Biomedical
Beyond the pill: contraception and the prevention of hereditary ovarian cancer
Peer Reviewed
Doi: http://dx.doi.org/10.1186/s13053-022-00227-z
Abstract
BRCA1 and BRCA2 mutation carriers face an elevated lifetime risk of developing ovarian cancer. Oral contraceptives have been shown to significantly decrease the risk of ovarian cancer by approximately 50% in this high-risk population. Changes in contraceptive formulations and patterns of use over time have introduced lower hormonal dosages, different steroid types and non-oral routes of administration. Specifically, there has been a considerable shift in patterns of contraceptive use and the increase in the uptake of non-oral, long-acting, reversible contraception (e.g., intrauterine devices, implants, injections) has corresponded to a decline in oral contraceptive pill use. Whether or not these other methods confer a protective effect against ovarian cancer in the general population is not clear. To our knowledge, there have been no such studies conducted among BRCA mutation carriers. Furthermore, the impact of these changes on the risk of developing ovarian cancer is not known. In this article, we will review the existing epidemiologic evidence regarding the role of contraceptives and the risk of ovarian cancer with a focus on women with a BRCA1 or BRCA2 mutation. We will discuss recent findings and gaps in the knowledge while extrapolating from studies conducted among women from the noncarrier population.
Key Questions
How do oral contraceptives impact ovarian cancer risk in BRCA1 and BRCA2 mutation carriers?
Oral contraceptives have been shown to significantly decrease the risk of ovarian cancer by approximately 50% in women with BRCA1 or BRCA2 mutations.
What changes have occurred in contraceptive use patterns over time?
There has been a considerable shift towards non-oral, long-acting reversible contraception methods, such as intrauterine devices, implants, and injections, leading to a decline in oral contraceptive pill use.
Is the protective effect against ovarian cancer observed with non-oral contraceptive methods?
The protective effect of non-oral contraceptive methods against ovarian cancer is not well established, and to date, no studies have specifically examined this in BRCA mutation carriers.
What gaps exist in current research regarding contraception and ovarian cancer prevention in high-risk populations?
There is a lack of studies evaluating the impact of newer contraceptive methods on ovarian cancer risk among BRCA mutation carriers, highlighting the need for further research in this area.
Doi: http://dx.doi.org/10.1186/s13053-022-00227-z