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Oral Contraceptive Use and Breast Cancer Risk for BRCA1 and BRCA2 Mutation Carriers: Systematic Review and
Agnieszka Barańska1, Wiesław Kanadys2
1Department of Medical Informatics and Statistics with E-Learning Lab, Medical University of Lublin, 20-954 Lublin, Poland.
Cancers
|October 14, 2022
Summary
Oral contraceptive use shows no overall breast cancer risk reduction, but starting oral contraceptives (OCs) at age 20 or older may increase risk. Further research is needed for BRCA carriers.
Area of Science:
- Oncology
- Genetics
- Epidemiology
Background:
- Oral contraceptive (OC) use is a significant modifiable risk factor for breast cancer.
- BRCA1 and BRCA2 mutations are strongly associated with increased breast and ovarian cancer risks.
Purpose of the Study:
- To evaluate the impact of oral contraceptive use on breast cancer risk, specifically considering BRCA1 and BRCA2 mutation status.
- To synthesize evidence from case-controlled studies through a systematic review and meta-analysis.
Main Methods:
- Systematic review and meta-analysis of case-controlled studies retrieved from MEDLINE, EMBASE, and Cochrane Library up to August 2021.
- Pooled data from studies involving 33,162 subjects, including 23,453 never users of oral contraceptives.
- Meta-regression analysis to assess the influence of age at first OC use, duration of use, and time since last use.
Main Results:
- Overall meta-analysis showed no statistically significant reduction in breast cancer risk (OR = 0.86, 95% CI: 0.70 to 1.06).
- A statistically significant increased breast cancer risk was observed for age at first OC use ≥20 years (OR = 1.21, 95% CI: 1.07 to 1.36).
- Multivariable meta-regression did not reveal significant effects of age at first OC use, duration of use, or time since last use on breast cancer risk.
Conclusions:
- Oral contraceptive use may have a varied effect on breast cancer risk, particularly in BRCA mutation carriers.
- The association between oral contraceptive use and breast cancer risk warrants further investigation, especially concerning specific user subgroups and genetic predispositions.
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