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

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cam.depositDate2022-01-13
cam.issuedOnline2022-01-20
cam.orpheus.successTue Feb 01 19:02:44 GMT 2022 - Embargo updated
dc.contributor.authorSchrijver, Lieske H
dc.contributor.authorMooij, Thea M
dc.contributor.authorPijpe, Anouk
dc.contributor.authorSonke, Gabe S
dc.contributor.authorMourits, Marian JE
dc.contributor.authorAndrieu, Nadine
dc.contributor.authorAntoniou, Antonis C
dc.contributor.authorEaston, Douglas F
dc.contributor.authorEngel, Christoph
dc.contributor.authorGoldgar, David
dc.contributor.authorJohn, Esther M
dc.contributor.authorKast, Karin
dc.contributor.authorMilne, Roger L
dc.contributor.authorOlsson, Håkan
dc.contributor.authorPhillips, Kelly-Anne
dc.contributor.authorTerry, Mary Beth
dc.contributor.authorHopper, John L
dc.contributor.authorvan Leeuwen, Flora E
dc.contributor.authorRookus, Matti A
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 and 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 and endometrial cancer risk long term. For 10 000 BRCA1 mutation carriers, 10 years of COCP use from age 20 to 30 years resulted in 66 additional COCP-associated cancer cases by the age of 35 years, in addition to 625 cases expected for never users. By the age of 70 years such COCP use resulted in 907 fewer cancer cases than the expected 9093 cases in never users. Triple-negative breast cancer estimates resulted in 196 additional COCP-associated cases by age 40 years, in addition to the 1454 expected. For 10 000 BRCA2 mutation carriers using COCP from age 20 to 30 years, 80 excess cancer cases were estimated by age 40 years in addition to 651 expected cases; by the age of 70 years, we calculated 382 fewer cases compared with the 6156 cases expected. The long-term benefit of COCP use diminished after risk-reducing bilateral salpingo-oophorectomy followed by menopausal hormone therapy use. CONCLUSION: Although COCP use in BRCA1 and BRCA2 mutation carriers initially increases breast, ovarian, and endometrial cancer risk, it strongly decreases lifetime cancer risk. Risk-reducing bilateral salpingo-oophorectomy 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.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.publicationNameJ Natl Cancer Inst
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
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