk-benefit estimates are needed for COCP-associated cancer. Methods: For a hypothetical cohort of 10,000 women, we calculated the increased or decreased cumulative incidence of COCP-associated (breast/ovarian/endometrial) cancer, examining 18 scenarios with differences in duration and timing of COCP use, uptake of prophylactic surgeries and menopausal hormone therapy. Results: COCP use initially increased breast cancer risk, and decreased ovarian/endometrial cancer risk long-term. For 10,000 BRCA1 mutation carriers ten years of COCP use from age 20-30 years resulted in 66 additional COCP-associated cancer cases by the age of 35 years, on top of 625 cases expected for never users. By the age of 70 years such COCP use resulted in 907 fewer cancer cases than the expected 9,093 cases in never users. Triple-negative breast cancer estimates resulted in 196 additional COCP-associated cases by age 40 years, on top of 1,454 expected. For 10,000 BRCA2 mutation carriers using COCP from age 20-30 years, 80 excess cancer cases were estimated by age 40 years on top of 651 expected cases; by the age of 70 years we calculated 382 fewer cases compared to the 6,156 cases expected. The long-term benefit of COCP use diminished after risk-reducing bilateral salpingo-oophorectomy (RRSO) followed by menopausal hormone therapy use. Conclusion: While COCP use in BRCA1 and BRCA2 mutation carriers initially increases breast/ovarian/endometrial cancer risk, it strongly decreases lifetime cancer risk. RRSO and menopausal hormone therapy use appear to counteract the long-term COCP-benefit.
dc.description.sponsorshipPink-Ribbon/Dutch-Cancer-Society (2014-187.WO76) and Transcan-JT (2012/Cancer-12-054)
dc.identifier.doi10.17863/CAM.80147
dc.identifier.eissn1460-2105
dc.identifier.issn0027-8874
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/332703
dc.language.isoeng
dc.publisherOxford University Press (OUP)
dc.publisher.departmentDepartment of Public Health And Primary Care, Cancer Genetic Epidemiology
dc.publisher.urlhttp://dx.doi.org/10.1093/jnci/djac004
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.subjectAdult
dc.subjectAged
dc.subjectBRCA1 Protein
dc.subjectBRCA2 Protein
dc.subjectBreast Neoplasms
dc.subjectContraceptives, Oral, Combined
dc.subjectEndometrial Neoplasms
dc.subjectFemale
dc.subjectGenes, BRCA1
dc.subjectGenes, BRCA2
dc.subjectGenetic Predisposition to Disease
dc.subjectHeterozygote
dc.subjectHumans
dc.subjectMutation
dc.subjectOvarian Neoplasms
dc.subjectOvariectomy
dc.subjectRisk Assessment
dc.subjectYoung Adult
dc.titleOral Contraceptive Use in BRCA1 and BRCA2 Mutation Carriers: Absolute Cancer Risks and Benefits
dc.typeArticle
dcterms.dateAccepted2022-01-10
prism.publicationNameJournal of the National Cancer Institute
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
pubs.licence-identifierapollo-deposit-licence-2-1
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1093/jnci/djac004

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
JNCI 2021 Schrijver Final.pdf
Size:
3.81 MB
Format:
Adobe Portable Document Format
Description:
Accepted version
Licence
http://www.rioxx.net/licenses/all-rights-reserved
Download

Collections

Cambridge University Research Outputs

Version History

Now showing 1 - 2 of 2
VersionDateSummary
2
 2023-12-22 10:24:58
Published version added
1*
 2022-01-14 00:31:25
* Selected version