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Ovarian Cancer Risk in Ashkenazi Jewish Carriers of BRCA1 and BRCA2 Mutations
Ist Teil von
Clinical cancer research, 2002-12, Vol.8 (12), p.3776-3781
Ort / Verlag
Philadelphia, PA: American Association for Cancer Research
Erscheinungsjahr
2002
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Purpose: Several studies to date have reported ovarian cancer risk due to inherited BRCA1 and BRCA2 mutations using familial data or population-based series of probands. Familial aggregation associated with both of these
methods may result in a substantial ascertainment bias. To address this, we have used a case-control design that does not
involve familial aggregation to estimate the lifetime penetrance of ovarian cancer due to BRCA1 and BRCA2 mutations.
Experimental Design: A total of 382 ovarian cancer cases self-identified as being Jewish with no prior diagnosis of breast cancer were derived
from two hospital-based series. In the first series, all 197 invasive epithelial ovarian cancer cases self-identified as Jewish
and without a prior history of breast cancer, diagnosed and treated at Memorial Sloan-Kettering Cancer Center between 1986
and 2000, were identified. In the second series, 185 Jewish invasive epithelial ovarian cancer patients without prior breast
cancer were identified in a study conducted at 11 centers in North America and Israel from 1995 to 1996. Controls were 3434
Jewish women without any prior history of breast or ovarian cancer from a large study of genotyped volunteers of Jewish origin
in the Washington, D. C. area recruited by investigators at the National Cancer Institute. The cases and controls were genotyped
for three Ashkenazi Jewish founder mutations, namely 185delAG and 5382insC in BRCA1 and 6174delT in BRCA2 . The lifetime penetrances were estimated using the odds ratios, mutation prevalence in the controls, and ovarian cancer incidence
rates in the general American population obtained from the Surveillance, Epidemiology and End Results database adjusted for
the incidence of ovarian cancer following breast cancer.
Results: Mutations were identified in 147 cases and 62 controls. The estimated penetrances at age 70 years were 37% (95% confidence
interval, 25–71%) for a BRCA1 mutation and 21% (95% CI, 13–41%) for a BRCA2 mutation.
Conclusions: The lifetime penetrances of BRCA1 mutations are lower than estimates obtained using familial data with multiple affected members but larger than estimates
from some population-based proband series. The lifetime penetrance estimate of a BRCA2 mutation is in the range reported by some of the studies based on familial data. These results could have implications for
clinical counseling, surgical interventions, and screening recommendations in women carrying these founder mutations.