Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study

Lieske H Schrijver; Håkan Olsson; Kelly-Anne Phillips; Mary Beth Terry; David E Goldgar; Karin Kast; Christoph Engel; Thea M Mooij; Julian Adlard; Daniel Barrowdale; Rosemarie Davidson; Ros Eeles; Steve Ellis; D Gareth Evans; Debra Frost; Louise Izatt; Mary E Porteous; Lucy E Side; Lisa Walker; Pascaline Berthet; Valérie Bonadona; Dominique Leroux; Emmanuelle Mouret-Fourme; Laurence Venat-Bouvet; Saundra S Buys; Melissa C Southey; Esther M John; Wendy K Chung; Mary B Daly; Anita Bane; Christi J van Asperen; Encarna B Gómez Garcia; Marian J E Mourits; Theo A M van Os; Marie-José Roos-Blom; Michael L Friedlander; Sue-Anne McLachlan; Christian F Singer; Yen Y Tan; Lenka Foretova; Marie Navratilova; Anne-Marie Gerdes; Trinidad Caldes; Jacques Simard; Edith Olah; Anna Jakubowska; Brita Arver; Ana Osorio; Catherine Noguès; Nadine Andrieu; EMBRACE; GENEPSO; BCFR; HEBON; kConFab; IBCCS

doi:10.1093/jncics/pky023

Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study

Lieske H Schrijver, Håkan Olsson, Kelly-Anne Phillips, Mary Beth Terry, David E Goldgar, Karin Kast, Christoph Engel, Thea M Mooij, Julian Adlard, Daniel Barrowdale, Rosemarie Davidson, Ros Eeles, Steve Ellis, D Gareth Evans, Debra Frost, Louise Izatt, Mary E Porteous, Lucy E Side, Lisa Walker, Pascaline BerthetValérie Bonadona, Dominique Leroux, Emmanuelle Mouret-Fourme, Laurence Venat-Bouvet, Saundra S Buys, Melissa C Southey, Esther M John, Wendy K Chung, Mary B Daly, Anita Bane, Christi J van Asperen, Encarna B Gómez Garcia, Marian J E Mourits, Theo A M van Os, Marie-José Roos-Blom, Michael L Friedlander, Sue-Anne McLachlan, Christian F Singer, Yen Y Tan, Lenka Foretova, Marie Navratilova, Anne-Marie Gerdes, Trinidad Caldes, Jacques Simard, Edith Olah, Anna Jakubowska, Brita Arver, Ana Osorio, Catherine Noguès, Nadine Andrieu, EMBRACE, GENEPSO, BCFR, HEBON, kConFab, IBCCS

EpiHealth: Epidemiology for Health

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Article number	pky023
Journal	JNCI Cancer Spectrum
Volume	2
Issue number	2
DOIs	https://doi.org/10.1093/jncics/pky023
Publication status	Published - 2018 Apr

Subject classification (UKÄ)

Cancer and Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/jncics/pky023Licence: CC BY-NC

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Schrijver, L. H., Olsson, H., Phillips, K.-A., Terry, M. B., Goldgar, D. E., Kast, K., Engel, C., Mooij, T. M., Adlard, J., Barrowdale, D., Davidson, R., Eeles, R., Ellis, S., Evans, D. G., Frost, D., Izatt, L., Porteous, M. E., Side, L. E., Walker, L., ... IBCCS (2018). Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study. JNCI Cancer Spectrum, 2(2), Article pky023. https://doi.org/10.1093/jncics/pky023

@article{774b8a1a69564d8e9462d0ba634198bb,

title = "Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study",

abstract = "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.",

author = "Schrijver, {Lieske H} and H{\aa}kan Olsson and Kelly-Anne Phillips and Terry, {Mary Beth} and Goldgar, {David E} and Karin Kast and Christoph Engel and Mooij, {Thea M} and Julian Adlard and Daniel Barrowdale and Rosemarie Davidson and Ros Eeles and Steve Ellis and Evans, {D Gareth} and Debra Frost and Louise Izatt and Porteous, {Mary E} and Side, {Lucy E} and Lisa Walker and Pascaline Berthet and Val{\'e}rie Bonadona and Dominique Leroux and Emmanuelle Mouret-Fourme and Laurence Venat-Bouvet and Buys, {Saundra S} and Southey, {Melissa C} and John, {Esther M} and Chung, {Wendy K} and Daly, {Mary B} and Anita Bane and {van Asperen}, {Christi J} and {G{\'o}mez Garcia}, {Encarna B} and Mourits, {Marian J E} and {van Os}, {Theo A M} and Marie-Jos{\'e} Roos-Blom and Friedlander, {Michael L} and Sue-Anne McLachlan and Singer, {Christian F} and Tan, {Yen Y} and Lenka Foretova and Marie Navratilova and Anne-Marie Gerdes and Trinidad Caldes and Jacques Simard and Edith Olah and Anna Jakubowska and Brita Arver and Ana Osorio and Catherine Nogu{\`e}s and Nadine Andrieu and EMBRACE and GENEPSO and BCFR and HEBON and kConFab and IBCCS",

year = "2018",

month = apr,

doi = "10.1093/jncics/pky023",

language = "English",

volume = "2",

journal = "JNCI Cancer Spectrum",

issn = "2515-5091",

publisher = "Oxford University Press",

number = "2",

}

Schrijver, LH, Olsson, H, Phillips, K-A, Terry, MB, Goldgar, DE, Kast, K, Engel, C, Mooij, TM, Adlard, J, Barrowdale, D, Davidson, R, Eeles, R, Ellis, S, Evans, DG, Frost, D, Izatt, L, Porteous, ME, Side, LE, Walker, L, Berthet, P, Bonadona, V, Leroux, D, Mouret-Fourme, E, Venat-Bouvet, L, Buys, SS, Southey, MC, John, EM, Chung, WK, Daly, MB, Bane, A, van Asperen, CJ, Gómez Garcia, EB, Mourits, MJE, van Os, TAM, Roos-Blom, M-J, Friedlander, ML, McLachlan, S-A, Singer, CF, Tan, YY, Foretova, L, Navratilova, M, Gerdes, A-M, Caldes, T, Simard, J, Olah, E, Jakubowska, A, Arver, B, Osorio, A, Noguès, C, Andrieu, N, EMBRACE, GENEPSO, BCFR, HEBON, kConFab & IBCCS 2018, 'Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study', JNCI Cancer Spectrum, vol. 2, no. 2, pky023. https://doi.org/10.1093/jncics/pky023

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 - 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

AU - EMBRACE

AU - GENEPSO

AU - BCFR

AU - HEBON

AU - kConFab

AU - IBCCS

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 - 10.1093/jncics/pky023

DO - 10.1093/jncics/pky023

M3 - Article

C2 - 31360853

SN - 2515-5091

VL - 2

JO - JNCI Cancer Spectrum

JF - JNCI Cancer Spectrum

IS - 2

M1 - pky023

ER -

Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study

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UN SDGs

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