Whittemore A S, Balise R R, Pharoah P D P, Dicioccio R A, Oakley-Girvan I, Ramus S J, Daly M, Usinowicz M B, Garlinghouse-Jones K, Ponder B A J, Buys S, Senie R, Andrulis I, John E, Hopper J L, Piver M S
Department of Health Research and Policy, Stanford University School of Medicine, HRP Redwood Building, Stanford, CA 94305-5405, USA.
Br J Cancer. 2004 Nov 29;91(11):1911-5. doi: 10.1038/sj.bjc.6602239.
Women with mutations of the genes BRCA1 or BRCA2 are at increased risk of ovarian cancer. Oral contraceptives protect against ovarian cancer in general, but it is not known whether they protect against the disease in carriers of these mutations. We obtained self-reported lifetime histories of oral contraceptive use from 451 women who carried mutations of BRCA1 or BRCA2. We used conditional logistic regression to estimate the odds ratios associated with oral contraceptive use, comparing the histories of 147 women with ovarian cancer (cases) to those of 304 women without ovarian cancer (controls) who were matched to cases on year of birth, country of residence and gene (BRCA1 vs BRCA2). Reference ages for controls had to exceed the ages at diagnosis of their matched cases. After adjusting for parity, the odds-ratio for ovarian cancer associated with use of oral contraceptives for at least 1 year was 0.85 (95 percent confidence interval, 0.53-1.36). The risk decreased by 5% (1-9%) with each year of use (P for trend=0.01). Use for 6 or more years was associated with an odds-ratio of 0.62 (0.35-1.09). These data support the hypothesis that long-term oral contraceptive use reduces the risk of ovarian cancer among women who carry mutations of BRCA1 or BRCA2.
携带BRCA1或BRCA2基因变异的女性患卵巢癌的风险会增加。一般来说，口服避孕药可预防卵巢癌，但对于携带这些基因突变的女性，口服避孕药是否能预防该病尚不清楚。我们从451名携带BRCA1或BRCA2基因突变的女性中获取了她们自我报告的口服避孕药使用终生史。我们采用条件逻辑回归来估计与口服避孕药使用相关的比值比，将147名卵巢癌女性（病例组）的病史与304名无卵巢癌女性（对照组）的病史进行比较，对照组在出生年份、居住国和基因（BRCA1与BRCA2）方面与病例组相匹配。对照组的参考年龄必须超过其匹配病例的诊断年龄。在调整了生育情况后，使用口服避孕药至少1年与卵巢癌相关的比值比为0.85（95%置信区间为0.53 - 1.36）。随着使用年限的增加，风险每年降低5%（1% - 9%）（趋势P值 = 0.01）。使用6年或更长时间的比值比为0.62（0.35 - 1.09）。这些数据支持了长期使用口服避孕药可降低携带BRCA1或BRCA2基因突变女性患卵巢癌风险这一假设。
