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Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study
LH. Schrijver, H. Olsson, KA. Phillips, MB. Terry, DE. Goldgar, K. Kast, C. Engel, TM. Mooij, J. Adlard, D. Barrowdale, R. Davidson, R. Eeles, S. Ellis, DG. Evans, D. Frost, L. Izatt, ME. Porteous, LE. Side, L. Walker, P. Berthet, V. Bonadona, D....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2017
PubMed Central
od 2017
Europe PubMed Central
od 2017
Oxford Journals Open Access Collection
od 2017
ROAD: Directory of Open Access Scholarly Resources
od 2017
PubMed
31360853
DOI
10.1093/jncics/pky023
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
Background: For BRCA1 and BRCA2 mutation carriers, the association between oral contraceptive preparation (OCP) use and breast cancer (BC) risk is still unclear. Methods: Breast camcer risk associations were estimated from OCP data on 6030 BRCA1 and 3809 BRCA2 mutation carriers using age-dependent Cox regression, stratified by study and birth cohort. Prospective, left-truncated retrospective and full-cohort retrospective analyses were performed. Results: For BRCA1 mutation carriers, OCP use was not associated with BC risk in prospective analyses (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 0.75 to 1.56), but in the left-truncated and full-cohort retrospective analyses, risks were increased by 26% (95% CI = 6% to 51%) and 39% (95% CI = 23% to 58%), respectively. For BRCA2 mutation carriers, OCP use was associated with BC risk in prospective analyses (HR = 1.75, 95% CI = 1.03 to 2.97), but retrospective analyses were inconsistent (left-truncated: HR = 1.06, 95% CI = 0.85 to 1.33; full cohort: HR = 1.52, 95% CI = 1.28 to 1.81). There was evidence of increasing risk with duration of use, especially before the first full-term pregnancy (BRCA1: both retrospective analyses, P < .001 and P = .001, respectively; BRCA2: full retrospective analysis, P = .002). Conclusions: Prospective analyses did not show that past use of OCP is associated with an increased BC risk for BRCA1 mutation carriers in young middle-aged women (40-50 years). For BRCA2 mutation carriers, a causal association is also not likely at those ages. Findings between retrospective and prospective analyses were inconsistent and could be due to survival bias or a true association for younger women who were underrepresented in the prospective cohort. Given the uncertain safety of long-term OCP use for BRCA1/2 mutation carriers, indications other than contraception should be avoided and nonhormonal contraceptive methods should be discussed.
Centre François Baclesse Caen France
CHU de Grenoble Hôpital Couple Enfant Département de Génétique Grenoble France
Clinical Genetics Guy's and St Thomas' NHS Foundation Trust London UK
Department of Clincial Genetics Rigshospitalet København Denmark
Department of Clinical Genetics Academic Medical Center Amsterdam the Netherlands
Department of Clinical Genetics Leiden University Medical Center Leiden the Netherlands
Department of Clinical Genetics South Glasgow University Hospitals Glasgow UK
Department of Dermatology University of Utah School of Medicine Salt Lake City UT
Department of Epidemiology Netherlands Cancer Institute Amsterdam the Netherlands
Department of Genetics and Pathology Pomeranian Medical University Szczecin Poland
Department of Medicine Huntsman Cancer Institute Salt Lake City UT
Department of Molecular Genetics National Institute of Oncology Budapest Hungary
Department of OB GYN and Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Oncology Lund University Hospital
Department of Pediatrics and Medicine Columbia University New York NY
Division of Population Science Fox Chase Cancer Center Philadelphia PA
Hôpital Universitaire Dupuytren Service d'Oncologie Médicale Limoges France
Human Genetics Group Spanish National Cancer Centre Madrid Spain
Oncogenetics Team The Institute of Cancer Research and Royal Marsden NHS Foundation Trust Sutton UK
Oxford Regional Genetics Service Churchill Hospital Oxford UK
Service de Génétique Oncologique Hôpital René Huguenin Institut Curie Saint Cloud France
South East of Scotland Regional Genetics Service Western General Hospital Edinburgh UK
Université Claude Bernard Lyon 1 Villeurbanne France
Yorkshire Regional Genetics Service Chapel Allerton Hospital Leeds UK
Citace poskytuje Crossref.org
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- $a Background: For BRCA1 and BRCA2 mutation carriers, the association between oral contraceptive preparation (OCP) use and breast cancer (BC) risk is still unclear. Methods: Breast camcer risk associations were estimated from OCP data on 6030 BRCA1 and 3809 BRCA2 mutation carriers using age-dependent Cox regression, stratified by study and birth cohort. Prospective, left-truncated retrospective and full-cohort retrospective analyses were performed. Results: For BRCA1 mutation carriers, OCP use was not associated with BC risk in prospective analyses (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 0.75 to 1.56), but in the left-truncated and full-cohort retrospective analyses, risks were increased by 26% (95% CI = 6% to 51%) and 39% (95% CI = 23% to 58%), respectively. For BRCA2 mutation carriers, OCP use was associated with BC risk in prospective analyses (HR = 1.75, 95% CI = 1.03 to 2.97), but retrospective analyses were inconsistent (left-truncated: HR = 1.06, 95% CI = 0.85 to 1.33; full cohort: HR = 1.52, 95% CI = 1.28 to 1.81). There was evidence of increasing risk with duration of use, especially before the first full-term pregnancy (BRCA1: both retrospective analyses, P < .001 and P = .001, respectively; BRCA2: full retrospective analysis, P = .002). Conclusions: Prospective analyses did not show that past use of OCP is associated with an increased BC risk for BRCA1 mutation carriers in young middle-aged women (40-50 years). For BRCA2 mutation carriers, a causal association is also not likely at those ages. Findings between retrospective and prospective analyses were inconsistent and could be due to survival bias or a true association for younger women who were underrepresented in the prospective cohort. Given the uncertain safety of long-term OCP use for BRCA1/2 mutation carriers, indications other than contraception should be avoided and nonhormonal contraceptive methods should be discussed.
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