Parity, oral contraceptives, and the risk of ovarian cancer among carriers and noncarriers of a BRCA1 or BRCA2 mutation
Parity, oral contraceptives, and the risk of ovarian cancer among carriers and noncarriers of a BRCA1 or BRCA2 mutation
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DOI：
10.1056/nejm200107263450401
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发表时间：
2001-07-26
影响因子：
158.5
通讯作者：
Piura, B
中科院分区：
文献类型：
--
作者：
Modan, B;Hartge, P;Piura, B
背景 多产和使用口服避孕药可降低患卵巢癌的风险，但它们对具有 BRCA1 或 BRCA2 突变的女性的这种风险的影响尚不清楚。 方法 我们对以色列犹太女性进行了一项基于人群的卵巢癌病例对照研究。女性接受了 BRCA1 的两种创始人突变和 BRCA2 的一种创始人突变检测，已知这两种突变在犹太人中很常见。我们在单独的分析中估计了生育和口服避孕药的使用对携带者和非携带者患卵巢癌风险的影响，其中包括所有未患有卵巢癌的对照女性。 结果 在接受突变分析的 751 名对照者中，13 名 (1.7%) 患有 BRCA1 或 BRCA2 突变，而 840 名卵巢癌女性中有 244 名 (29.0%) 患有 BRCA1 或 BRCA1 或 BRCA2 突变。 BRCA2 突变。总体而言，正如预期的那样，每多出生一次和每多使用口服避孕药一年，就会降低患卵巢癌的风险。在对携带者和非携带者的单独分析中，额外生育具有保护作用，但口服避孕药的使用似乎仅能降低非携带者的风险；在携带者中，每次出生时患卵巢癌的几率降低 12%（95% 置信区间，2.3% 至 21%），每年使用口服避孕药则降低 0..2%（-4.9% 至 5.0%）。结论 BRCA1 或 BRCA2 突变携带者患卵巢癌的风险随着每次出生而降低，但不会随着口服避孕药使用时间的增加而降低。这些数据表明，在此类突变携带者中使用口服避孕药对卵巢癌进行化学预防还为时过早。 （N Engl J Med 2001；345：235-40。）版权所有 (C) 2001 马萨诸塞州医学会。
Background Multiparity and the use of oral contraceptives reduce the risk of ovarian cancer, but their effects on this risk in women with a BRCA1 or BRCA2 mutation are unclear.Methods We conducted a population-based case control study of ovarian cancer among Jewish women in Israel. Women were tested for the two founder mutations in BRCA1 and the one founder mutation in BRCA2 that are known to be common among Jews. We estimated the effects of parity and oral-contraceptive use on the risk of ovarian cancer in carriers and noncarriers in separate analyses that included all control women, who did not have ovarian cancer.Results Of 751 controls who underwent mutation analysis, 13 (1.7 percent) had a BRCA1 or BRCA2 mutation, whereas 244 of 840 women with ovarian cancer (29.0 percent) had a BRCA1 or BRCA2 mutation. Overall, each additional birth and each additional year of use of oral contraceptives were found to lower the risk of ovarian cancer, as expected. Additional births were protective in separate analyses of carriers and non-carriers, but oral-contraceptive use appeared to reduce the risk only in noncarriers; among carriers, the reduction in the odds of ovarian cancer was 12 percent per birth (95 percent confidence interval, 2.3 to 21 percent) and 0..2 percent per year of oral-contraceptive use (-4.9 to 5.0 percent).Conclusions The risk of ovarian cancer among carriers of a BRCA1 or BRCA2 mutation decreases with each birth but not with increased duration of use of oral contraceptives. These data suggest that it is premature to use oral contraceptives for the chemoprevention of ovarian cancer in carriers of such mutations. (N Engl J Med 2001;345:235-40.) Copyright (C) 2001 Massachusetts Medical Society.