TY - JOUR
T1 - Oral Contraceptive Use and Breast Cancer Risk
T2 - Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study
AU - EMBRACE, GENEPSO, BCFR, HEBON, kConFab, and IBCCS
AU - Schrijver, Lieske H
AU - Olsson, Håkan
AU - Phillips, Kelly-Anne
AU - Terry, Mary Beth
AU - Goldgar, David E
AU - Kast, Karin
AU - Engel, Christoph
AU - Mooij, Thea M
AU - Adlard, Julian
AU - Barrowdale, Daniel
AU - Davidson, Rosemarie
AU - Eeles, Ros
AU - Ellis, Steve
AU - Evans, D Gareth
AU - Frost, Debra
AU - Izatt, Louise
AU - Porteous, Mary E
AU - Side, Lucy E
AU - Walker, Lisa
AU - Berthet, Pascaline
AU - Bonadona, Valérie
AU - Leroux, Dominique
AU - Mouret-Fourme, Emmanuelle
AU - Venat-Bouvet, Laurence
AU - Buys, Saundra S
AU - Southey, Melissa C
AU - John, Esther M
AU - Chung, Wendy K
AU - Daly, Mary B
AU - Bane, Anita
AU - van Asperen, Christi J
AU - Gómez Garcia, Encarna B
AU - Mourits, Marian J E
AU - van Os, Theo A M
AU - Roos-Blom, Marie-José
AU - Friedlander, Michael L
AU - McLachlan, Sue-Anne
AU - Singer, Christian F
AU - Tan, Yen Y
AU - Foretova, Lenka
AU - Navratilova, Marie
AU - Gerdes, Anne-Marie
AU - Caldes, Trinidad
AU - Simard, Jacques
AU - Olah, Edith
AU - Jakubowska, Anna
AU - Arver, Brita
AU - Osorio, Ana
AU - Noguès, Catherine
AU - Andrieu, Nadine
N1 - Erratum to "Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study" by Lieske H Schrijver et al [This corrects the article DOI: 10.1093/jncics/pky023.][This corrects the article DOI: 10.1093/jncics/pky023.].
PY - 2018/4
Y1 - 2018/4
N2 - 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.
AB - 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.
U2 - https://doi.org/10.1093/jncics/pky023
DO - https://doi.org/10.1093/jncics/pky023
M3 - Article
C2 - 31360853
SN - 2515-5091
VL - 2
SP - pky023
JO - JNCI cancer spectrum
JF - JNCI cancer spectrum
IS - 2
ER -