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Oral contraceptive use had no significant effect on breast, ovarian cancer risk in BRCA1/2 carriers
Oral contraceptive users who carried BRCA1 or BRCA2 mutations were at similar risk for breast and ovarian cancers as individuals in the general population, according to results of a systematic review and meta-analysis.
Patricia G. Moorman, PhD, of the Duke University School of Medicine, and colleagues evaluated data from nine studies that included women with BRCA1/2 mutations. Four of the studies addressed oral contraceptive use and ovarian cancer risk, and five studies addressed oral contraceptive use and breast cancer risk.
Patricia G. Moorman
Results showed all women with BRCA mutations who used oral contraceptives were at decreased risk for ovarian cancer (OR=0.58; 95% CI, 0.46-0.73) compared with nonusers. The inverse association was stronger than that observed among women in the general population (OR=0.73).
Moorman and colleagues observed similar results when they evaluated BRCA1 and BRCA2 mutation carriers separately. Researchers reported an OR of 0.55 (95% CI, 0.47-0.66) for BRCA1 mutation carriers and an OR of 0.65 (95% CI, 0.34-1.24) among BRCA2 mutation carriers.
All women with BRCA mutations who used oral contraceptives were at a statistically insignificant increased risk for breast cancer (OR=1.21; 95% CI, 0.93-1.58) compared with nonusers. The risk was slightly higher than that observed for the general population (OR=1.08).
Once again, researchers reported similar results when they evaluated BRCA1 and BRCA2 mutation carriers separately. Researchers reported an OR of 1.19 (95% CI, 0.92-1.55) for BRCA1 mutation carriers and an OR of 1.36 (95% CI, 0.89-2.10) for BRCA2 mutation carriers.
Moorman and colleagues noted they did not have sufficient data to examine the effects of timing or duration of oral contraceptive use on cancer risk.
Findings from one study suggested that risk for ovarian cancer among all BRCA mutation carriers decreased with oral contraceptive use within the past 10 years, whereas individual studies that examined duration of and time since last oral contraceptive use suggested no statistically significant effect on breast cancer risk in BRCA mutation carriers.
Moorman and colleagues identified seven studies that examined oral contraceptive use in women who did not have BRCA mutations but did have a family history of breast or ovarian cancer. They said no overall pattern could be determined, but they were unable to combine the data for meta-analyses due to variations in the studies.
“There is insufficient evidence to recommend oral contraceptive use as a chemoprevention strategy in high-risk women if they otherwise would not be taking them for contraception,” Moorman and colleagues wrote. “Conversely, if women with BRCA1/2 mutations or family history of breast or ovarian cancers desire to use oral contraceptives for contraception, there is no evidence to recommend against their use in these high-risk populations.”
Disclosure: The researchers report no relevant financial disclosures.
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