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Previous Volume 339:424-428 August 13, 1998 Number 7 Next

	Full Text PDF Editorial by Rubin, S. C. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Women with mutations in either the BRCA1 or the BRCA2 gene have a high lifetime risk of ovarian cancer. Oral contraceptives protect against ovarian cancer in general, but it is not known whether they also protect against hereditary forms of ovarian cancer.

Methods We enrolled 207 women with hereditary ovarian cancer and 161 of their sisters as controls in a case–control study. All the patients carried a pathogenic mutation in either BRCA1 (179 women) or BRCA2 (28 women). The control women were enrolled regardless of whether or not they had either mutation. Lifetime histories of oral-contraceptive use were obtained by interview or by written questionnaire and were compared between patients and control women, after adjustment for year of birth and parity.

Results The adjusted odds ratio for ovarian cancer associated with any past use of oral contraceptives was 0.5 (95 percent confidence interval, 0.3 to 0.8). The risk decreased with increasing duration of use (P for trend, <0.001); use for six or more years was associated with a 60 percent reduction in risk. Oral-contraceptive use protected against ovarian cancer both for carriers of the BRCA1 mutation (odds ratio, 0.5; 95 percent confidence interval, 0.3 to 0.9) and for carriers of the BRCA2 mutation (odds ratio, 0.4; 95 percent confidence interval, 0.2 to 1.1).

Conclusions Oral-contraceptive use may reduce the risk of ovarian cancer in women with pathogenic mutations in the BRCA1 or BRCA2 gene.

Source Information

From the Centre for Research on Women's Health, Women's College Hospital, University of Toronto, Toronto (S.A.N., S.B., J.-S.B.); the Department of Epidemiology and Public Health, Yale University, New Haven, Conn. (H.R.); the Department of Medical Genetics, University of British Columbia, Vancouver, Canada (R.M.); the Unit of Medical Genetics, Norwegian Radium Hospital, Oslo, Norway (A.D.); the Department of Medical Informatics, University of Utah, Salt Lake City (S.N.); the Department of Oncology, Lund University, Lund, Sweden (H.O.); the Department of Obstetrics and Gynecology, Notre Dame Hospital, Montreal (D.P.); the Istituto Nazionale Tumori, Milan, Italy (P.R.); the Department of Medical Genetics, St. Mary's Hospital, Manchester, United Kingdom (G.E.); and the Cancer Research Campaign Genetic Epidemiology Unit, Cambridge University, Cambridge, United Kingdom (B.A.J.P.). Jan G.M. Klijn, M.D. (Department of Medical Oncology, Rotterdam Cancer Institute, Rotterdam, the Netherlands), was also an author.

Address reprint requests to Dr. Narod at the Centre for Research on Women's Health, Women's College Hospital, 790 Bay St., Rm. 750a, Toronto, ON M5G 1N8, Canada.

Full Text of this Article

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Oral Contraceptives and Hereditary Ovarian Cancer
de Souza R. M., Lazzaron A. R., Kaplan R. C., Narod S. A., Brunet J.-S., The Hereditary Ovarian Cancer Clinical Study Group
Extract | Full Text  
N Engl J Med 1999; 340:59-60, Jan 7, 1999. Correspondence

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