Ovarian Cancer Canada

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BRCA and Risk for Ovarian Cancer: There’s More to the Story

“This meta-analysis revealed, very importantly, that in fact the data suggest a similar degree of protection against the development of ovarian cancer, compared with the baseline risk in women with BRCA1 and BRCA2 mutations, with the use of oral contraceptives.” 

Maurie Markman, MD

http://www.medscape.com/viewarticle/821779?src=wnl_edit_tpal&uac=185065HV 

Hello. I’m Dr. Maurie Markman from Cancer Treatment Centers of America in Philadelphia. I wanted to briefly discuss an interesting and important topic in the world of genomic medicine.

This relates to the question that might be asked of oncologists or primary care doctors who have a patient or a family in which it is known that there is an abnormality that increases the risk for a particular cancer, such as a BRCA1 mutation [and the risk for breast and ovarian cancer], and whether factors that have been identified in the general population as being either protective or potentially harmful in terms of risk also pertain to the individual with the genetic abnormality increasing risk.

A great example of this is the question surrounding the use of oral contraceptives. Long-term oral contraceptive use is known to be associated with a decreased lifetime risk of the development of ovarian cancer.[1] The question is: If a woman has a known mutation [that increases her risk, such as] BRCA1 or BRCA2, does she also have a similar protective effect from oral contraceptives?

A paper published in November 2013 in the Journal of Clinical Oncology, entitled “Oral Contraceptives and Risk of Ovarian Cancer and Breast Cancer Among High-Risk Women: A Systematic Review and Meta-Analysis,” directly addressed this question.[2] In looking at a number of papers that had been published in the literature, this meta-analysis revealed, very importantly, that in fact the data suggest a similar degree of protection against the development of ovarian cancer, compared with the baseline risk in women with BRCA1 and BRCA2 mutations, with the use of oral contraceptives.

Now, of course, this information cannot just be assumed to be correct; prospective studies need to be performed to address the question. But, in this case, it is fair to say that the data do support a protective effect of oral contraceptives on the development of ovarian cancer in a woman with a BRCA1 or BRCA2 mutation compared with her baseline risk if she were not taking oral contraceptives.

It will be important for us to see future studies on these very important questions as we begin to develop data suggesting that particular patient populations have risks of certain kinds of cancers, based on genetic abnormalities or even polymorphisms within the normal genome. We will need to determine whether favorable or unfavorable factors within the population also pertain to these individuals who have been documented to have a high risk based on these particular genetic alterations or normal polymorphisms.

I thank you for your attention and would encourage you to read this paper in the Journal of Clinical Oncology, which is very important in terms of directing the specific question on the use of oral contraceptives and the risk for ovarian cancer in a woman with a BRCA1 or BRCA2 mutation.

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This entry was posted on April 1, 2014 by in Research Updates and tagged , , , .

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