Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations

A case-control study

Steven A. Narod, Ping Sun, Parviz Ghadirian, Henry T. Lynch, Claudine Isaacs, Judy Garber, Barbara Weber, Beth Karlan, David Fishman, Barry Rosen, Nadine Tung, Susan L. Neuhausen

Research output: Contribution to journalArticle

180 Citations (Scopus)

Abstract

Background In several case-control and prospective studies, tubal ligation has been associated with a decreased risk of invasive epithelial ovarian cancer. We aimed to assess the potential of tubal ligation in reducing the risk of ovarian cancer in women who carry predisposing mutations in the BRCA1 or BRCA2 genes. Methods We did a matched case-control study among women from Canada, the USA, and the UK who had undergone genetic testing and who carried a pathogenic mutation in BRCA1 or BRCA2. Cases were 232 women with a history of invasive ovarian cancer, and controls were 232 women without ovarian cancer, and who had both ovaries intact. Cases and controls were matched for year of birth, country of residence, and mutation (BRCA1 or BRCA2). The odds ratio for developing ovarian cancer was estimated for tubal ligation, adjusting for oral contraceptive use, parity, history of breast cancer, and ethnic group. Findings In an unadjusted analysis among BRCA1 carriers, significantly fewer cases than controls had ever had tubal ligation (30 of 173 [18%] vs 60 of 173 [35%], odds ratio 0·37 [95% CI 0·21-0·63]; p=0·0003). After adjustment for oral contraceptive use, parity, history of breast cancer and ethnic group, the odds ratio was 0·39 (p=0·002). Combination of tubal ligation and past use of an oral contraceptive was associated with an odds ratio of 0·28 (0·15-0·52). No protective effect of tubal ligation was seen among carriers of the BRCA2 mutation. Interpretation Tubal ligation is a feasible option to reduce the risk of ovarian cancer in women with BRCA1 mutations who have completed childbearing.

Original languageEnglish
Pages (from-to)1467-1470
Number of pages4
JournalThe Lancet
Volume357
Issue number9267
DOIs
StatePublished - May 12 2001

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Tubal Sterilization
Ovarian Neoplasms
Case-Control Studies
Mutation
Oral Contraceptives
Odds Ratio
Parity
Ethnic Groups
BRCA2 Gene
Breast Neoplasms
BRCA1 Gene
Genetic Testing
Canada
Ovary
Parturition
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Narod, S. A., Sun, P., Ghadirian, P., Lynch, H. T., Isaacs, C., Garber, J., ... Neuhausen, S. L. (2001). Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: A case-control study. The Lancet, 357(9267), 1467-1470. https://doi.org/10.1016/S0140-6736(00)04642-0

Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations : A case-control study. / Narod, Steven A.; Sun, Ping; Ghadirian, Parviz; Lynch, Henry T.; Isaacs, Claudine; Garber, Judy; Weber, Barbara; Karlan, Beth; Fishman, David; Rosen, Barry; Tung, Nadine; Neuhausen, Susan L.

In: The Lancet, Vol. 357, No. 9267, 12.05.2001, p. 1467-1470.

Research output: Contribution to journalArticle

Narod, SA, Sun, P, Ghadirian, P, Lynch, HT, Isaacs, C, Garber, J, Weber, B, Karlan, B, Fishman, D, Rosen, B, Tung, N & Neuhausen, SL 2001, 'Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: A case-control study', The Lancet, vol. 357, no. 9267, pp. 1467-1470. https://doi.org/10.1016/S0140-6736(00)04642-0
Narod, Steven A. ; Sun, Ping ; Ghadirian, Parviz ; Lynch, Henry T. ; Isaacs, Claudine ; Garber, Judy ; Weber, Barbara ; Karlan, Beth ; Fishman, David ; Rosen, Barry ; Tung, Nadine ; Neuhausen, Susan L. / Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations : A case-control study. In: The Lancet. 2001 ; Vol. 357, No. 9267. pp. 1467-1470.
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AU - Ghadirian, Parviz

AU - Lynch, Henry T.

AU - Isaacs, Claudine

AU - Garber, Judy

AU - Weber, Barbara

AU - Karlan, Beth

AU - Fishman, David

AU - Rosen, Barry

AU - Tung, Nadine

AU - Neuhausen, Susan L.

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N2 - Background In several case-control and prospective studies, tubal ligation has been associated with a decreased risk of invasive epithelial ovarian cancer. We aimed to assess the potential of tubal ligation in reducing the risk of ovarian cancer in women who carry predisposing mutations in the BRCA1 or BRCA2 genes. Methods We did a matched case-control study among women from Canada, the USA, and the UK who had undergone genetic testing and who carried a pathogenic mutation in BRCA1 or BRCA2. Cases were 232 women with a history of invasive ovarian cancer, and controls were 232 women without ovarian cancer, and who had both ovaries intact. Cases and controls were matched for year of birth, country of residence, and mutation (BRCA1 or BRCA2). The odds ratio for developing ovarian cancer was estimated for tubal ligation, adjusting for oral contraceptive use, parity, history of breast cancer, and ethnic group. Findings In an unadjusted analysis among BRCA1 carriers, significantly fewer cases than controls had ever had tubal ligation (30 of 173 [18%] vs 60 of 173 [35%], odds ratio 0·37 [95% CI 0·21-0·63]; p=0·0003). After adjustment for oral contraceptive use, parity, history of breast cancer and ethnic group, the odds ratio was 0·39 (p=0·002). Combination of tubal ligation and past use of an oral contraceptive was associated with an odds ratio of 0·28 (0·15-0·52). No protective effect of tubal ligation was seen among carriers of the BRCA2 mutation. Interpretation Tubal ligation is a feasible option to reduce the risk of ovarian cancer in women with BRCA1 mutations who have completed childbearing.

AB - Background In several case-control and prospective studies, tubal ligation has been associated with a decreased risk of invasive epithelial ovarian cancer. We aimed to assess the potential of tubal ligation in reducing the risk of ovarian cancer in women who carry predisposing mutations in the BRCA1 or BRCA2 genes. Methods We did a matched case-control study among women from Canada, the USA, and the UK who had undergone genetic testing and who carried a pathogenic mutation in BRCA1 or BRCA2. Cases were 232 women with a history of invasive ovarian cancer, and controls were 232 women without ovarian cancer, and who had both ovaries intact. Cases and controls were matched for year of birth, country of residence, and mutation (BRCA1 or BRCA2). The odds ratio for developing ovarian cancer was estimated for tubal ligation, adjusting for oral contraceptive use, parity, history of breast cancer, and ethnic group. Findings In an unadjusted analysis among BRCA1 carriers, significantly fewer cases than controls had ever had tubal ligation (30 of 173 [18%] vs 60 of 173 [35%], odds ratio 0·37 [95% CI 0·21-0·63]; p=0·0003). After adjustment for oral contraceptive use, parity, history of breast cancer and ethnic group, the odds ratio was 0·39 (p=0·002). Combination of tubal ligation and past use of an oral contraceptive was associated with an odds ratio of 0·28 (0·15-0·52). No protective effect of tubal ligation was seen among carriers of the BRCA2 mutation. Interpretation Tubal ligation is a feasible option to reduce the risk of ovarian cancer in women with BRCA1 mutations who have completed childbearing.

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