The Rule: The Pill Prevents Ovarian Cancer
July 25, 2001 -- Ovarian cancer is a rare but devastatingly deadly form of cancer. One way women can prevent the disease is to take oral contraceptives. However, new research shows that the Pill is not as protective in women who have mutations in one or both of two particular genes associated with ovarian and other cancers.
For women who have alterations in BRCA1 or BRCA2 genes, "there seems to be no protective effect [against ovarian cancer] from the use of oral contraceptives," study author Sholom Wacholder, PhD, tells WebMD. He is a senior investigator at the National Cancer Institute's division of epidemiology and genetics in Bethesda, Md.
Wacholder examined 840 Jewish women in Israel with ovarian cancer and 751 women without the disease. Genetic testing revealed that 244 of the women with ovarian cancer had alterations in the BRCA1 or BRCA2 genes, compared with only 13 of those without the disease. For the women without the genetic mutations, the longer they had been taking oral contraceptives, the less likely they were to develop ovarian cancer. This did not hold true for women with the mutations.
Women's health expert Kenneth E. Johnson, DO, assistant professor of obstetrics and gynecology at NOVA Southeastern University College of Medicine in Fort Lauderdale, Fla., is not convinced that these findings have any real practical relevance.
That's because the number of women who have BRCA1 and BRCA2 mutations is extremely low. "Although it's got a lot of media hype, it really is not a big deal and never will be. ... 98-99% of the 9,000 [yearly] deaths from ovarian cancer do not [involve abnormalities in] these genes," Johnson says.
In both groups, the more children a woman had, the less likely she was to develop ovarian cancer.
According to Johnson, most experts believe that oral contraceptives and having children protect the ovary from cancer in the same way: They both "quiet it down" by reducing the number of times an egg is released from the ovary.
At this point, it's not clear why having children protects women with the BRCA1 or BRCA2 alterations from ovarian cancer but oral contraceptives do not.
Regardless, Johnson still recommends birth control pills for all eligible women. "Even in this small group, it again showed that, in the non-BRCA1 and -BRCA2 carriers, this whole theme of a ... quiet ovary getting exposed ... to birth control pills [is less likely to become cancerous]. That's really the news."