Oral contraceptives have been proven to decrease a woman’s risk of developing ovarian cancer, but does it have the same protective effect against high-risk disease – meaning that the patient dies within 12 months of diagnosis?
Jennifer M. Mongiovi, a PhD student at the University of Buffalo, and colleagues conducted research through the Roswell Park Comprehensive Cancer Center to find out. They discovered that after adjusting for age, site and parity, oral contraceptive use was associated with a 46% reduction in the odds of death within 12 months.
Mongiovi recently presented her findings at the AACR Annual Meeting, where she sat down with OncLive, a sister publication of Oncology Nursing News, for a discussion on her findings.
OncLive: Can you highlight what is currently known about the association between oral contraceptives and the risk for ovarian cancer, compared to non-users?
Mongiovi: Any use of oral contraceptives is known to be protective against ovarian cancer. The more protection is derived with a longer use of the pills.
Our group decided to look at highly fatal ovarian cancer, meaning that there was a death within 12 months of diagnosis because we feel that this represents a more aggressive disease. The prognosis for ovarian cancer in general isn't great, but especially when survival is less than a year, that's pretty important. So, the association established with oral contraceptive use and ovarian cancer in general is good, it's favorable. However, we were curious to see if this might differ based on this type of aggressive disease.
What were the methods of your research?
The data that was used was pooled from the Ovarian Cancer Association Consortium. Essentially these are case-controlled studies from all over the world that were pooled together to make a more globally representative sample. This also increases the size of the study sample that we were able to use.
Then we chose to identify these cases that had died within the 12 months of diagnosis and then match them to controls from their study site and pool these samples together. It gave us a large, representative sample. Then we compared the odds of the diagnosis of this highly fatal cancer to death within 18 months of diagnosis and the existing literature to see whether or not our observed association was different.
What were the key findings?
It is established that oral contraceptives are protective for ovarian cancer. We noticed a much greater association within this highly fatal group compared to death within 2 or 5 years and the existing literature out there. We also found that it was for the use of any oral contraceptives, regardless of the duration, but also that with every 5 years, there was a dramatic decrease in the odds of this cancer.
What are the clinical implications of this research?
While our study was large, it was great in that sense of being representative, it was retrospective, so these are case-controlled studies that have already occurred. With all types of data like this, it would be great to have some sort of prospective design, a randomized trial or something like that, looking at oral contraceptive use within this high-risk population, or essentially going forward if that's something that we could look at. It would be more something patients should discuss with their physicians going forward if they are at high-risk whether or not this should be something that they should look into.